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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/28637064/safety-and-efficacy-of-glycopyrrolate-as-a-premedication-for-endoscopic-submucosal-dissection-a-randomized-double-blind-placebo-controlled-study
#1
Eui Joo Kim, Min Young Um, Kyoung Oh Kim, Jung Ho Kim, Su Young Kim, Dong Kyun Park, Kwang An Kwon, Jun Won Chung, Yoon Jae Kim
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications: glycopyrrolate (0.004 mg/kg intramuscularly [IM]) or placebo (2...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#2
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28611336/safety-of-non-anesthesia-provider-administered-propofol-sedation-in-non-advanced-gastrointestinal-endoscopic-procedures-a-meta-analysis
#3
REVIEW
Basavana Gouda, Gowri Gouda, Anuradha Borle, Akash Singh, Ashish Sinha, Preet M Singh
BACKGROUND/AIMS: The aim of the study was to evaluate the safety of non-anesthesia provider (NAPP) administered propofol sedation in patients undergoing non-advanced gastrointestinal (GI) endoscopic procedures. MATERIALS AND METHODS: Pubmed, Embase, Cochrane central register of controlled trials, Scopus, and Web of Science databases were searched for prospective observational trials involving non-advanced endoscopic procedures. From a total of 608 publications, 25 [colonoscopy (9), upper GI endoscopy (5), and combined procedures (11)] were identified to meet inclusion criteria and were analyzed...
May 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28600597/comparison-of-propofol-with-midazolam-in-endoscopic-submucosal-dissection-for-esophageal-squamous-cell-carcinoma-a-randomized-controlled-trial
#4
Masaki Ominami, Yasuaki Nagami, Masatsugu Shiba, Kazunari Tominaga, Taishi Sakai, Hirotsugu Maruyama, Kunihiro Kato, Hiroaki Minamino, Shusei Fukunaga, Fumio Tanaka, Satoshi Sugimori, Noriko Kamata, Hirohisa Machida, Hirokazu Yamagami, Tetsuya Tanigawa, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa
BACKGROUND: Interruption of sedation due to a poor response to modified neuroleptanalgesia (m-NLA) with midazolam often occurs during endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) because most patients have a history of heavy alcohol intake. Recently, propofol has been used feasibly and safely during endoscopic procedures. The aim of this study was to clarify the efficacy and safety of propofol compared with that of midazolam during ESD for ESCC...
June 9, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28542645/co2-insufflation-versus-air-insufflation-for-endoscopic-submucosal-dissection-a-meta-analysis-of-randomized-controlled-trials
#5
Xuan Li, Hao Dong, Yifeng Zhang, Guoxin Zhang
BACKGROUND: Carbon dioxide (CO2) insufflation is increasingly used for endoscopic submucosal dissection (ESD) owing to the faster absorption of CO2 as compared to that of air. Studies comparing CO2 insufflation and air insufflation have reported conflicting results. OBJECTIVES: This meta-analysis is aimed to assess the efficacy and safety of use of CO2 insufflation for ESD. METHODS: Clinical trials of CO2 insufflation versus air insufflation for ESD were searched in PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database...
2017: PloS One
https://www.readbyqxmd.com/read/28533665/new-flexible-endoscopic-controlled-stapler-technique-for-the-treatment-of-zenker-s-diverticulum-a-case-series
#6
Johanna Wilmsen, Robert Baumbach, Dietmar Stüker, Vincens Weingart, Frank Neser, Stefan Karl Gölder, Christof Pfundstein, Ellen Claudia Nötzel, Thomas Rösch, Siegbert Faiss
AIM: To report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy. METHODS: From November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28509772/safety-of-deep-sedation-in-the-endoscopy-suite
#7
Megan L Allen
PURPOSE OF REVIEW: As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. RECENT FINDINGS: The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28501533/promising-modalities-to-identify-and-monitor-eosinophilic-esophagitis
#8
Girish Hiremath, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histologic evidence of intense eosinophilic inflammation involving the esophagus in the absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity approximately 2 decades ago, there has been a remarkable increase in the recognition of this clinicopathologic entity. The current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies, with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsy specimens for histologic assessment and to evaluate treatment response...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28484734/comparative-quality-assessment-of-esophageal-examination-with-transnasal-and-sedated-endoscopy
#9
Nicholas R Crews, Emmanuel C Gorospe, Michele L Johnson, Louis-Michel Wong Kee Song, David A Katzka, Prasad G Iyer
Background Unsedated transnasal esophagoscopy (TNE) may offer a less expensive, mobile alternative to sedated esophagogastroduodenoscopy (EGD) for evaluations of reflux related complications. Comparisons of imaging quality by these methods are lacking. Methods Two reviewers evaluated videos of TNE and EGD procedures, performed during a community randomized study comparing endoscopic techniques. Subjects were randomized to EGD, TNE in endoscopy suite, or TNE in mobile research unit. Endoscopic quality was assessed using a validated scoring tool...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28434448/gastric-hypomotility-after-second-generation-cryoballoon-ablation-unrecognized-silent-nerve-injury-after-cryoballoon-ablation
#10
Shinsuke Miyazaki, Hiroaki Nakamura, Hiroshi Taniguchi, Hitoshi Hachiya, Takamitsu Takagi, Miyako Igarashi, Takatsugu Kajiyama, Tomonori Watanabe, Takashi Niida, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Few data are available on gastric hypomotility (GH) after cryoballoon pulmonary vein isolation. Also, the use of esophageal temperature monitoring for the prevention of endoscopically detected esophageal lesions (EDELs) is not well established. OBJECTIVE: The purpose of this study was to investigate GH and the impact of an esophageal probe on EDELs during second-generation cryoballoon ablation. METHODS: One hundred four patients with paroxysmal atrial fibrillation undergoing second-generation cryoballoon ablation under conscious sedation followed by esophagogastroscopy were prospectively included...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28431636/systemic-air-embolism-after-endoscopy-without-vessel-injury-a-summary-of-reported-cases
#11
Peter Voigt, Stefan Schob, Sebastian Gottschling, Thomas Kahn, Alexey Surov
INTRODUCTION: Systemic air embolism (SAE) is a rare but serious complication following endoscopic procedures. It may occur with or without direct vessel injury. The aim of this work is to review cases of SAE following endoscopy without proven vessel injury. METHODS: In this systematic review PubMed database was screened for SAE following endoscopy from 1990 to 2015. Only cases without proven major vessel injury were included in the analysis. Including one case of SAE after colonoscopy from our hospital the analysis comprised 40 cases...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#12
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28411359/incidence-and-treatment-of-bile-stones-after-liver-transplant
#13
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality. MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28409844/balloon-eustachian-tuboplasty-under-local-anesthesia-is-it-feasible
#14
MULTICENTER STUDY
Veera Luukkainen, Ilkka Kivekäs, Sari Hammarén-Malmi, Markus Rautiainen, Leena Pöyhönen, Antti A Aarnisalo, Jussi Jero, Saku T Sinkkonen
OBJECTIVE: To study whether balloon Eustachian tuboplasty (BET) is a feasible and safe procedure under local anesthesia. STUDY DESIGN: Prospective multicenter case-control study. METHODS: Patients undergoing either BET (n = 13) or endoscopic sinus surgery (ESS) (n = 12) under local anesthesia, with the possibility of sedation and analgesia, were monitored during the procedure and recovery period for possible adverse effects. After the procedure, the patients responded to a questionnaire assessing their experience...
May 2017: Laryngoscope
https://www.readbyqxmd.com/read/28393105/patients-with-primary-sclerosing-cholangitis-require-more-sedation-during-endoscopic-retrograde-cholangiography
#15
Carsten Keil, Lukas Aguirre Dávila, Theodor Framke, Henrike Lenzen, Michael P Manns, Tim O Lankisch, Torsten Voigtländer
Background and study aims Patients with primary sclerosing cholangitis (PSC) require repeated endoscopic retrograde cholangiography (ERC). Our aim was to evaluate whether patients with PSC require higher doses of sedation during ERC. Patients and methods We retrospectively analyzed all patients undergoing ERC from 2006 to 2013 who received conscious sedation with propofol and midazolam. The duration of the intervention and a potential progression of propofol consumption or intervention time by visit number were analyzed...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28381847/is-anesthetist-directed-sedation-better-for-advanced-endoscopic-procedures
#16
Turki AlAmeel, Bahaa Bseiso
No abstract text is available yet for this article.
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28381846/editorial-polyps-pain-and-propofol-is-water-exchange-the-panacea-for-all
#17
Piet C de Groen
Water exchange (WE) is a relatively new method of endoscope insertion during colonoscopy. Although its origin is rooted in the insertion phase of colonoscopy, allowing the procedure to proceed with more ease, less discomfort, and less or no sedation, its most important value may reside in the withdrawal phase. In this issue, a randomized, prospective study from China specifically designed to examine the effect of WE on adenoma detection rate (ADR) confirms previous findings: WE improves ADR. Here we discuss the trial results, the benefits of WE, and the challenges that may preclude or delay widespread WE implementation...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28375709/a-novel-hands-free-abdominal-compression-device-for-colonoscopy-significantly-decreases-cecal-intubation-time-a-prospective-single-blinded-pilot-study
#18
Allison R Schulman, Marvin Ryou, Walter W Chan
BACKGROUND: Colonoscopy outcome is limited by endoscope looping, which leads to patient discomfort, prolonged procedure, and increased sedation requirement. Traditional manual abdominal pressure is imprecise and manually intensive. A hands-free abdominal compression device (ACD) may improve colonoscopy outcome. We aimed to assess the effect of a novel ACD on colonoscopy outcomes compared to manual pressure. MATERIALS AND METHODS: This was a prospective single-blinded study of patients undergoing outpatient colonoscopy...
June 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28341128/-a-bronchial-mucous-gland-adenoma-resected-by-endoscopic-procedure
#19
C Vergnenègre, J Hureaux, B Morvant, T Urban, T Jeanfaivre
INTRODUCTION: Surgical resection is usually performed for the treatment of endobronchial tumors. This case describes the use of endoscopic resection as an initial treatment, allowing to spare lung parenchyma. CASE REPORT: A patient was admitted to the emergency unit with right lower lobe pneumonia. A thoracic CT-scan and subsequent bronchoscopy revealed an intrabronchial tumor between the right main and intermediate bronchus. Biopsies were non-diagnostic and a PET-scanner did not find any abnormalities...
March 22, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28337480/intra-channel-stent-release-technique-for-fluoroless-endoscopic-ultrasound-guided-lumen-apposing-metal-stent-placement-changing-the-paradigm
#20
Andrea Anderloni, Fabia Attili, Silvia Carrara, Domenico Galasso, Milena Di Leo, Guido Costamagna, Alessandro Repici, Rastislav Kunda, Alberto Larghi
Background Recently, a novel lumen-apposing fully covered self-expanding metal stent (LA-FCSEMS) mounted on an electrocautery-enhanced delivery system has been developed to perform endoscopic ultrasound (EUS)-guided transluminal drainage. From early experience, however, release of the proximal flange of the stent has mostly been done using endoscopic view guidance to ensure proper positioning. Aim We describe a new technique that we have named the Intra-Channel Stent Release Technique (ICSRT) to perform stent placement under complete EUS control, without the use of either fluoroscopic or endoscopic views...
January 2017: Endoscopy International Open
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