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endoscopic procedures and sedation

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https://www.readbyqxmd.com/read/29446162/eus-guided-transenteric-pancreatic-duct-drainage-without-cautery-for-obstructive-pancreatitis-due-to-ampullary-carcinoma
#1
Takeshi Miyata, Ken Kamata, Mamoru Takenaka
Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has been described as an alternative to surgical procedures [1-5]. The patient was a 64-year-old woman with resectable ampullary carcinoma. She was scheduled to undergo pancreatoduodenectomy for the carcinoma; however, obstructive pancreatitis developed. Abdominal computed tomography (CT) revealed dilation of the main pancreatic duct from the tail side of the tumor. Trans-papillary pancreatic duct drainage was attempted; however, the guidewire could not be inserted over the tumor (Figure 1A)...
February 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29426291/paediatric-pancreaticobiliary-endoscopy-a-21-year-experience-from-a-tertiary-hepatobiliary-centre-and-systematic-literature-review
#2
Margaret G Keane, Mayur Kumar, Natascha Cieplik, Douglas Thorburn, Gavin J Johnson, George J Webster, Michael H Chapman, Keith J Lindley, Stephen P Pereira
BACKGROUND: In adults ERCP and endoscopic ultrasound (EUS) are standard methods of evaluating and treating many hepatopancreaticobiliary (HPB) conditions. HPB disease is being diagnosed with increasing frequency in children but information about role of ERCP and EUS and their outcomes in this population remain limited. Therefore the aims of this study were to describe the paediatric ERCP and EUS experience from a large tertiary referral HPB centre, and to systematically compare outcomes with those of other published series...
February 9, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29422678/clinical-translation-of-tethered-confocal-microscopy-capsule-for-unsedated-diagnosis-of-eosinophilic-esophagitis
#3
Nima Tabatabaei, DongKyun Kang, Minkyu Kim, Tao Wu, Catriona N Grant, Mireille Rosenberg, Norman S Nishioka, Paul E Hesterberg, John Garber, Qian Yuan, Aubrey J Katz, Guillermo J Tearney
Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29421914/the-safety-of-deep-sedation-with-propofol-controlled-by-the-endoscopist-in-endoscopic-retrograde-cholangiopancreatography-ercp-a-prospective-study-in-a-tertiary-hospital
#4
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29397050/bronchoalveolar-lavage-for-diagnosis-of-tuberculosis-infection-in-elephants
#5
R Hermes, J Saragusty, I Moser, S Holtze, J Nieter, K Sachse, T Voracek, A Bernhard, T Bouts, F Göritz, T B Hildebrandt
Tuberculosis (TB) has been known to affect elephants for thousands of years. It was put into spotlight when few circus elephants were diagnosed carrying Mycobacterium (M.) tuberculosis. Because of the zoonotic risk and high susceptibility to M. tuberculosis, periodic testing was enacted since, in captive breeding programmes. Presently, trunk wash is the recommended diagnostic procedure for TB. Trunk wash, however, puts the operator at risk, has low sensitivity, and is prone to contamination. Here, bronchoalveolar lavage is described for the first time for TB diagnosis in elephants...
February 5, 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29340298/efficacy-and-safety-of-sedation-during-endoscopic-submucosal-dissection-of-gastric-cancers-using-a-comparative-trial-of-propofol-versus-midazolam
#6
Hitomi Kikuchi, Takuto Hikichi, Ko Watanabe, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Yuki Sato, Katsutoshi Obara, Hiromasa Ohira
Background and study aims : Proper sedation is necessary for the safe and satisfactory completion of endoscopic submucosal dissection (ESD) for early gastric cancer. This study was conducted as a comparative trial of efficacy and safety, comparing propofol-based sedation and midazolam-based sedation during ESD of early gastric cancer patients. Patients and methods : This study examined 64 lesions in 58 patients treated using ESD with midazolam plus pentazocine between July 2013 and January 2014 (group M) and 237 lesions in 216 patients treated by ESD using propofol plus pentazocine between February 2014 and December 2015 (group P)...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29325445/the-morbidity-of-ureteral-strictures-in-patients-with-prior-ureteroscopic-stone-surgery-multi-institutional-outcomes
#7
Philip Clark May, Ryan S Hsi, Henry H Tran, Marshall Stoller, Ben H Chew, Thomas Chi, Manint Usawachintachit, Brian D Duty, John L Gore, Jonathan D Harper
Purpose Nephrolithiasis is an increasingly common ailment in the United States. Ureteroscopic management has supplanted shockwave lithotripsy as the most common treatment of upper tract stone disease. Ureteral stricture is a rare but serious complication of stone disease and its management. The impact of new technologies and more widespread ureteroscopic management on stricture rates is unknown. We describe our experience in managing strictures incurred following ureteroscopy for upper tract stone disease. Materials and methods Records for patients managed at 4 tertiary care centers between December 2006 and October 2015 with the diagnosis of ureteral stricture following ureteroscopy for upper tract stone disease were retrospectively reviewed...
January 12, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#8
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29298872/acute-sedation-associated-complications-in-gi-endoscopy-prosed-2-study-results-from-the-prospective-multicentre-electronic-registry-of-sedation-associated-complications
#9
Angelika Behrens, Anton Kreuzmayr, Hendrik Manner, Herbert Koop, Albrecht Lorenz, Claus Schaefer, Mathais Plauth, Jens-Uwe Jetschmann, Christian von Tirpitz, Marcus Ewald, Michael Sackmann, Wanja Renner, Martin Krüger, Dieter Schwab, Werner Hoffmann, Olaf Engelke, Oliver Pech, Frank Kullmann, Sonja Pampuch, Berthold Lenfers, Uwe Weickert, Dieter Schilling, Stephan Boehm, Susanne Beckebaum, Vito Cicinnati, Joachim F Erckenbrecht, Franz Ludwig Dumoulin, Claus Benz, Thomas Rabenstein, Georg Haltern, Martin Balsliemke, Christian de Mas, Gerhard Kleber, Christian Pehl, Christoph Vogt, Ralf Kiesslich, Wolfgang Fischbach, Irmtraut Koop, Jens Kuehne, Matthias Breidert, Nils Lennart Sass, Andrea May, Christian Friedrich, Ronni Veitt, Rainer Porschen, Mark Ellrichmann, Alexander Arlt, Wolfgang Schmitt, Markus Dollhopf, Werner Schmidbaur, Axel Dignass, Volker Schmitz, J Labenz, Gernot Kaiser, Alexander Krannich, Nico Barteska, Christian Ell
OBJECTIVES: Sedation has been established for GI endoscopic procedures in most countries, but it is also associated with an added risk of complications. Reported complication rates are variable due to different study methodologies and often limited sample size. DESIGNS: Acute sedation-associated complications were prospectively recorded in an electronic endoscopy documentation in 39 study centres between December 2011 and August 2014 (median inclusion period 24 months)...
January 3, 2018: Gut
https://www.readbyqxmd.com/read/29228523/advanced-therapeutic-gastrointestinal-endoscopy-in-children-today-and-tomorrow
#10
Zaheer Nabi, Duvvur Nageshwar Reddy
Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories...
December 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29227055/does-the-reporting-of-gastro-intestinal-endoscopy-meet-the-minimal-terminology-standard-at-king-edward-viii-hospital
#11
S P Maharaj, M A Noorbhai, T E Madiba
BACKGROUND: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology. METHOD: This was a retrospective observational study of upper endoscopy reports between January and December 2014. The data extracted were compared to the current reporting standard listed in the MST. To assess and grade the quality of reporting we developed a Gastrointestinal Reporting Score, which incorporates MST variables in addition to demographic details, indication for endoscopy, report legibility, sedation and the use of classification systems to describe pathology...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29208758/respiratory-volume-monitoring-reduces-hypoventilation-and-apnea-in-subjects-undergoing-procedural-sedation
#12
Robert H Nichols, Justin A Blinn, Thuan M Ho, Robert A McQuitty, Michael P Kinsky
INTRODUCTION: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#13
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29184611/safety-of-gastrointestinal-endoscopy-with-conscious-sedation-in-obstructive-sleep-apnea
#14
Christian M Andrade, Brijesh Patel, Meghana Vellanki, Ambuj Kumar, Gitanjali Vidyarthi
AIM: To perform a systematic review and meta-analysis to assess the safety of conscious sedation in patients with obstructive sleep apnea (OSA). METHODS: A comprehensive electronic search of MEDLINE and EMBASE was performed from inception until March 1, 2015. In an effort to include unpublished data, abstracts from prior gastroenterological society meetings as well as other reference sources were interrogated. After study selection, two authors utilizing a standardized data extraction form collected the data independently...
November 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29183278/capnography-sensor-use-is-associated-with-reduction-of-adverse-outcomes-during-gastrointestinal-endoscopic-procedures-with-sedation-administration
#15
Michael W Jopling, Jiejing Qiu
BACKGROUND: Evidence to date suggests that capnography monitoring during gastrointestinal endoscopic procedures (GEP) reduces the incidence of hypoxemia, but the association of capnography monitoring with the incidence of other adverse outcomes surrounding these procedures has not been well studied. Our aims were to estimate the incidence of pharmacological rescue events and death at discharge from an inpatient or outpatient hospitalization where GEP was performed with sedation, and to determine if capnography monitoring was associated with reduced incidence of these adverse outcomes...
November 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29179691/comparison-of-sedation-between-the-endoscopy-room-and-operation-room-during-endoscopic-submucosal-dissection-for-neoplasms-in-the-upper-gastrointestinal-tract
#16
Daisuke Yamaguchi, Naoko Yamaguchi, Yuki Takeuchi, Takahiro Yukimoto, Kei Ikeda, Kosuke Matsumoto, Rikako Kinoshita, Saori Kamachi, Kyosuke Sugiyama, Tomohito Morisaki, Keisuke Ario, Hisako Yoshida, Ryo Katsuki, Seiji Tsunada, Kazuma Fujimoto
BACKGROUND: The present study was performed to compare the safety of sedation during endoscopic submucosal dissection (ESD) in the endoscopy room versus operation room. METHODS: In total, 297 patients with gastrointestinal tumors who underwent ESD from January 2011 to December 2016 were retrospectively reviewed. The patients were divided into two groups: those who underwent ESD in the endoscopy room without propofol (Group E) versus operation room with propofol (Group O)...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29142513/sedation-for-routine-gastrointestinal-endoscopic-procedures-a-review-on-efficacy-safety-efficiency-cost-and-satisfaction
#17
REVIEW
Otto S Lin
Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#18
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29130583/endoscopic-retrograde-cholangio-pancreatography-in-the-management-of-biliary-complications-after-paediatric-liver-transplantation
#19
Sivaramakrishnan Venkatesh Karthik, Seng-Hock Quak, Marion M Aw
BACKGROUND: The published paediatric experience with Endoscopic retrograde cholangio-pancreatography (ERCP) in the diagnosis and management of biliary complications following liver transplantation (LT) is limited. AIMS: We describe our experience with ERCP in the management of children following LT who presented with biliary complications, over a 20 year period (1995-2014). METHODS: The retrospectively reviewed data is summarized descriptively...
November 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29117722/endoscopic-ultrasound-guided-pancreatic-fluid-collections-transmural-drainage-outcomes-in-100-consecutive-cases-of-pseudocysts-and-walled-off-necrosis-a-single-centre-experience-from-the-united-kingdom
#20
Chander Shekhar, Ben Maher, Colm Forde, Brinder Singh Mahon
BACKGROUND AND AIM: Endoscopic ultrasound-guided drainage is a minimally invasive first-line modality for the drainage of pancreatic fluid collection (PFC) resulting in a shorter hospital stay and less morbidity compared with surgical cystogastrostomy. Our aim is to evaluate potential differences in the outcomes of endoscopic ultrasound (EUS) guided transmural drainage (EUS-TD) drainage of pancreatic pseudocyst (PP) and walled-off necrosis (WON). METHOD: We retrospectively reviewed 100 consecutive EUS-guided drainages of PFC utilising EUS reports; clinical notes and imaging with follow-up (FU) to 12 months...
November 9, 2017: Scandinavian Journal of Gastroenterology
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