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Quality endoscopy

Long Chen, Wen Tang, Nigel W John, Tao Ruan Wan, Jian Jun Zhang
BACKGROUND AND OBJECTIVE: While Minimally Invasive Surgery (MIS) offers considerable benefits to patients, it also imposes big challenges on a surgeon's performance due to well-known issues and restrictions associated with the field of view (FOV), hand-eye misalignment and disorientation, as well as the lack of stereoscopic depth perception in monocular endoscopy. Augmented Reality (AR) technology can help to overcome these limitations by augmenting the real scene with annotations, labels, tumour measurements or even a 3D reconstruction of anatomy structures at the target surgical locations...
May 2018: Computer Methods and Programs in Biomedicine
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Peter M Irving, Tariq Iqbal, Chuka Nwokolo, Sreedhar Subramanian, Stuart Bloom, Neeraj Prasad, Ailsa Hart, Charles Murray, James O Lindsay, Adam Taylor, Rachel Barron, Stephen Wright
Background: Cannabidiol (CBD) exhibits anti-inflammatory properties that could improve disease activity in inflammatory bowel disease. This proof-of-concept study assessed efficacy, safety and tolerability of CBD-rich botanical extract in ulcerative colitis (UC) patients. Methods: Patients aged 18 years or older, with left-sided or extensive UC, Mayo scores of 4-10 (endoscopy scores ≥1), and on stable 5-aminosalicylic acid dosing, were randomized to 10-weeks' CBD-rich botanical extract or placebo capsules...
March 10, 2018: Inflammatory Bowel Diseases
Michael R Kolber, Shelley Ross
BACKGROUND AND OBJECTIVES: In Canada, few family physicians (FPs) perform endoscopy. Conflicting evidence exists on the quality of endoscopy performed by Canadian FPs, which may be explained by differing skillsets of these endoscopists. The objective of this study was to perform the first exploration of the practice, skills, and knowledge of Canadian FP endoscopists. METHODS: A cross-sectional survey, including direct knowledge test, was used. RESULTS: Twenty Canadian FP endoscopists completed the survey...
March 2018: Family Medicine
Way-Seah Lee, Chun-Wei Tee, Zhong-Lin Koay, Tat-Seng Wong, Fatimah Zahraq, Hee-Wei Foo, Sik-Yong Ong, Shin-Yee Wong, Ruey-Terng Ng
AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center. METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks...
March 7, 2018: World Journal of Gastroenterology: WJG
Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
A Pérez-Mendoza, Á M Zárate-Guzmán, E S Galvis García, S Sobrino Cossío, J Djamus Birch
INTRODUCTION AND AIMS: Gastric cancer is one of the main causes of cancer worldwide, but there is currently no global screening strategy for the disease. Endoscopy is the screening method of choice in some Asian countries, but no standardized technique has been recognized. Systematic alphanumeric-coded endoscopy can increase gastric lesion detection. The aim of the present article was to compare the usefulness of systematic alphanumeric-coded endoscopy with conventional endoscopy for the detection of premalignant lesions and early gastric cancer in subjects at average risk for gastric cancer...
March 8, 2018: Revista de Gastroenterología de México
Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat
BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal complaints. GERD, caused by the reflux of stomach contents into the esophagus, leads to troublesome symptoms such as heartburn and regurgitation. It is classified into two types: erosive esophagitis, characterized by visible esophageal mucosa erosion in endoscopy, and non-erosive reflux disease (NERD). GERD is a chronic and recurrent disease that impairs the quality of life and imposes socioeconomic and therapeutic burdens to both patients and society...
March 2018: Journal of Integrative Medicine
Christopher D Mills, Chere McCamley, Michael P Swan
GOALS: To determine the effect of carbon dioxide insufflation on the most important outcome measure of colonoscopic quality: adenoma detection rate (ADR). BACKGROUND: Bowel cancer is the second most common cause of cancer deaths in males and females in Australia. Carbon dioxide has in recent times become the insufflation methodology of choice for screening colonoscopy for bowel cancer, as this has been shown to have significant advantages when compared with traditional air insufflation...
March 7, 2018: Journal of Clinical Gastroenterology
Gregory S Cooper, Sanford D Markowitz, Zhengyi Chen, Missy Tuck, Joseph E Willis, Barry M Berger, Dean E Brenner, Li Li
BACKGROUND: There is uncertainty as to the appropriate follow-up of patients who test positive on multimarker stool DNA (sDNA) testing and have a colonoscopy without neoplasia. AIMS: To determine the prevalence of missed colonic or occult upper gastrointestinal neoplasia in patients with an apparent false positive sDNA. METHODS: We prospectively identified 30 patients who tested positive with a commercially available sDNA followed by colonoscopy without neoplastic lesions...
March 7, 2018: Digestive Diseases and Sciences
William Syrmis, Russell Richard, Sue Jenkins-Marsh, Siew C Chia, Phillip Good
BACKGROUND: Malignant bowel obstruction (MBO) is a common problem in patients with intra-abdominal cancer. Oral water soluble contrast (OWSC) has been shown to be useful in the management of adhesive small bowel obstruction in identifying patients who will recover with conservative management alone and also in reducing the length of hospital stay. It is not clear whether the benefits of OWSC in adhesive small bowel obstruction are also seen in patients with MBO. OBJECTIVES: To determine the reliability of OWSC media and follow-up abdominal radiographs in predicting the success of conservative treatment in resolving inoperable MBO with conservative management...
March 7, 2018: Cochrane Database of Systematic Reviews
Alida Andrealli, Silvia Paggi, Arnaldo Amato, Emanuele Rondonotti, Gianni Imperiali, Nicoletta Lenoci, Giovanna Mandelli, Natalia Terreni, Giancarlo Spinzi, Franco Radaelli
Background: A split-dose (SD) regimen is crucial for colonoscopy quality. Compliance with SD for early morning colonoscopy is generally poor. The present study evaluated whether pre-colonoscopy counselling, in addition to a dedicated leaflet, might increase SD uptake. Methods: Consecutive 50-69-year-old patients undergoing screening colonoscopy before 10 a.m. were randomized to either receive written information only on bowel preparation (Written Group, WG) or written and oral instructions (Written and Oral Group, WaOG)...
March 2018: United European Gastroenterology Journal
Miguel Areia, Manon Cw Spaander, Ernst J Kuipers, Mário Dinis-Ribeiro
Background: Endoscopic screening for gastric cancer is debatable in countries with an intermediate risk. Objective: The objective of this article is to determine the cost-utility of screening strategies for gastric cancer in a European country. Methods: We conducted a cost-utility analysis using a Markov model comparing three screening strategies versus no screening: stand-alone upper endoscopy, endoscopy combined with a colorectal cancer screening colonoscopy after a positive faecal occult blood test or pepsinogens serologic screening...
March 2018: United European Gastroenterology Journal
Roberto L Kaiser Junior, Luiz G de Quadros, Mikaell A G Faria, Fernanda S L Kaiser, Juan C O Campo, Idiberto J Zotarelli Filho
Background: Colonoscopy procedures are commonly performed and have high success rates. However, poor or inadequate bowel preparation is one of the most common reasons for a repeated or failed colonoscopy. We therefore performed an observational study followed by propensity score modeling to evaluate and compare the quality of bowel preparation with the use of Aquanet bowel cleansing devices (BCDs) versus the use of oral sodium picosulfate solution. Methods: We performed a prospective cross-sectional study to compare the quality of pre-endoscopic bowel preparation using a BCD with oral solution...
February 2018: Gastroenterology Research
Dragoş Predescu, Silviu Constantinoiu
Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method...
January 2018: Chirurgia
Arianna Barbetta, Shahdabul Faraz, Pari Shah, Hans Gerdes, Meier Hsu, Kay See Tan, Tamar Nobel, Manjit S Bains, Matthew Bott, James M Isbell, David B Sewell, David R Jones, Daniela Molena
BACKGROUNDS AND AIMS: As treatment for esophageal cancer often involves a multidisciplinary approach, the initial endoscopic report is essential for communication between providers. Several guidelines have been established to standardize endoscopic reporting. This study evaluates the compliance of esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS) reporting with the current national guidelines. METHODS: Combining the National Comprehensive Cancer Network and Society of Thoracic Surgeons guidelines, 11 quality indicators (QIs) for EGD and 8 for EUS were identified...
March 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Matthew Clark, Asim Shuja, Ashley Thomas, Scott Steinberg, Joseph Geffen, Miguel Malespin, Silvio W de Melo Jr
Background: Studying the role of gastroenterologists' attire can provide insight into patients' perceptions and help us optimize the physician-patient relationship. In this study we assessed patients' preference concerning gastroenterologists' attire, and its influence on patients' trust, empathy and perceptions of the quality of care in the clinic and endoscopic suite. Methods: A cross-sectional survey was conducted from August 2016 to February 2017. A total of 240 consecutive patients who presented to the Gastroenterology Department at the University of Florida in Jacksonville both in the clinic and endoscopic suite were included in this study...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Daniel Skubleny, Jerry T Dang, Samuel Skulsky, Noah Switzer, Chunhong Tian, Xinzhe Shi, Christopher de Gara, Daniel W Birch, Shahzeer Karmali
BACKGROUND: Sentinel node navigation surgery (SNNS) for gastric cancer using infrared visualization of indocyanine green (ICG) is intriguing because it may limit operative morbidity. We are the first to systematically review and perform meta-analysis on the diagnostic utility of ICG and infrared electronic endoscopy (IREE) or near infrared fluorescent imaging (NIFI) for SNNS exclusively in gastric cancer. METHODS: A search of electronic databases MEDLINE, EMBASE, SCOPUS, Web of Science, and the Cochrane Library using search terms "gastric/stomach" AND "tumor/carcinoma/cancer/neoplasm/adenocarcinoma/malignancy" AND "indocyanine green" was completed in May 2017...
February 26, 2018: Surgical Endoscopy
Kavel Visrodia, Liam Zakko, Siddharth Singh, Cadman L Leggett, Prasad G Iyer, Kenneth K Wang
BACKGROUND AND AIMS: A small but significant proportion of patients with Barrett's esophagus (BE) have persistent dysplasia or intestinal metaplasia (IM) after treatment with radiofrequency ablation (RFA). Cryotherapy is a cold-based ablative modality that is increasingly being used in this setting. We aimed to better understand the efficacy of second-line cryotherapy in BE patients with persistent dysplasia or IM after RFA by conducting a systematic review and meta-analysis. METHODS: We performed a systematic literature search of PUBMED, EMBASE, and Web of Sciences through September 1, 2017...
February 21, 2018: Gastrointestinal Endoscopy
Rebecca L Bartles, James E Leggett, Shannan Hove, Catherine D Kashork, Lian Wang, Margret Oethinger, Lynda Baxter, Jack J Brandabur
BACKGROUND AND AIMS: In a pilot study (8) we demonstrated that current guidelines for duodenoscope and linear echoendoscope (DLE) reprocessing using a single cycle of high-level disinfection (HLD) in an automated reprocessor may be inadequate. In August 2015, the FDA offered double-HLD as a possible response to address this concern. As a result, Providence Health & Services adopted double-HLD as standard procedure for DLE, but no rigorous clinical studies supported this practice. We undertook a quality improvement (QI) study to compare single-HLD versus double-HLD at 4 of our 34 hospitals...
February 21, 2018: Gastrointestinal Endoscopy
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