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Quality and endoscopy

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https://www.readbyqxmd.com/read/28821598/quality-standards-in-upper-gastrointestinal-endoscopy-a-position-statement-of-the-british-society-of-gastroenterology-bsg-and-association-of-upper-gastrointestinal-surgeons-of-great-britain-and-ireland-augis
#1
Sabina Beg, Krish Ragunath, Andrew Wyman, Matthew Banks, Nigel Trudgill, D Mark Pritchard, Stuart Riley, John Anderson, Helen Griffiths, Pradeep Bhandari, Phillip Kaye, Andrew Veitch
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high- quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy...
August 18, 2017: Gut
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#2
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28813197/split-bolus-injection-producing-simultaneous-late-arterial-and-portal-venous-phases-in-ct-enterography-preliminary-results
#3
Johannes Boos, Jieming Fang, Christina M Chingkoe, Michele Perillo, Martin Smith, Vassilios Raptopoulos, Olga R Brook
OBJECTIVE: The purpose of this article is to evaluate the image quality and added value of split-bolus contrast agent injection combining late arterial and portal venous phases compared with single-bolus contrast agent injection late arterial phase CT enterography. MATERIALS AND METHODS: Consecutive patients who underwent CT enterography before and after implementation of a single-bolus CT enterography protocol were included. Attenuation and contrast-to-noise ratio (CNR) were assessed by ROI measurements of the bowel wall and arterial and venous structures...
August 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28812156/accredited-residents-perform-colonoscopy-to-the-same-high-standards-as-consultants
#4
Dedrick Kok Hong Chan, Reuben Kong Min Wong, Khay Guan Yeoh, Ker-Kan Tan
BACKGROUND: Endoscopy remains a critical component of General Surgery and Gastroenterology training. Whilst residents need to gain experience, the quality of endoscopy which patients receive cannot be compromised. We conducted this study to compare quality indicators between consultants and residents with regards to colonoscopy. METHODS: A review of colonoscopies from a prospectively collected database was performed from September 2011 to February 2016. Quality indicators such as caecum intubation rate, adenoma detection rate, adherence to a 6-min withdrawal rule, mean number of polyps detected per colonoscope, and complications were collected and compared between the two groups...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28806445/use-of-laboratory-markers-in-addition-to-symptoms-for-diagnosis-of-inflammatory-bowel-disease-in-children-a-meta-analysis-of-individual-patient-data
#5
Gea A Holtman, Yvonne Lisman-van Leeuwen, Andrew S Day, Ulrika L Fagerberg, Paul Henderson, Stevan T Leach, Gøri Perminow, David Mack, Patrick F van Rheenen, Els van de Vijver, David C Wilson, Johannes B Reitsma, Marjolein Y Berger
Importance: Blood markers and fecal calprotectin are used in the diagnostic workup for inflammatory bowel disease (IBD) in pediatric patients. Any added diagnostic value of these laboratory markers remains unclear. Objective: To determine whether adding laboratory markers to evaluation of signs and symptoms improves accuracy when diagnosing pediatric IBD. Data Sources: A literature search of MEDLINE and EMBASE from inception through September 26, 2016...
August 14, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28803452/colonoscopic-surveillance-quality-guidelines-and-effectiveness
#6
REVIEW
Timothy J Chittleborough, Joseph C Kong, Glen R Guerra, Robert Ramsay, Alexander G Heriot
Colonoscopic surveillance in patients with a personal or family history of colorectal carcinoma or colonic polyps represents a significant workload for endoscopy services. Effective colonoscopic surveillance relies on quality endoscopic examination and appropriate surveillance interval. This review will discuss quality in colonoscopy and review guidelines for surveillance.
August 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28802373/clinical-curative-effect-and-safety-of-balloon-sinuplasty-in-children-with-chronic-rhinosinusitis
#7
Jia Liu, Zigai Zhao, Yang Chen, Bin Xu, Jiren Dai, Yong Fu
OBJECTIVE: Balloon Sinuplasty for the management of paranasal sinus inflammatory diseases was introduced in otolaryngology in 2005. Over the past decade, evidence strongly supports its safety and efficacy for the treatment of chronic rhinosinusitis (CRS) in adults. Because it requires no bone or tissue removal, this procedure could be suitable in children. We present our initial experience of its use for the treatment of CRS in children. MATERIALS AND METHODS: A prospective study was performed of 30 children with failed medical therapy, who were scheduled for surgery...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28799068/colorectal-cancer-screening-in-asia
#8
REVIEW
Han-Mo Chiu, Wen-Feng Hsu, Li-Chun Chang, Ming-Hsiang Wu
PURPOSE OF REVIEW: Colorectal cancer (CRC) is increasing in Asia, especially in regions with higher levels of economic development. Several Asian countries have launched population CRC screening programs to combat this devastating disease because previous studies have demonstrated that either fecal occult blood test or lower gastrointestinal endoscopy can effectively reduce CRC mortality. RECENT FINDINGS: Screening includes engaging the population, testing, administering a confirmation examination, and treating screening-detected neoplasms; thus, monitoring the whole process using measurable indicators over time is of utmost importance...
August 10, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28783925/education-and-training-guidelines-for-the-board-of-the-korean-society-of-gastrointestinal-endoscopy
#9
REVIEW
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28783921/training-in-endoscopy-enteroscopy
#10
REVIEW
Jinsu Kim
The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28783920/training-in-endoscopy-colonoscopy
#11
REVIEW
Hyun Joo Jang
Colonoscopy is effective in reducing the morbidity and mortality associated with colorectal cancer (CRC). Interval cancers or post-colonoscopy CRCs, are cancers detected within the surveillance interval, or between 6-36 months after a clearing colonoscopy. The incidence of interval cancers is 3.4%-9.2% of all detected CRCs, as reported in population-based studies. Colonoscopy is a technically difficult procedure that is challenging to learn, and needs time and effort to gain competency. Therefore, trainee competence is a critical component of CRC screening and surveillance...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28741364/propofol-sedation-implementation-utility-of-the-failure-mode-and-effect-analysis-patient-focused-quality-and-safety
#12
Adrián Huergo Fernández, Pedro Amor Martín, Fernando Fernández Cadenas
Sedation is a key component of digestive endoscopy. While ensuring procedural safety and quality represents a primary goal, a detailed assessment of patient-focused risks and improvements is lacking on most occasions. Failure mode and effect analysis (FMEA) is a useful tool in this context as a means of raising barriers and defense mechanisms to prevent adverse events from developing.
July 25, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28739432/magnetic-resonance-enterography-with-oral-mannitol-solution-diagnostic-efficacy-and-image-quality-in-crohn-disease
#13
M Koplay, S Guneyli, H Cebeci, H Korkmaz, H H Emiroglu, T Sekmenli, Y Paksoy
PURPOSE: The aim of this study was to investigate the diagnostic efficacy and image quality of magnetic resonance enterography (MRE) using oral mannitol solution for the evaluation Crohn disease (CD). MATERIALS AND METHODS: We retrospectively evaluated MRE examinations of 153 patients with an assumed or definitive diagnosis of CD. There were 65 men and 88 women, with a mean age of 35.7 years (range: 6-73years). MRE findings of the patients were compared to histopathologic results obtained by surgery-fiberoptic endoscopy...
July 21, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28737951/monitoring-of-small-bowel-crohn-s-disease
#14
Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
In recent years, the therapeutic paradigm in Crohn's disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such "treat-to-target" approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn's disease, the small bowel is affected in the majority of patients; frequently, Crohn's involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28737439/systematic-review-and-meta-analysis-is-bowel-preparation-still-necessary-in-small-bowel-capsule-endoscopy
#15
Diana E Yung, Emanuele Rondonotti, Catherine Sykes, Marco Pennazio, John N Plevris, Anastastios Koulaouzidis
INTRODUCTION: Optimal bowel preparation for small bowel capsule endoscopy(SBCE) is controversial. This meta-analysis aimed to investigate the effects of laxatives in SBCE. METHODS: A comprehensive literature search was conducted for studies investigating the use of laxatives in SBCE. The primary outcome was diagnostic yield(DY) for SB findings; secondary outcomes SB visualization quality(SBVQ) and completion rate(CR). Pooled odds ratios(ORs) with 95% confidence intervals(CIs) and number needed to treat(NNT) were calculated...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28716161/post-adenoidectomy-quality-of-life-in-children-with-refractory-chronic-rhinosinusitis
#16
V Bettadahalli, A Chakravarti
OBJECTIVE: This study aimed to evaluate post-adenoidectomy quality of life in children with refractory chronic rhinosinusitis. METHODS: A prospective interventional study of children aged 4-12 years with chronic refractory rhinosinusitis was conducted. A total of 60 children completed follow up. Nasal endoscopy and non-contrast computed tomography of the paranasal sinuses were performed, and both symptoms and their effects on patient quality of life pre- and post-adenoidectomy were evaluated...
July 18, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28711286/novel-therapeutic-targets-for-inflammatory-bowel-disease
#17
REVIEW
Marjorie Argollo, Gionata Fiorino, Pieter Hindryck, Laurent Peyrin-Biroulet, Silvio Danese
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are immune mediated conditions associated with progressive damage of the inflamed gut tissue, and have a considerable impact on the patient's quality of life. The pathogenesis remains uncertain, but it is clear that complex mechanisms associated with host and luminal factors are involved, generating an unbalance between pro- and anti-inflammatory signaling. It is well established that the purpose of an adequate and complete control of the intestinal inflammation measured not only by clinical symptoms, but also with more objective data such as fecal biomarkers (calprotectin) and endoscopy...
July 12, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28701200/assessing-colonoscopic-inspection-skill-using-a-virtual-withdrawal-simulation-a-preliminary-validation-of-performance-metrics
#18
Christine M Zupanc, Guy M Wallis, Andrew Hill, Robin Burgess-Limerick, Stephan Riek, Annaliese M Plooy, Mark S Horswill, Marcus O Watson, Hans de Visser, David Conlan, David G Hewett
BACKGROUND: The effectiveness of colonoscopy for diagnosing and preventing colon cancer is largely dependent on the ability of endoscopists to fully inspect the colonic mucosa, which they achieve primarily through skilled manipulation of the colonoscope during withdrawal. Performance assessment during live procedures is problematic. However, a virtual withdrawal simulation can help identify and parameterise actions linked to successful inspection, and offer standardised assessments for trainees...
July 12, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28688938/a-comparative-study-of-endoscopic-surveillance-in-hereditary-diffuse-gastric-cancer-according-to-cdh1-mutation-status
#19
Emma Z Mi, Ella Z Mi, Massimiliano di Pietro, Maria O'Donovan, Richard H Hardwick, Susan Richardson, Hisham Ziauddeen, Paul C Fletcher, Carlos Caldas, Marc Tischkowitz, Krish Ragunath, Rebecca C Fitzgerald
BACKGROUND AND AIMS: Hereditary diffuse gastric cancer (HDGC) accounts for 1% of gastric cancer cases. For patients with a germline CDH1 mutation, risk-reducing gastrectomy is recommended. However, for those delaying surgery or families with no causative mutation identified, regular endoscopy is advised. This study aimed to determine the yield of signet ring cell carcinoma (SRCC) foci in individuals with a CDH1 pathogenic variant compared with those without and how this varies with successive endoscopies...
July 5, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28681569/diagnostic-use-of-endoscopic-full-thickness-wall-resection-eftr-a-novel-minimally-invasive-technique-for-colonic-tissue-sampling-in-patients-with-severe-gastrointestinal-motility-disorders
#20
P V Valli, D Pohl, M Fried, R Caduff, P Bauerfeind
BACKGROUND: Complex gastrointestinal (GI) motility disorders such as chronic intestinal pseudo-obstruction (CIPO) or Hirschsprung's disease (HD) are challenging to diagnose and treat appropriately. Thorough assessment of patient history, radiographic exams, endoscopy, and motility measurements aid in diagnostic workup, yet underlying histology is the cornerstone to enable a more distinct diagnosis of neuromuscular GI disorders. Traditionally, surgical procedures have been performed to obtain specimen suitable for accurate histologic analysis...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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