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Quality improvement endoscopy

Duk Hwan Kim, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong
OBJECTIVES: The objective of this study was to determine whether a pre-training program influences the entire learning process and overall proficiency of colonoscopy during fellowship. METHODS: From March 2011 to February 2013, a total of 28 first-year gastrointestinal fellows were trained in colonoscopy at a single tertiary center. Before entering their fellowship training, all fellows were board certified in internal medicine, but had no experience performing a full colonoscopy...
2016: PloS One
Scott L Zuckerman, Ilya Laufer, Arjun Sahgal, Yoshiya J Yamada, Meic H Schmidt, Dean Chou, John H Shin, Naresh Kumar, Daniel M Sciubba
STUDY DESIGN: Systematic review. OBJECTIVE: The aim of this study was to review the techniques, indications, and outcomes of minimally invasive surgery (MIS) and separation surgery with subsequent radiosurgery in the treatment of patients with metastatic spine disease. SUMMARY OF BACKGROUND DATA: The utilization of MIS techniques in patients with spine metastases is a growing area within spinal oncology. Separation surgery represents a novel paradigm where radiosurgery provides long-term control after tumor is surgically separated from the neural elements...
October 15, 2016: Spine
Nancy Roxana Machaca Quea, Fabian Emura, Fernando Barreda Bolaños, Yuliana Salvador Arias, Fernando Antonio Arévalo Suárez, Alejandro Piscoya Rivera
Background and study aims: In the Western world, gastric cancer (GC) usually presents at an advanced stage, carrying a high mortality rate. Studies have reported that 14 % to 26 % of GCs are missed at endoscopy up to 3 years before diagnosis. Systematic Alphanumeric Coded Endoscopy (SACE) has been proposed to improve quality of esophagogastroduodenoscopy (EGD) by facilitating a complete examination of the upper gastrointestinal tract. This prospective cross-sectional study was designed to determine the frequency of gastric intraepithelial neoplasia (GIN) by using the SACE approach in cohort of patients from low socioeconomic level...
October 2016: Endoscopy International Open
Raf Bisschops, Miguel Areia, Emmanuel Coron, Daniela Dobru, Bernd Kaskas, Roman Kuvaev, Oliver Pech, Krish Ragunath, Bas Weusten, Pietro Familiari, Dirk Domagk, Roland Valori, Michal F Kaminski, Cristiano Spada, Michael Bretthauer, Cathy Bennett, Carlo Senore, Mário Dinis-Ribeiro, Matthew D Rutter
No abstract text is available yet for this article.
October 2016: United European Gastroenterology Journal
J S Park, D K Chan, S R Parikh, A K Meyer, K W Rosbe
OBJECTIVE: To study the efficacy of surgical management for obstructive sleep apnea (OSA) syndrome in children with hypotonia, and to identify common anatomic sites of airway obstruction. METHODS: Retrospective chart review of polysomnographic parameters and quality of life instrument scores for seventy eight children with hypotonia who underwent surgical intervention for sleep-disordered breathing at two tertiary children's hospitals, and analysis of drug-induced sleep endoscopy data using a previously validated scoring system...
November 2016: International Journal of Pediatric Otorhinolaryngology
Gyanesh Sethi, Arunabha Chakravarti
OBJECTIVE: The present study aims to evaluate the role of Endoscopic Sinus Surgery (ESS) in refractory pediatric Chronic Rhinosinusitis (CRS) and to assess the change in quality of life after ESS. MATERIALS AND METHODS: This prospective interventional study included 35 children (aged between 6 and 12 years) of refractory CRS, not responding to 4 weeks of maximal medical therapy attending the pediatric ENT clinic of a tertiary referral centre. Study period was from November 2013 to March 2016...
November 2016: International Journal of Pediatric Otorhinolaryngology
James E East, Jasper L Vleugels, Philip Roelandt, Pradeep Bhandari, Raf Bisschops, Evelien Dekker, Cesare Hassan, Gareth Horgan, Ralf Kiesslich, Gaius Longcroft-Wheaton, Ana Wilson, Jean-Marc Dumonceau
Background and aim: This technical review is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the utilization of advanced endoscopic imaging in gastrointestinal (GI) endoscopy. Methods: This technical review is based on a systematic literature search to evaluate the evidence supporting the use of advanced endoscopic imaging throughout the GI tract. Technologies considered include narrowed-spectrum endoscopy (narrow band imaging [NBI]; flexible spectral imaging color enhancement [FICE]; i-Scan digital contrast [I-SCAN]), autofluorescence imaging (AFI), and confocal laser endomicroscopy (CLE)...
October 6, 2016: Endoscopy
Mathieu Pioche, Jérôme Rivory, Toshihiro Nishizawa, Toshio Uraoka, Sandrine Touzet, Marc O'Brien, Jean-Christophe Saurin, Thierry Ponchon, Angélique Denis, Naohisa Yahagi
Background and study aim: Endoscopic submucosal dissection (ESD) is currently the reference method to achieve an en bloc resection for large lesions; however, the technique is difficult and risky, with a long learning curve. In order to reduce the morbidity, training courses that use animal models are recommended. Recently, self-learning software has been developed to assist students in their training. The aim of this study was to evaluate the impact of this tool on the ESD learning curve. Methods: A prospective, randomized, comparative study enrolled 39 students who were experienced in interventional endoscopy...
October 5, 2016: Endoscopy
Filippo Ricciardiello, Elena Cantone, Teresa Abate, Antonella M Di Lullo, Flavia Oliva, Maurizio Iengo, Giuseppe De Bernardo
BACKGROUND: This study evaluates endoscopic and quality of life (QoL) outcomes in two groups, composed by both allergic (A) and non-allergic (N-A) adolescents undergoing septoplasty with concurrent turbinate surgery by radiofrequency treated after surgery with nasal spray containing liposomes and vitamins A and E. METHODS: This double-blind randomized study was carried out on 40 patients (22 males, 18 females, mean age 15.5 ± 1.0 years) undergoing septoplasty and volumetric tissue reduction of inferior turbinates by radiofrequency for post-traumatic deformities and severe nasal obstruction...
October 5, 2016: Minerva Pediatrica
Kajetan L von Eckardstein, Dorothee Mielke, Reza Akhavan-Sigari, Veit Rohde
Background and Study Aims In microvascular decompression of the trigeminal nerve for trigeminal neuralgia (TN), the site of conflict is occasionally difficult to identify. Endoscopy has been described to better evaluate the anatomical conflict in such situations. We hypothesized that indocyanine green (ICG) angiography could allow for better visualization of the compressing artery and its anatomical relation to the nerve. Material and Methods ICG angiography was performed in 17 TN patients undergoing microvascular decompression...
September 23, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Kan Lin, Wei Zheng, Chwee Ming Lim, Zhiwei Huang
We assess the clinical utility of a unique simultaneous fingerprint (FP) (i.e., 800-1800 cm(-1)) and high-wavenumber (HW) (i.e., 2800-3600 cm(-1)) fiber-optic Raman spectroscopy for in vivo diagnosis of laryngeal cancer at endoscopy. A total of 2124 high-quality in vivo FP/HW Raman spectra (normal = 1321; cancer = 581) were acquired from 101 tissue sites (normal = 71; cancer = 30) of 60 patients (normal = 44; cancer = 16) undergoing routine endoscopic examination. FP/HW Raman spectra differ significantly between normal and cancerous laryngeal tissue that could be attributed to changes of proteins, lipids, nucleic acids, and the bound water content in the larynx...
September 1, 2016: Biomedical Optics Express
Yuichi Sagara, Satoshi Shinozaki, Tomonori Yano, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
The over-the-scope clip (OTSC) system is a new technology that enables closure of fistulae which cannot be closed with a conventional clip. A 57-year-old woman had long-term hypoalbuminemia, edema and general malaise. Peroral double-balloon endoscopy (DBE) showed a jejuno-sigmoid fistula and blind loop syndrome of the jejunum and ileum, because ingested food bypassed the ileum through the fistula. She was advised to undergo surgical closure of the fistula, but she refused the procedure. For 7 years following DBE, repeat courses of antibiotics were required to treat bacterial overgrowth due to blind loop syndrome...
September 23, 2016: Clinical Journal of Gastroenterology
Shannon Stogryn, Jason Park, Krista Hardy, Ashley Vergis
BACKGROUND: Synoptic operative reporting is a solution to the poor quality of narrative reports. OBJECTIVE: To develop operative report quality indicators (QI) for laparoscopic Roux-en-Y gastric bypass (LRYGB) to generate validated parameters by which these reports can be evaluated and improved. SETTING: University hospital in Canada. METHODS: A Delphi protocol was used to determine QIs for LRYGB reporting. Bariatric surgeons across Canada were recruited along with key physician stakeholders to participate via a secure web-based platform...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
James B Haddow, Maria Walshe, Dinesh Aggarwal, Ankur Thapar, John Hardman, Jonathan Wilson, Ayo Oshowo, Chetan Bhan, Hasan Mukhtar
We aimed to improve the lead-time and the patient experience of the diagnostic stage of the suspected colorectal cancer pathway. This project worked within the constraints of limited resources and an austere environment. The core team included a project manager trained in quality improvement methodologies. Senior and Fleming's planned change model was used as the overall framework. Baseline data supported the case for change and highlighted targets for improvement. A stakeholder workshop employed social movement theory, lean thinking, experience-based design and patient stories to engage influential leaders and secure support and commitment...
September 2016: Healthcare
Giuditta Mannelli, Lorenzo Cecconi, Oreste Gallo
BACKGROUND: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions macroscopically challenging to identify and distinguish from initial cancerous foci. OBJECT: Different modalities of diagnostic techniques of laryngeal epithelial lesions exist and they do not offer a single system to make a differential diagnosis. Hence, this meta-analysis aimed to synthesize the validity of each single diagnostic tool to improve laryngeal patient management...
October 2016: Critical Reviews in Oncology/hematology
Sebastian Dippold, Manfred Nusseck, Bernhard Richter, Matthias Echternach
In the cases of uncertainty, even if the patient has no complaints about his voice quality, sometimes, benign vocal fold mass lesions are removed to exclude malignancy with the risk of resultant dysphonia. Narrow Band Imaging (NBI) enables a specific visualization of vessel structures in the superficial tissue. Benign lesions of the larynx are frequently characterized by abnormal vessel configuration or an absence of vessels in the area of the lesion. It was hypothesized that, in the primary diagnosis of patients with these benign lesions, the combination of white light and NBI endoscopy enables a better detection compared with white light endoscopy alone...
September 8, 2016: European Archives of Oto-rhino-laryngology
Ulrike W Denzer
BACKGROUND: The verbalisation of quality standards and parameters by medical societies are relevant for qualitative improvement but may also be an instrument to demand more resources for health care or be a unique characteristic. Within the health care system 3 different quality levels can be defined: structure, process and result quality. METHODS: The current S2k guideline of the German Society for Gastroenterology (quality requirements for gastrointestinal endoscopy) AWMF registry no...
February 2016: Visc Med
Mubin I Syed, Kamal Morar, Azim Shaikh, Paul Craig, Omar Khan, Sumeet Patel, Hooman Khabiri
PURPOSE: To report 6-month safety and efficacy results of a pilot study of left gastric artery (LGA) embolization for the treatment of morbid obesity (ie, body mass index [BMI] > 40 kg/m(2)). MATERIALS AND METHODS: Four white patients (three women; average age, 41 y [range, 30-54 y]; mean weight, 259.3 lbs [range, 199-296 lbs]; mean BMI, 42.4 kg/m(2) [range, 40.2-44.9 kg/m(2)]) underwent an LGA embolization procedure with 300-500-µm Bead Block particles via right common femoral or left radial artery approach...
October 2016: Journal of Vascular and Interventional Radiology: JVIR
Dong-Hoon Yang
No abstract text is available yet for this article.
September 15, 2016: Gut and Liver
Giovanni Favero, Cristina Anton, Xin Le, Alexandre Silva E Silva, Nasuh Utku Dogan, Tatiana Pfiffer, Christhardt Köhler, Edmund Chada Baracat, Jesus Paula Carvalho
BACKGROUND: Laparoscopy is considered the method of choice in the operative treatment of type I endometrial carcinoma (EC). However, there is a paucity of data regarding the safety of endoscopy for type II EC because these malignancies have several biological similarities with ovarian cancer. OBJECTIVES: This study aimed to evaluate the feasibility, operative outcomes, and oncologic safety of laparoscopic surgery in patients with type II EC. METHODS: A retrospective study with histologically confirmed serous or clear-cell EC without peritoneal carcinomatosis treated by laparoscopy (G1) or laparotomy (G2) was conducted...
August 22, 2016: International Journal of Gynecological Cancer
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