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Quality improvement endoscopy

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https://www.readbyqxmd.com/read/28318326/optimal-use-of-polyethylene-glycol-for-preparation-of-small-bowel-video-capsule-endoscopy-a-network-meta-analysis
#1
Shan Wu, Yun-Jie Gao, Zhi-Zheng Ge
OBJECTIVE: Standardized strategy of bowel preparation before video capsule endoscopy (VCE) remains controversial. We aimed to assess the ideal dose of PEG based on small bowel visualization quality (SBVQ), diagnostic yield (DY) and complete rate (CR) of VCE using a network meta-analysis (NMA) of randomized controlled trials (RCTs). METHODS: This NMA included RCTs comparing any of the following bowel preparation interventions for VCE: fasting overnight ('Fast'), 1 liter PEG ('PEG 1L'), 2-liter PEG ('PEG 2L'), or 4-liter PEG ('PEG 4L')...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28301778/risk-stratified-versus-non-risk-stratified-diagnostic-testing-for-management-of-suspected-acute-biliary-obstruction-comparative-effectiveness-costs-and-the-role-of-mr-cholangiopancreatography
#2
Stella K Kang, David Hoffman, Bart Ferket, Michelle I Kim, R Scott Braithwaite
Purpose To analyze the cost effectiveness of the American Society for Gastrointestinal Endoscopy (ASGE) risk stratification guidelines versus magnetic resonance (MR) cholangiopancreatography-based treatment of patients with possible choledocholithiasis. Materials and Methods A decision-analytic model was constructed to compare cost and effectiveness of three diagnostic strategies for gallstone disease with possible choledocholithiasis: noncontrast MR cholangiopancreatography, contrast material-enhanced MR imaging/MR cholangiopancreatography, and ASGE risk stratification guidelines for diagnostic evaluation recommending endoscopy (high risk), MR cholangiopancreatography (intermediate risk), or no test (low risk)...
March 16, 2017: Radiology
https://www.readbyqxmd.com/read/28293023/advances-in-image-enhancement-in-colonoscopy-for-detection-of-adenomas
#3
REVIEW
Takahisa Matsuda, Akiko Ono, Masau Sekiguchi, Takahiro Fujii, Yutaka Saito
High-quality colonoscopy is mandatory to prevent adenoma recurrence and colorectal cancer. In the past few years, technical advances have been developed with the purpose of improving adenoma detection rate (ADR), one of the most important validated colonoscopy quality benchmarks. Several techniques or devices are used to optimize visualization: observation techniques; add-on devices; auxiliary imaging devices; colonoscopes with increased field of view; and colonoscopes with an integrated inflatable reusable balloon...
March 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28277483/endoscopy-assisted-ear-surgery-for-treatment-of-chronic-otitis-media-with-cholesteatoma-adhesion-or-retraction-pockets
#4
Cagatay Han Ulku
The objective of this study was to analyze the results of endoscopy-assisted ear surgery for the treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets.Fifty-one patients who underwent oto-endoscopy-assisted canal wall up tympanomastoid surgery and/or limited anterior atticotomy with tympanoplasty for chronic otitis media with cholesteatoma, adhesion, or retraction pocket from 2006 to 2013 have been included in this study. Eradication of the disease from the middle ear and mastoid air cells was achieved by combination of the oto-microscobic and oto-endoscopic approaches...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28275307/effects-of-hydrotalcite-combined-with-esomeprazole-on-gastric-ulcer-healing-quality-a-clinical-observation-study
#5
Rui-Qi Yang, Hua Mao, Li-Yun Huang, Pei-Zhu Su, Min Lu
AIM: To evaluate the effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality. METHODS: Forty-eight patients diagnosed with gastric ulcer between June 2014 and February 2016 were randomly allocated to the combination therapy group or monotherapy group. The former received hydrotalcite combined with esomeprazole, and the latter received esomeprazole alone, for 8 wk. Twenty-four healthy volunteers were recruited and acted as the healthy control group...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28268235/performance-measures-for-lower-gastrointestinal-endoscopy-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#6
Michal F Kaminski, Siwan Thomas-Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garborg, James E East, Maciej Rupinski, Birgitte Seip, Cathy Bennett, Carlo Senore, Silvia Minozzi, Raf Bisschops, Dirk Domagk, Roland Valori, Cristiano Spada, Cesare Hassan, Mario Dinis-Ribeiro, Matthew D Rutter
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 Rate of adequate bowel preparation (minimum standard 90 %); 2 Cecal intubation rate (minimum standard 90 %); 3 Adenoma detection rate (minimum standard 25 %); 4 Appropriate polypectomy technique (minimum standard 80 %); 5 Complication rate (minimum standard not set); 6 Patient experience (minimum standard not set); 7 Appropriate post-polypectomy surveillance recommendations (minimum standard not set)...
March 7, 2017: Endoscopy
https://www.readbyqxmd.com/read/28267035/interventions-for-healthcare-professionals-organizations-and-patients-to-enhance-quality-of-life-for-people-diagnosed-with-palliative-esophagogastric-cancer-a-systematic-review
#7
Alison Cowley, Fiona Bath-Hextall, Joanne Cooper
BACKGROUND: Esophagogastric (EG) cancer is the fifth most common malignancy, and its incidence is increasing. The disease is fast paced, and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence into the most effective service models to support EG cancer patients. OBJECTIVES: The overall objective of this quantitative systematic review was to establish best practice in relation to interventions targeted at healthcare professionals or the structures in which healthcare professionals deliver care (i...
March 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28249809/opportunities-for-improvement-in-the-contemporary-management-of-acute-variceal-hemorrhage-a-systematic-review-of-observational-studies
#8
REVIEW
Elliot B Tapper, Lauren Beste, Michael Curry, Alan Bonder, Akbar Waljee, Sameer Saini
BACKGROUND AND AIMS: Gastroenterologists should strive to improve the outcomes associated with acute variceal hemorrhage (AVH) by optimizing care delivery and clinician preparedness through training. Unfortunately, data regarding contemporary outcomes and management of AVH are limited. METHODS: We performed a systematic review of cohort studies examining outcomes and management of AVH from January 1990 to September 2016. We pooled data on mortality and utilization of medical therapy, endoscopic interventions, balloon tamponade (BT), and salvage procedures (portal decompressive surgery or transjugular portosystemic shunt (TIPS))...
February 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28244948/safety-of-large-volume-same-day-oral-bowel-preparations-during-deep-sedation-a-prospective-observational-study
#9
Kanwarpreet Tandon, Charl Khalil, Fernando Castro, Alison Schneider, Mosaab Mohameden, Seifeldin Hakim, Kinchit Shah, Chau To, Colin O'Rourke, Jeffrey Jacobs
BACKGROUND: Colonoscopy quality is directly related to the bowel preparation. It is well established that bowel preparations are improved when at least part of the laxative is ingested on the day of the procedure. However, there is concern that this can result in higher gastric residual volumes (GRV) and increase the risk of pulmonary aspiration. The aim of this study is to evaluate GRV and gastric pH in patients who received day-before bowel preparation versus those ingesting their laxative on the day of colonoscopy under anesthesiologist-directed propofol deep sedation...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28195823/clinical-safety-of-bariatric-arterial-embolization-preliminary-results-of-the-beat-obesity-trial
#10
Clifford R Weiss, Olaguoke Akinwande, Kaylan Paudel, Lawrence J Cheskin, Brian Holly, Kelvin Hong, Aaron M Fischman, Rahul S Patel, Eun J Shin, Kimberley E Steele, Timothy H Moran, Kristen Kaiser, Amie Park, David M Shade, Dara L Kraitchman, Aravind Arepally
Purpose To conduct a pilot prospective clinical trial to evaluate the feasibility, safety, and short-term efficacy of bariatric embolization, a recently developed endovascular procedure for the treatment of obesity, in patients with severe obesity. Materials and Methods This is an institutional review board- and U.S. Food and Drug Administration-approved prospective physician-initiated investigational device exemption study. This phase of the study ran from June 2, 2014, to August 4, 2015. Five severely obese patients (four women, one man) who were 31-49 years of age and who had a mean body mass index of 43...
February 14, 2017: Radiology
https://www.readbyqxmd.com/read/28191498/a-prospective-study-of-patient-safety-incidents-in-gastrointestinal-endoscopy
#11
Manmeet Matharoo, Adam Haycock, Nick Sevdalis, Siwan Thomas-Gibson
Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs). Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28179979/flexible-gastro-intestinal-endoscopy-clinical-challenges-and-technical-achievements
#12
REVIEW
Niehls Kurniawan, Martin Keuchel
Flexible gastro-intestinal (GI) endoscopy is an integral diagnostic and therapeutic tool in clinical gastroenterology. High quality standards for safety, patients' comfort, and efficiency have already been achieved. Clinical challenges and technical approaches are discussed in this short review. Image enhanced endoscopy for further characterization of mucosal and vascular patterns includes dye-spray or virtual chromoendoscopy. For confocal laser endoscopy, endocytoscopy, and autofluorescence clinical value has not yet been finally evaluated...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28161449/outcomes-and-quality-of-life-assessment-after-gastric-per-oral-endoscopic-pyloromyotomy-with-video
#13
Sunil Dacha, Parit Mekaroonkamol, Lianyong Li, Nikrad Shahnavaz, Sonali Sakaria, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
BACKGROUND AND AIM: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is emerging as a promising option for the treatment of gastroparesis. This study assessed outcomes and quality of life after GPOEM for gastroparesis, performed in an endoscopy unit at a major tertiary referral center. METHODS: We performed a retrospective review of patients who had undergone GPOEM from June 2015 to July 2016. Data were collected from electronic medical records and included patient demographics, endoscopy records, hospitalization records, clinic visits, and electronic messages...
February 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28120058/endoscopic-reconstruction-of-csf-pathways-in-ventricular-tumors
#14
Piero Andrea Oppido
Neuroendoscopy is now considered to be a minimally invasive surgical approach for expanding lesions bulging into the ventricle, and it is also considered to be a relevant tool for performing biopsy procedures, fenestration of cystic walls, or for performing tumor removal in selected cases. Furthermore, the use of neuroimaging and the accurate follow-up of brain tumor patients have allowed the documentation of tumoral and pseudotumoral cystic areas that cause the obstruction of cerebrospinal fluid (CSF) pathways...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28067823/biomarkers-to-monitor-gluten-free-diet-compliance-in-celiac-patients
#15
REVIEW
María de Lourdes Moreno, Alfonso Rodríguez-Herrera, Carolina Sousa, Isabel Comino
Gluten-free diet (GFD) is the only treatment for celiac disease (CD). There is a general consensus that strict GFD adherence in CD patients leads to full clinical and histological remission accompanied by improvement in quality of life and reduced long-term complications. Despite the importance of monitoring the GFD, there are no clear guidelines for assessing the outcome or for exploring its adherence. Available methods are insufficiently accurate to identify occasional gluten exposure that may cause intestinal mucosal damage...
January 6, 2017: Nutrients
https://www.readbyqxmd.com/read/28040500/a-modification-of-nissen-fundoplication-improves-patients-outcome-and-may-reduce-procedure-related-failure-rate
#16
Romeo Bardini, Sabrina Rampado, Renato Salvador, Lisa Zanatta, Imerio Angriman, Silvia Degasperi, Angelica Ganss, Edoardo Savarino
BACKGROUND: Laparoscopic anti-reflux surgery has a failure rate of 10-20%. We aimed to investigate whether a modification of Nissen fundoplication (MNF) may improve patients' outcome and reduce failure rate. MATERIALS & METHODS: We prospectively compared 40 consecutive patients with gastroesophageal reflux disease who underwent anti-reflux surgery: 20 Nissen fundoplication (NF) and 20 the MNF approach. Eight cases in the MNF group needed redo surgery. The MNF consisted in suturing the esophagus to the diaphragmatic crura on each side by means of 4 non-absorbable stitches and in fixing the upper stitch of the valve to diaphragm...
February 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27994617/preliminary-experience-using-full-spectrum-endoscopy-for-colorectal-cancer-screening-matched-case-controlled-study
#17
Sayo Ito, Kinichi Hotta, Kenichiro Imai, Masao Yoshida, Kimihiro Igarashi, Yuichiro Yamaguchi, Kohei Takizawa, Naomi Kakushima, Masaki Tanaka, Noboru Kawata, Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Hiroyuki Ono
Background/Aim. High-quality colonoscopy is needed to reduce the morbidity and mortality of colorectal cancer. Full-spectrum endoscopy (FUSE) has recently shown potential in improving adenoma detection during colonoscopy. This study aimed to evaluate the feasibility and utility of FUSE colonoscopy. Methods. From April 2015 to February 2016, 130 patients underwent FUSE colonoscopy for screening at a tertiary cancer center. Cecal intubation rate (CIR), procedure time, polyp/adenoma detection rate (PDR/ADR), and mean number of adenomas per colonoscopy (APC) were compared in matched-control patients (n = 260) who underwent standard colonoscopy (SC)...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27988287/endoscopic-multiple-biopsy-and-rapid-diagnosis-by-in-situ-fixation-and-histopathologic-processing
#18
David S Zimmon, Fred B Smith, Forrest Manheimer, Cathy Fan, Chantel Njiwaji, Sergei Aksenov, Premtesh Chattoo
BACKGROUND AND AIMS: Endoscopic forceps biopsy and fixation are laborious and prolong the procedure and anesthesia. Multiple biopsy overcomes these shortcomings with a single endoscope pass that cuts, like a needle biopsy, up to 25 biopsy samples of uniform size and depth during endoscope withdrawal. Biopsy specimens are collected in acquisition order and stored in a perforated plastic storage chamber within the perforated metal tip. The tip is cut off, immersed in fixative, and sent to pathology...
December 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27988235/quality-assurance-in-gastrointestinal-endoscopy-an-egyptian-experience
#19
REVIEW
Ahmed S Gado, Basel A Ebeid, Anthony T Axon
Over the last four decades, gastrointestinal endoscopy has become of paramount importance to diagnose, treat and prevent diseases of the digestive tract. Practice variation, however, is likely to have an important effect on the effectiveness of endoscopy and can impair the delivery of high-quality endoscopic procedures. There have been increasing demands to assess the quality of service and track and improve patient outcomes. Quality assurance has paved its way into professional guidelines for physicians. Developing a modern endoscopy unit demands the institution of a quality assurance programme, continuous training and monitoring of service delivery...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27977544/outcomes-from-pediatric-gastroenterology-maintenance-of-certification-using-web-based-modules
#20
Josephine Sheu, Stanford Chun, Emily O'Day, Sara Cheung, Rusvelda Cruz, Jenifer R Lightdale, Douglas S Fishman, Athos Bousvaros, Jeannie S Huang
OBJECTIVES: Beginning in 2013, the North American Society of Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) sponsored and developed subspecialty-field specific quality improvement (QI) activities to provide Part 4 Maintenance of Certification (MOC) credit for ongoing certification of pediatric gastroenterologists by the American Board of Pediatrics (ABP). Each activity was a web-based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change...
December 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
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