World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Study of wrist-ankle acupuncture therapy for optimizing anaesthesia scheme of painless gastroscopy and improving painless gastroscopy related complications.","authors":"Li-Yan Zheng, Sui-Cai Mi, Ling-Yan Wu, Zheng-Jin Xu, Hao Lu","doi":"10.4253/wjge.v15.i2.56","DOIUrl":"10.4253/wjge.v15.i2.56","url":null,"abstract":"<p><strong>Background: </strong>Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice. Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia. In clinical work, adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients. With the increase in propofol dosage, the risk of serious adverse drug reactions, such as respiratory depression and hypotension, increases significantly; the use of opioids often causes gastrointestinal reactions in patients after examination, such as nausea, vomiting, delayed recovery of gastrointestinal function and other complications, which seriously affect their quality of life.</p><p><strong>Aim: </strong>To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.</p><p><strong>Methods: </strong>Two hundred patients were selected and randomly divided into a treatment group (<i>n</i> = 100) and a control group (<i>n</i> = 100). Both groups were routinely anaesthetized with the nalbuphine and propofol regimen, gastroscopy began after the patient lost consciousness, and given supportive treatment and vital sign monitoring. If the patient interrupted the surgery due to intraoperative torsion, intravenous propofol was used to relieve his or her discomfort. The treatment group received wrist-ankle acupuncture on this basis.</p><p><strong>Results: </strong>The general data before treatment, American Society of Anesthesiologist (ASA) grade and operation time between the two groups was no significant difference. The Wakeup time, and the Self-ambulation time in the treatment group was significantly faster than that in the control group (<i>P</i> < 0.05). The total dose of propofol in the treatment group was 109 ± 8.17 mg, significantly lower than that in the control group (<i>P</i> < 0.05). The incidence of respiratory depression and hypotension was not significantly different, but the incidence of hiccups was significantly lower than that in the control group (<i>P</i> < 0.05). After the examination, the incidence of nausea, vomiting, abdominal distension, and abdominal pain was 11%, 8%, 6%, and 5%, respectively, which was significantly lower than that in the control group (<i>P</i> < 0.05). In addition, both the operators and the patients were more satisfied with this examination, with no significant difference between the groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme, reduces propofol total dose; shortens patient Wakeup time and Self-ambulation time, improves patient compliance and tolerance, is beneficial to clinical application.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 2","pages":"56-63"},"PeriodicalIF":1.4,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/d6/WJGE-15-56.PMC10011893.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9130686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stenting as a bridge to surgery in obstructing colon cancer: Long-term recurrence pattern and competing risk of mortality.","authors":"Aik Yong Chok,&nbsp;Yun Zhao,&nbsp;Hui Jun Lim,&nbsp;Yvonne Ying Ru Ng,&nbsp;Emile John Kwong Wei Tan","doi":"10.4253/wjge.v15.i2.64","DOIUrl":"https://doi.org/10.4253/wjge.v15.i2.64","url":null,"abstract":"<p><strong>Background: </strong>Stenting as a bridge to curative surgery (SBTS) for obstructing colon cancer (OCC) has been associated with possibly worse oncological outcomes.</p><p><strong>Aim: </strong>To evaluate the recurrence patterns, survival outcomes, and colorectal cancer (CRC)-specific death in patients undergoing SBTS for OCC.</p><p><strong>Methods: </strong>Data from 62 patients undergoing SBTS at a single tertiary centre over ten years between 2007 and 2016 were retrospectively examined. Primary outcomes were recurrence patterns, overall survival (OS), cancer-specific survival (CSS), and CRC-specific death. OS and CSS were estimated using the Kaplan-Meier curves. Competing risk analysis with cumulative incidence function (CIF) was used to estimate CRC-specific mortality with other cause-specific death as a competing event. Fine-Gray regressions were performed to determine prognostic factors of CRC-specific death. Univariate and multivariate subdistribution hazard ratios and their corresponding Wald test <i>P</i> values were calculated.</p><p><strong>Results: </strong>28 patients (45.2%) developed metastases after a median period of 16 mo. Among the 18 patients with single-site metastases: Four had lung-only metastases (14.3%), four had liver-only metastases (14.3%), and 10 had peritoneum-only metastases (35.7%), while 10 patients had two or more sites of metastatic disease (35.7%). The peritoneum was the most prevalent (60.7%) site of metastatic involvement (17/28). The median follow-up duration was 46 mo. 26 (41.9%) of the 62 patients died, of which 16 (61.5%) were CRC-specific deaths and 10 (38.5%) were deaths owing to other causes. The 1-, 3-, and 5-year OS probabilities were 88%, 74%, and 59%; 1-, 3-, and 5-year CSS probabilities were 97%, 83%, and 67%. The highest CIF for CRC-specific death at 60 mo was liver-only recurrence (0.69). Liver-only recurrence, peritoneum-only recurrence, and two or more recurrence sites were predictive of CRC-specific death.</p><p><strong>Conclusion: </strong>The peritoneum was the most common metastatic site among patients undergoing SBTS. Liver-only recurrence, peritoneum-only recurrence, and two or more recurrence sites were predictors of CRC-specific death.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 2","pages":"64-76"},"PeriodicalIF":2.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/2a/WJGE-15-64.PMC10011892.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buried bumper syndrome: A critical analysis of endoscopic release techniques.","authors":"Alexandra Menni,&nbsp;Georgios Tzikos,&nbsp;George Chatziantoniou,&nbsp;Persefoni Gionga,&nbsp;Theodosios S Papavramidis,&nbsp;Anne Shrewsbury,&nbsp;George Stavrou,&nbsp;Katerina Kotzampassi","doi":"10.4253/wjge.v15.i2.44","DOIUrl":"https://doi.org/10.4253/wjge.v15.i2.44","url":null,"abstract":"<p><p>Buried bumper syndrome (BBS) is the situation in which the internal bumper of the gastrostomy tube, due to prolonged compression of the tissues between the external and the internal bumper, migrates from the gastric lumen into the gastric wall or further, into the tract outside the gastric lumen, ending up anywhere between the stomach mucosa and the surface of the skin. This restricts liquid food from entering the stomach, since the internal opening is obstructed by gastric mucosal overgrowth. We performed a comprehensive search of the PubMed literature to retrieve all the case-reports and case-series referring to BBS and its management, after which we focused on the endoscopic techniques for releasing the internal bumper to re-establish the functionality of the tube. From the \"push\" and the \"push and pull T\" techniques to the most sophisticated-using high tech instruments, all 10 published techniques have been critically analysed and the pros and cons presented, in an effort to optimize the criteria of choice based on maximum efficacy and safety.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 2","pages":"44-55"},"PeriodicalIF":2.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/d0/WJGE-15-44.PMC10011891.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic treatment and management of rectal neuroendocrine tumors less than 10 mm in diameter.","authors":"Xiao-Xin Ma,&nbsp;Li-Sheng Wang,&nbsp;Luo-Lin Wang,&nbsp;Ting Long,&nbsp;Zheng-Lei Xu","doi":"10.4253/wjge.v15.i2.19","DOIUrl":"https://doi.org/10.4253/wjge.v15.i2.19","url":null,"abstract":"<p><p>Rectal neuroendocrine tumors (rNETs) measuring less than 10 mm in diameter are defined as small rNETs. Due to the low risk of distant invasion and metastasis, endoscopic treatments, including modified endoscopic mucosal resection, endoscopic submucosal dissection, and other transanal surgical procedures, are effective. This review article proposes a follow-up plan according to the size and histopathology of the tumor after operation.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 2","pages":"19-31"},"PeriodicalIF":2.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/25/WJGE-15-19.PMC10011890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9137664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic fluorescent lymphography for gastric cancer.","authors":"Calcedonio Calcara,&nbsp;Sila Cocciolillo,&nbsp;Ylenia Marten Canavesio,&nbsp;Vincenzo Adamo,&nbsp;Silvia Carenzi,&nbsp;Daria Ilenia Lucci,&nbsp;Alberto Premoli","doi":"10.4253/wjge.v15.i2.32","DOIUrl":"https://doi.org/10.4253/wjge.v15.i2.32","url":null,"abstract":"<p><p>Lymphography by radioisotope or dye is a well-known technique for visualizing the lymphatic drainage pattern in a neoplastic lesion and it is in use in gastric cancer. Indocyanine green (ICG) more recently has been validated in fluorescent lymphography studies and is under evaluation as a novel tracer agent in gastric cancer. The amount and dilution of ICG injected as well as the site and the time of the injection are not standardized. In our unit, endoscopic submucosal injections of ICG are made as 0.5 mg in 0.5 mL at four peritumoral sites the day before surgery (for a total of 2.0 mg in 2.0 mL). Detection instruments for ICG fluorescence are evolving. Near-infrared systems integrated into laparoscopic or robotic instruments (near-infrared fluorescence imaging) have shown the most promising results. ICG fluorescence recognizes the node that receives lymphatic flow directly from a primary tumor. This is defined as the sentinel lymph node, and it has a high predictive negative value at the cT1 stage, able to reduce the extent of gastrectomy and lymph node dissection. ICG also enhances the number of lymph nodes detected during extended lymphadenectomy for advanced gastric cancer. Nevertheless, the practical effects of ICG use in a single patient are not yet clear. Standardization of the technique and further studies are needed before fluorescent lymphography can be used extensively worldwide. Until then, current guidelines recommend an extensive lymphadenectomy as the standard approach for gastric cancer with suspected metastasis.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 2","pages":"32-43"},"PeriodicalIF":2.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/fb/WJGE-15-32.PMC10011894.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9137667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric cancer in 2022: Is there still a role for endoscopic ultrasound?","authors":"Gemma Rossi,&nbsp;Maria Chiara Petrone,&nbsp;Andrew J Healey,&nbsp;Paolo Giorgio Arcidiacono","doi":"10.4253/wjge.v15.i1.1","DOIUrl":"https://doi.org/10.4253/wjge.v15.i1.1","url":null,"abstract":"<p><p>Gastric cancer (GC) represents the fourth leading cause of cancer death worldwide and many factors can influence its development (diet, geographic area, genetic, Helicobacter pylori or Epstein-Barr virus infections). High quality endoscopy represents the modality of choice for GC diagnosis. The correct morphologic classification during a high-resolution endoscopy is fundamental for oncologic diagnosis, staging and therapeutic decisions. Since its initial introduction in clinical practice the endoscopic ultrasound (EUS) has been considered a valuable tool for tumor (T-) and lymph nodes (N-) staging also in GC, in order to establish the best therapeutic strategy for the patient (<i>e.g.</i>, upfront surgery <i>vs</i> neoadjuvant treatments). EUS tools as elastography, Doppler and contrast administration can improve diagnosis mainly in case of malignant lymph node evaluation. EUS has a marginal role in disease staging but has a fundamental role in case of a pre-endoscopic resection management and in the new era of endoscopic mucosal resection or submucosal dissection as minimally invasive surgery. Diagnosis and locoregional staging of GC with EUS are a method of inarguable value for the assessment of gastric wall involvement and presence of infiltrated paragastric lymph nodes. EUS can also have a role in disease restaging in those patients who have undergone neoadjuvant treatment. EUS can also have a role in the advanced phases of the disease, in facilitating palliative, minimally-invasive treatments, such as gastroenterostomy or biliary drainages. This review intends to discuss the modern role of EUS in GC topic.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 1","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/3d/WJGE-15-1.PMC9846830.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10573281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier's disease with an underlying lipoma: A case report.","authors":"Michal Kmiecik,&nbsp;Aleksandra Walczak,&nbsp;Pawel Samborski,&nbsp;Jacek Paszkowski,&nbsp;Agnieszka Dobrowolska,&nbsp;Jacek Karczewski,&nbsp;Ewelina Swora-Cwynar","doi":"10.4253/wjge.v15.i1.10","DOIUrl":"https://doi.org/10.4253/wjge.v15.i1.10","url":null,"abstract":"<p><strong>Background: </strong>Ménétrier's disease is a rare condition characterized by enlarged gastric folds, usually located in the whole body and fundus of the stomach. This report presents an unusual case of localized Ménétrier's disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding. The mass was successfully removed with endoscopic submucosal dissection.</p><p><strong>Case summary: </strong>Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding, manifesting as fatigue and melena. A large polypoid mass (4 cm × 1 cm) with enlarged mucosal folds was found in the body of the stomach, between the lesser curvature and posterior wall. A small ulcer at the distal end of the mass was identified as the source of the bleeding. Biopsy was negative for neoplasia. Computed tomography showed a submucosal lesion beneath the affected mucosa, most likely a lipoma. The mass was removed <i>en bloc</i> with tunneling endoscopic submucosal dissection. Final pathology determined that the mass included Ménétrier's disease and a submucosal lipoma. The patient was scheduled for follow-up esophagogastroduodenoscopy.</p><p><strong>Conclusion: </strong>Localized Ménétrier's disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 1","pages":"10-18"},"PeriodicalIF":2.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/31/WJGE-15-10.PMC9846829.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10580074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our initial single port robotic cholecystectomy experience: A feasible and safe option for benign gallbladder diseases.","authors":"Huseyin Kemal Rasa,&nbsp;Ayhan Erdemir","doi":"10.4253/wjge.v14.i12.769","DOIUrl":"https://doi.org/10.4253/wjge.v14.i12.769","url":null,"abstract":"<p><strong>Background: </strong>Although single-port laparoscopic cholecystectomy has been performed for over 25 years, it is still not popular. The narrow working space used in this surgery limits the movement of instruments and causes ergonomic challenges. Robotic surgery not only resolves the ergonomic challenges of single-port laparoscopic surgery but is also considered a good option with its additional technical advantages, like a three-dimensional display and not being affected by tremors. However, the extent to which these technical and ergonomic advantages positively affect the surgical outcomes and how safe the single-port robotic surgeries need to be assessed for each particular surgery.</p><p><strong>Aim: </strong>To evaluate the feasibility and safety of single-port robotic cholecystectomy for patients with cholelithiasis.</p><p><strong>Methods: </strong>The electronic records of the first 40 consecutive patients with gallbladder lithiasis who underwent single-port robotic cholecystectomy from 2013 to 2021 were analyzed retrospectively. In addition to the demographic characteristics of the patients, we analyzed American Society of Anesthesiologists (ASA) scores and body mass index. The presence of an accompanying umbilical hernia was also noted. The amount of blood loss during the operation, the necessity to place a drain in the subhepatic area, and the need to use grafts during the closure of the fascia of the port site were determined. Hospital stay, readmission rates, perioperative and postoperative complications, the Clavien-Dindo complication scores and postoperative analgesia requirements were also evaluated.</p><p><strong>Results: </strong>The mean age of the 40 patients included in the study was 49.5 ± 11.6 years, and 26 were female (65.0%). The umbilical hernia was present in 24 (60.0%) patients, with a body mass index median of 29.3 kg/m² and a mean of 29.7 ± 5.2 kg/m². Fifteen (37.5%) of the patients were evaluated as ASA I, 18 (45.0%) as ASA II, and 7 (17.5%) as ASA III. The mean bleeding amount during the operation was 58.4 ± 55.8 mL, and drain placement was required in 12 patients (30.0%). After port removal, graft reinforcement during fascia closure was preferred in 14 patients (35.0%). The median operation time was 93.5 min and the mean was 101.2 ± 27.0 min. The mean hospital stay was 1.4 ± 0.6 d, and 1 patient was readmitted to the hospital due to pain (2.5%). Clavien-Dindo I complications were seen in 14 patients (35.0%), and five (12.5%) complications were wound site problems.</p><p><strong>Conclusion: </strong>In addition to the technological and ergonomic advantages robotic surgery provides surgeons, our study strongly supports that single-port robotic cholecystectomy is a feasible and safe option for treating patients with gallstones.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"14 12","pages":"769-776"},"PeriodicalIF":2.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/58/WJGE-14-769.PMC9782565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-flow oxygen <i>via</i> oxygenating mouthguard in short upper gastrointestinal endoscopy: A randomised controlled trial.","authors":"Kim Hay Be,&nbsp;Leonardo Zorron Cheng Tao Pu,&nbsp;Brett Pearce,&nbsp;Matthew Lee,&nbsp;Luke Fletcher,&nbsp;Rebecca Cogan,&nbsp;Philip Peyton,&nbsp;Rhys Vaughan,&nbsp;Marios Efthymiou,&nbsp;Sujievvan Chandran","doi":"10.4253/wjge.v14.i12.777","DOIUrl":"https://doi.org/10.4253/wjge.v14.i12.777","url":null,"abstract":"<p><strong>Background: </strong>Anaesthetic care during upper gastrointestinal (GI) endoscopy has the unique challenge of maintaining ventilation and oxygenation <i>via</i> a shared upper airway. Supplemental oxygen is recommended by international society guidelines, however, the optimal route or rate of oxygen delivery is not known. Various oxygen delivery devices have been investigated to improve oxygenation during upper GI endoscopy, however, these are limited by commercial availability, costs and in some cases, the expertise required for insertion. Anecdotally at our centre, higher flows of supplemental oxygen can safely be delivered <i>via</i> an oxygenating mouthguard routinely used during upper GI endoscopic procedures.</p><p><strong>Aim: </strong>To assess the incidence of hypoxaemia (SpO₂ < 90%) in patients undergoing upper GI endoscopy receiving supplemental oxygen using an oxygenating mouthguard at 20 L/min flow compared to standard nasal cannula (SNC) at 2 L/min flow.</p><p><strong>Methods: </strong>A single centre, prospective, randomised clinical trial at two sites of an Australian tertiary hospital between October 2020 and September 2021 was conducted. Patients undergoing elective upper gastrointestinal endoscopy under deep sedation were randomised to receive supplemental oxygen <i>via</i> high-flow <i>via</i> oxygenating mouthguard (HFMG) at 20 L/min flow or SNC at 2 L/min flow. The primary outcome was the incidence of hypoxaemia of any duration measured by pulse oximetry. Intraprocedural-related, procedural-related, and sedation-related adverse events and patient-reported outcomes were also recorded.</p><p><strong>Results: </strong>Three hundred patients were randomised. Eight patients were excluded after randomisation. 292 patients were included in the intention-to-treat analysis. The incidence of hypoxaemia was significantly reduced in those allocated HFMG. Six patients (4.4%) allocated to HFMG experienced an episode of hypoxaemia, compared to thirty-four (22.1%) patients allocated to SNC (<i>P</i> value < 0.001). No significant difference was observed in the rates of adverse events or patient-reported outcome measures.</p><p><strong>Conclusion: </strong>The use of HFMG offers a novel approach to reducing the incidence of hypoxaemia during short upper gastrointestinal endoscopic procedures in low-risk patients undergoing deep sedation.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"14 12","pages":"777-788"},"PeriodicalIF":2.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/a2/WJGE-14-777.PMC9782568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study.","authors":"Chikamasa Ichita,&nbsp;Sayuri Shimizu,&nbsp;Akiko Sasaki,&nbsp;Chihiro Sumida,&nbsp;Takashi Nishino,&nbsp;Karen Kimura","doi":"10.4253/wjge.v14.i12.759","DOIUrl":"https://doi.org/10.4253/wjge.v14.i12.759","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend colonoscopy within 24 h for acute lower gastrointestinal bleeding; however, the evidence in support for colonic diverticular hemorrhage (CDH) indications remains insufficient.</p><p><strong>Aim: </strong>To investigate the effectiveness of early colonoscopy on the length of hospital stay for CDH patients.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study. Patients who underwent colonoscopy within 24 h of presentation (early group) were compared with those who underwent colonoscopy beyond 24 h of presentation (elective group). The primary outcome was the length of hospital stay, and secondary outcomes were the identification of stigmata of recent hemorrhage (SRH), rebleeding, red blood cell transfusion more than 4 units, and interventional radiology and abdominal surgery after colonoscopy.</p><p><strong>Results: </strong>We identified 574 CDH cases. Patients were divided into the early (<i>n</i> = 328) and elective (<i>n</i> = 226) groups. After propensity score matching, 191 pairs were generated. The length of hospital stay did not significantly differ between the two groups (early group <i>vs</i> elective group; median, 7 <i>vs</i> 8 d; <i>P</i> = 0.10). The early group had a significantly high identification of SRH (risk difference, 11.6%; 95%CI: 2.7 to 20.3; <i>P</i> = 0.02). No significant differences were found in the rebleeding (risk difference, 4.7%; 95%CI: -4.1 to 13.5; <i>P</i> = 0.35), red blood cell transfusion more than 4 units (risk difference, 1.6%; 95%CI: -7.5 to 10.6; <i>P</i> = 0.82), and interventional radiology and abdominal surgery rate after colonoscopy (risk difference, 0.5%; 95%CI: -2.2 to 3.2; <i>P</i> = 1.00).</p><p><strong>Conclusion: </strong>Early colonoscopy within 24 h, on arrival for CDH, could not improve the length of hospital stay.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"14 12","pages":"759-768"},"PeriodicalIF":2.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/3d/WJGE-14-759.PMC9782567.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}