Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Gastric Peroral Endoscopic Myotomy (G-POEM) for the Management of Gastroparesis","authors":"Ernesto Robalino Gonzaga ,&nbsp;Peter V. Draganov ,&nbsp;Dennis Yang","doi":"10.1016/j.tige.2023.09.002","DOIUrl":"10.1016/j.tige.2023.09.002","url":null,"abstract":"<div><p><span><span>Gastroparesis is a chronic debilitation condition characterized by delayed gastric emptying. Medically refractory gastroparesis poses a significant burden on patients and the </span>health care<span> system. Managing these patients can be challenging, partly due to the overlap of symptoms with other functional disorders and the lack of a consistent association between symptoms and the degree of gastric dysmotility. Gastric </span></span>peroral endoscopic myotomy (G-POEM) has recently emerged as a novel therapeutic option for managing gastroparesis. This review provides an overview of G-POEM for medically refractory gastroparesis, discussing patient selection, technical aspects of the procedure, clinical outcomes, and future directions.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135760566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Automated, Real-time Adenoma Detection Rate and Colonoscopy Quality Metrics Calculator","authors":"Todd A. Brenner ,&nbsp;Branislav Bujnak ,&nbsp;Matthew Alverson ,&nbsp;Alexandra T. Strauss ,&nbsp;Anmol Singh ,&nbsp;Saowanee Ngamruengphong ,&nbsp;Mouen Khashab ,&nbsp;Vikesh Singh ,&nbsp;Eun Ji Shin ,&nbsp;Venkata S. Akshintala","doi":"10.1016/j.tige.2023.07.004","DOIUrl":"10.1016/j.tige.2023.07.004","url":null,"abstract":"<div><h3>Background and Aims</h3><p><span>High-quality colonoscopy reduces the risk of death from colorectal cancer. The </span>adenoma detection rate (ADR) is the principal measure of colonoscopy quality but is onerous to calculate. We report the development of a fully automated platform for calculation of the ADR and other key colonoscopy quality indicators without the need for manual data entry.</p></div><div><h3>Methods</h3><p>Endoscopy<span> and pathology reports from 6 centers were collected over a 3-month period and collated using a novel data transfer interface. Text-based classification parameters were developed to identify average-risk screening colonoscopies, adenomatous pathology, cecal intubation, and withdrawal time. Automated quality metrics calculators based on these classifications were built into a web-based reporting platform, and the resulting quality metrics were benchmarked against those produced through a manual record review. Confirmation of the calculator's performance was performed in a validation cohort with data collected over a 1-month period, 6 months after the initial study.</span></p></div><div><h3>Results</h3><p>The study included 3809 colonoscopies (mean age 56.1 ± 6.40 years, 53.7% female, 38 endoscopists). The automated calculator yielded an ADR of 45.1% compared with 44.3% on manual review. Correct classification of ADR-qualifying screening colonoscopies was achieved with high predictive value, with a sensitivity of 0.918 and specificity of 1.0. The cecal intubation rate was 95.8%, and the average withdrawal time was 10:05 minutes.</p></div><div><h3>Conclusion</h3><p>We demonstrate the feasibility and performance of a colonoscopy quality reporting platform capable of calculating the ADR and other key metrics using novel, fully automated pathology report integration and a text query-based classification accessible in a wide range of practice settings.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120976849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Channel Scope Multibending Method–Assisted Gastric Endoscopic Submucosal Dissection at the Greater Curvature of the Fundus: A Case Report (With Video)","authors":"Zeyu Wu,&nbsp;Lijuan Mao,&nbsp;Qide Zhang","doi":"10.1016/j.tige.2024.06.005","DOIUrl":"10.1016/j.tige.2024.06.005","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave Imaging as a Diagnostic Tool in Upper Gastrointestinal Endoscopy","authors":"BIBEK SAHA ,&nbsp;POULAMI SAMADDAR ,&nbsp;KEERTHY GOPALAKRISHNAN ,&nbsp;SHIVARAM POIGAI ARUNACHALAM ,&nbsp;PRASAD G. IYER ,&nbsp;CADMAN L. LEGGETT","doi":"10.1016/j.tige.2024.06.007","DOIUrl":"10.1016/j.tige.2024.06.007","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopy and Its Alternatives in Resource-Limited Countries in Africa","authors":"Akwi Asombang ,&nbsp;Purnima Bhat","doi":"10.1016/j.tige.2024.06.004","DOIUrl":"10.1016/j.tige.2024.06.004","url":null,"abstract":"<div><p>Endoscopy service provision in low-income countries is sparse and inadequate to meet patient demands. Although novel endoscopic therapeutics have dramatically changed the way diseases are treated in the developed world, in low-resource countries, even basic services such as upper gastrointestinal (GI) endoscopy and colonoscopy are lacking. The need for endoscopy is apparent with high rates of upper GI bleeding from varices and peptic ulcers, and the rapidly growing rates of inflammatory bowel disease and GI cancers in these regions. There are limited alternatives to endoscopy available and are in general more risky and less efficacious. In Africa, the barriers to endoscopy service provision vary across the continent and serve as a model for challenges to overcome in providing health services in limited-resource environments. Although the clinical need for endoscopy grows, there has not been a parallel growth in the number of trained endoscopists with most regions having only one endoscopist for every 400,000 people. Many countries do not have a formal GI training program. Infrastructure investment remains insufficient, not fit-for-purpose, and endoscopy equipment is not consistently available in many regions. Nevertheless, some units continue to provide endoscopy services in challenging environments, modifying workflow to suit the limited structure, and adapting to local constraints while still trying to maintain endoscopy standards for their patients. The challenges are further amplified in bringing services to remote areas where, in some countries, more than 75% of the population resides, requiring innovative approaches such as mobile endoscopy units. Endoscopy is an essential life-saving medical service that is scarcely available in low-income countries. By examining the challenges to the development of endoscopy services throughout Africa, we hope to understand better the mechanisms by which GI medical services can be optimally delivered in low-and-middle–income countries.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030724000382/pdfft?md5=e3f93ac47df789439541f14697c0563f&pid=1-s2.0-S2590030724000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950404","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":"Utilization of a Small-Caliber Balloon Dilator for Endoscopic Ultrasound-Guided Hepaticogastrostomy Creation: Case Series","authors":"Mark Hanscom ,&nbsp;Courtney Stead ,&nbsp;Harris Feldman ,&nbsp;Dhruval Amin ,&nbsp;Neil B. Marya","doi":"10.1016/j.tige.2023.08.001","DOIUrl":"10.1016/j.tige.2023.08.001","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128061735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Through-the-scope Sutures for Complex Tissue Apposition: A Series of Novel Cases","authors":"Calvin X. Geng ,&nbsp;Jagannath Kadiyala ,&nbsp;Ross C.D. Buerlein ,&nbsp;Vanessa M. Shami ,&nbsp;Andrew Y. Wang ,&nbsp;Alexander Podboy","doi":"10.1016/j.tige.2023.09.003","DOIUrl":"10.1016/j.tige.2023.09.003","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135408192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps and Improvement Opportunities in Post-colonoscopy Communication","authors":"Paolo R. Ramirez ,&nbsp;Andrew A. Pineda ,&nbsp;Andrew W. Schultz ,&nbsp;Michael Mayo Smith ,&nbsp;Audrey H. Calderwood","doi":"10.1016/j.tige.2023.10.001","DOIUrl":"10.1016/j.tige.2023.10.001","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Training in the African Context","authors":"","doi":"10.1016/j.tige.2024.05.001","DOIUrl":"10.1016/j.tige.2024.05.001","url":null,"abstract":"<div><p>The need for endoscopic service has been well established within gastroenterology globally, and it is equally critical in areas with limited resources. We highlight the educational situation in underserved areas, pertinent goals to aim for, current initiatives and programs, as well as limitations and potential for improvement. Gastroenterology training for medical and surgical endoscopists includes variable components of basic and advanced endoscopies. Various models for training have been used, including traditional 1- to 3-year fellowships, short courses for upskilling, exchange programs, bolus or apprenticeship training, and training camps. There is a steadily increasing demand for endoscopic procedures in the region. We highlight the successes and challenges of current models, which are at various levels, including trainee, institutional, and even geopolitical. In addition, we explore the role that national and international societies as well as industry partners and other stakeholders play in influencing and implementing training. Given the diversity in access to resources as well as endoscopic capacity, we also highlight some of the innovative ways that have been used to provide and continue endoscopy training. Successful training also involves curriculum development, adoption of guidelines, and discussions on assessment of competency as well as having a glimpse into the future of endoscopy training in resource-limited settings. Ultimately, the goal is to ensure harmonized and quality training efforts across the various settings.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030724000321/pdfft?md5=c4837c18881f5fb0b81403fbfac72359&pid=1-s2.0-S2590030724000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134839","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":"Efficacy and Predictors of Success of Esophageal Hydraulic Balloon Dilation in Patients With and Without Previous Foregut Surgery","authors":"Anh D. Nguyen ,&nbsp;Austin Dickerson ,&nbsp;Jesse Zhang ,&nbsp;Ashton Ellison ,&nbsp;Chanakyaram A. Reddy ,&nbsp;Daisha J. Cipher ,&nbsp;Rhonda F. Souza ,&nbsp;Stuart J. Spechler ,&nbsp;Vani JA Konda","doi":"10.1016/j.tige.2023.12.002","DOIUrl":"10.1016/j.tige.2023.12.002","url":null,"abstract":"<div><h3>Background and Aims</h3><p>The advantages of esophageal hydraulic balloon dilation<span><span> include the ability to dilate up to 30 mm without fluoroscopic guidance and real-time display of the esophagogastric junction diameter during dilation. We aimed to explore the safety and efficacy of esophageal hydraulic balloon dilation in patients with and without previous </span>foregut surgery, as well as to evaluate for predictors of clinical success.</span></p></div><div><h3>Methods</h3><p>We reviewed our database for patients who had esophageal hydraulic balloon dilation, and patients were divided into those with and without previous foregut surgery. Clinical success was determined by improvement in Eckardt/Brief Esophageal Dysphagia<span> Questionnaire scores or, if not available, by physician assessment documented in the medical records<span><span>. Technical success was defined as the ability to successfully perform esophageal hydraulic balloon dilation with visualization of the waist and stabilization of the balloon. Univariate analysis and </span>logistic regression were used to evaluate predictors of clinical success after dilation.</span></span></p></div><div><h3>Results</h3><p>Among 80 patients who had esophageal hydraulic balloon dilation (36 without and 44 with previous foregut surgery), clinical success was achieved in 48% of patients without previous foregut surgery (43% in achalasia<span> and 73% in esophagogastric junction outflow obstruction) and 83% of patients with previous foregut surgery (87% in surgically treated achalasia and 80% in patients without achalasia with previous fundoplication). Technical success was achieved in 86% of patients without previous foregut surgery and 98% in patients with previous foregut surgery. There was 1 esophageal perforation (1.3%). Opiate use was a negative predictor of clinical success.</span></p></div><div><h3>Conclusion</h3><p>Clinical success rates after esophageal hydraulic balloon dilation differ depending on the patient's foregut surgery history. Opiate users appear to have a lower clinical success rate compared with nonusers.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139013664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}