Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Adenoma-Based Colonoscopy Quality Metrics for the 45–49 Years Old Military Screening Population","authors":"","doi":"10.1016/j.tige.2024.02.002","DOIUrl":"10.1016/j.tige.2024.02.002","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><p><span>With the rising incidence of colorectal cancer in younger individuals, guidelines now recommend initiating average-risk screening at age 45 years. We sought to assess the impact of this younger screening population on established and emerging </span>colonoscopy quality metrics.</p></div><div><h3>METHODS</h3><p>We compared all well-described lesion detection rates by colonic segment removed during initial, average-risk screening colonoscopies in the San Antonio Market military healthcare network from July 2019 to September 2022.</p></div><div><h3>RESULTS</h3><p><span>A total of 2165 colonoscopies met the inclusion criteria, with 755 (34.9%) colonoscopies performed on patients aged 45-49 years old. The detection rates for adenomas<span>, proximal adenomas, advanced adenomas, and adenomas per colonoscopy were lower in the 45-49 years old group (33.4%, 18.7%, 3.8%, and 0.58, respectively) compared with the 50-75 years old group (42.7%, 24.2%, 7.7%, and 1.11, respectively; all </span></span><em>P</em> &lt; 0.05). There was no difference in serrated polyp detection in the 45-49 years old group (11.5%) compared with the 50-75 years old group (12.5%; <em>P</em><span> = 0.287). There were no differences in withdrawal times, cecal intubation<span> rates, or bowel preparation adequacy across age groups.</span></span></p></div><div><h3>CONCLUSION</h3><p>In our screening population, we found that adenoma-based colonoscopy quality metrics were significantly lower in the 45-49 years old population compared to the traditional screening age cohort, while there was no difference in serrated polyp detection. Endoscopists should anticipate a small decline in colonoscopy quality benchmarks as the screening population becomes younger, although these results require validation through multicenter, prospective monitoring.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 3","pages":"Pages 216-223"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271809","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":"26 3","pages":"Pages 283-297"},"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":"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":"26 1","pages":"Pages 2-11"},"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":"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":"26 1","pages":"Pages 46-55"},"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":"Cyst Detection Rate: A Quality Indicator in the Era of Pancreatic Screening Endoscopic Ultrasonography","authors":"","doi":"10.1016/j.tige.2024.04.001","DOIUrl":"10.1016/j.tige.2024.04.001","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 3","pages":"Pages 298-300"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259003072400031X/pdfft?md5=633f2366d471480e7a43eaecfa7dab2d&pid=1-s2.0-S259003072400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141058435","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":"Opportunities for International Collaboration in Resource-Limited Settings: Insights From Africa","authors":"","doi":"10.1016/j.tige.2024.05.003","DOIUrl":"10.1016/j.tige.2024.05.003","url":null,"abstract":"<div><p>International collaborations have significant impacts on patient care, endoscopy education, and research. These collaborations can be mutually enriching for all parties involved. Resource-limited settings may suffer from inadequate infrastructure or expertise to meet societal needs, yet they offer unique opportunities that can benefit collaborating partners. Unfortunately, there is often a lack of clear guidance on how to establish collaborations between professionals in the global South and their European or American counterparts. This review aims to address this issue by describing the key elements of successful partnerships, identifying reasons for failure, highlighting hidden pitfalls, and offering strategies for beneficial and productive collaboration. The review emphasizes the importance of understanding cultural differences and provides recommendations for all parties involved in a collaboration. Our goal is to provide an essential guide for fostering strong, mutually beneficial partnerships in international collaborations between resource-rich and resource-limited settings.</p></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 3","pages":"Pages 261-269"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590030724000345/pdfft?md5=446dbabcc2b18fc837db96b6c8bc4615&pid=1-s2.0-S2590030724000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404031","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":"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":"26 4","pages":"Pages 303-305"},"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":"26 4","pages":"Pages 362-364"},"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":"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":"26 1","pages":"Pages 38-41"},"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":"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":"26 1","pages":"Pages 90-92"},"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}