Techniques in Gastrointestinal Endoscopy最新文献_第3页

How to decrease the risk of perforation in endoscopic submucosal dissection (ESD) 内镜下粘膜下剥离术(ESD)中如何降低穿孔风险

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.05.001

Sang Gyun Kim MD , Joo Ha Hwang MD, PhD

引用次数: 1

Endoscopic management of perforation, leaks, and fistulas 穿孔、渗漏和瘘管的内镜治疗

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.04.005

Peter D. Siersema MD, PhD, FASGE

引用次数: 1

Novel endoscopic modalities for closure of perforations, leaks, and fistula in the gastrointestinal tract 新型内镜治疗胃肠道穿孔、渗漏和瘘管的方法

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.04.004

Joshua S. Winder MD, Eric M. Pauli MD, FACS, FASGE

引用次数: 6

Endoscopic clip placement for the prevention of perforation after colonic endoscopic mucosal resection 内镜下夹片置入预防结肠内镜黏膜切除术后穿孔

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.04.003

Brian R. Boulay MD, MPH , Simon K. Lo MD, FACP

{"title":"Endoscopic clip placement for the prevention of perforation after colonic endoscopic mucosal resection","authors":"Brian R. Boulay MD, MPH , Simon K. Lo MD, FACP","doi":"10.1016/j.tgie.2019.04.003","DOIUrl":"10.1016/j.tgie.2019.04.003","url":null,"abstract":"<div>Endoscopically placed clips have gained a prominent role in the management of bleeding or perforation during endoscopic mucosal resection of large colonic polyps. Clips may be used to treat intraprocedural complications, but may also be placed prophylactically when patients are at an increased risk for post-procedural bleeding or delayed perforation. Polyp size, location, resection technique, and appearance of the resection defect can all influence the decision on whether to place prophylactic clips. Not all post-polypectomy defects require clip placement. The downsides of clip placement include increased cost and the possibility of “clip artifact” mimicking residual polyp on surveillance examinations. When clipping, attention to proper technique can ensure secure closure of the defect and efficient placement of additional clips. Over-the-scope clips and endoscopic suturing are other strategies which can be used for treatment of bleeding or perforation, though each requires attachment to the scope and training for use.</div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45898870","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}

引用次数: 0

Efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks 内镜下真空治疗结直肠吻合口瘘的疗效观察

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.05.002

Mauro Verra MD, Edoardo Forcignanò MD, Giacomo Lo Secco MD, Alberto Arezzo MD

{"title":"Efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks","authors":"Mauro Verra MD, Edoardo Forcignanò MD, Giacomo Lo Secco MD, Alberto Arezzo MD","doi":"10.1016/j.tgie.2019.05.002","DOIUrl":"10.1016/j.tgie.2019.05.002","url":null,"abstract":"<div>Anastomotic leak is a frequent and a threatening complication following colorectal surgery, and it is associated with early- and long-term morbidity and mortality. Anastomotic leak can be managed with surgical or conservative approaches; clinically stable patients without generalized peritonitis may be managed endoscopically with a view to reducing surgery-related morbidity. A novel minimally invasive approach is the endoscopic vacuum therapy (EVT) that is indicated to treat large anastomotic leaks associated with extraluminal infected cavities. It is based on the application of a local negative pressure inside the extraluminal cavity in order to drain, to induce granulation of the tissue with subsequent leak healing by secondary intention. We performed a review of the literature on the use of EVT in the treatment of colorectal anastomotic leaks. Mean success rate was 81%; the presence of a derivative stoma and early onset of the therapy seem to be positive predicting factor. Few major complications requiring discontinuation of the treatment and no mortality related to the procedure were reported. EVT represents promising alternative to surgery in the treatment of selected cases of anastomotic leak, with few complications and high success rate.</div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46188137","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}

引用次数: 1

Endoscopic treatment of ERCP-related duodenal perforation 内镜下治疗ercp相关十二指肠穿孔

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.04.002

Nicole Evans MD, James L. Buxbaum MD

引用次数: 2

Endoscopic management of esophagorespiratory fistulas 食管呼吸瘘管的内镜治疗

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.03.012

Brian Larson MD, Douglas G. Adler MD, FACG, AGAF, FASGE

{"title":"Endoscopic management of esophagorespiratory fistulas","authors":"Brian Larson MD, Douglas G. Adler MD, FACG, AGAF, FASGE","doi":"10.1016/j.tgie.2019.03.012","DOIUrl":"10.1016/j.tgie.2019.03.012","url":null,"abstract":"<div>Esophagorespiratory fistulas (ERFs) are pathologic communications between the esophagus and respiratory tract. They are devastating conditions of malignant or benign (often iatrogenic) etiologies. Patients with ERF have significantly increased mortality and decreased quality of life. Multiple management options exist for the treatment of ERFs including surgical, endoscopic, and oncologic approaches. Surgical management, with fistula closure and removal of diseased esophageal or pulmonary tissue, is the time-honored treatment of ERF. However, these surgeries are major undertakings and many patients with ERF are poor surgical candidates. As such oncologic and endoscopic therapies are often employed. Many endoscopic therapies exist for the management of ERF and include: esophageal stenting, airway stenting, combined esophageal, and airway stenting, over-the-scope clip placement, cardiac septal occlusion devices, and other novel therapies (argon plasma coagulation, fibrin glue, endoscopic suturing, and polyglycolic acid sheets). These treatments can be employed alone or in combination. Each endoscopic management strategy has its own clinical success rate and adverse events. Although advances in endoscopic techniques have broadened the tools available to treat ERFs; little if any data are available comparing the various endoscopic management strategies. Despite this an experienced clinician may select the appropriate intervention to maximize the risks/benefits of the procedure based on the size, location, and etiology of the fistula.</div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.03.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42556009","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}

引用次数: 2

Endoscopic strategies for the treatment of postbariatric surgery leaks and fistulas 内窥镜治疗减肥术后瘘漏的策略

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.03.011

Dilhana S. Badurdeen MD , Katherine Lamond MD , Alex Gandsas MD, MBA, FACS , Vivek Kumbhari MD

引用次数: 2

Diagnosis and endoscopic treatment of esophageal leakage: a systematic review 食管漏的诊断和内镜治疗:系统回顾

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-04-01 DOI: 10.1016/j.tgie.2019.04.001

Bram D. Vermeulen MD, Peter D. Siersema MD, PhD

{"title":"Diagnosis and endoscopic treatment of esophageal leakage: a systematic review","authors":"Bram D. Vermeulen MD, Peter D. Siersema MD, PhD","doi":"10.1016/j.tgie.2019.04.001","DOIUrl":"10.1016/j.tgie.2019.04.001","url":null,"abstract":"<div>When esophageal leakage is suspected, diagnostic work-up usually starts with endoscopy followed by CT of the thorax. Clinicians should consider esophageal leakage a clinical emergency as early diagnosis and treatment are associated with improved outcome. Upon diagnosis, acute therapeutic management in a specialized center with appropriate multidisciplinary infrastructure and expertise is indicated as innovative endoscopic treatment options have become reasonable alternatives to invasive surgical interventions. Promising endoscopic treatment options include esophageal stent placement, endoscopic vacuum therapy, and over-the-scope clip placement. In effort to evaluate the current literature, a systematic literature search was performed on studies reporting clinical outcome of patients treated with these endoscopic treatment options for benign esophageal perforations and anastomotic leakage. The systematic search yielded 15 studies (932 patients) discussing stent placement, 14 studies (295 patients) discussing endoscopic vacuum therapy, and 8 studies (41 patients) discussing over-the-scope clip placement. Clinical success was achieved in the majority of all patients. However, the studies predominantly consisted of small single-center retrospective case series. Careful selection of patients is therefore recommended when considering endoscopic therapy for esophageal leakage. Furthermore, clinical tools may aid in predicting patients’ prognosis and selection of patients that could benefit from endoscopic therapy. In the future, randomized studies comparing available endoscopic treatment options are needed to guide treatment choice for patients with esophageal leakage in daily clinical practice.</div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44507975","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}

引用次数: 2

Combined surgical and endoscopic approaches to full-thickness resection 全层切除术的外科和内镜联合入路

Techniques in Gastrointestinal Endoscopy Pub Date : 2019-01-01 DOI: 10.1016/j.tgie.2019.03.004

Thomas C. Tsai MD, MPH, Ozanan R. Meireles MD

{"title":"Combined surgical and endoscopic approaches to full-thickness resection","authors":"Thomas C. Tsai MD, MPH, Ozanan R. Meireles MD","doi":"10.1016/j.tgie.2019.03.004","DOIUrl":"10.1016/j.tgie.2019.03.004","url":null,"abstract":"<div>With the emergence of advanced endoscopic technologies and techniques, endoscopic resection has emerged as an important therapeutic modality. However, endoscopic full-thickness resection can be limited by concerns for R0 resection, margins, potential for seeding the peritoneal cavity, perforation, or difficulty in closing the full-thickness defect. Combined laparoscopic surgery with endoscopic-full thickness resection has become an important cooperative strategy that leverages the unique skillsets of both the endoscopist and the laparoscopic surgeon. Several techniques have emerged that range from endoscopic resection with laparoscopic assistance, laparoscopic resection with endoscopic assistance, and finally to truly cooperative laparoendoscopic surgery. The application of combined laparoscopic surgery and endoscopic full-thickness resection shows great promise especially for subepithelial tumors of the upper gastrointestinal tract, but more widespread applications need to be tempered by focusing on clinical benefit to the patient.</div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2019.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43276363","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}

引用次数: 2