Journal of interventional gastroenterology最新文献

{"title":"Feasibility and safety of magnetic-controlled capsule endoscopy system in examination of human stomach: a pilot study in healthy volunteers.","authors":"Zhuan Liao, Xiao-Dong Duan, Lei Xin, Lu-Min Bo, Xin-Hong Wang, Guo-Hua Xiao, Liang-Hao Hu, Song-Lin Zhuang, Zhao-Shen Li","doi":"10.4161/jig.23751","DOIUrl":"10.4161/jig.23751","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and safety of magnetic-controlled capsule endoscopy (MCE) system for examination of human stomach.</p><p><strong>Methods: </strong>This pilot study enrolled 34 healthy volunteers. All subjects swallowed the MCE and gas-producing powder for gastric distention. An external robot was used to generate magnetic field to manipulate MCE inside the stomach. The primary measurements included safety, gastric preparation, maneuverability and visualization of gastric mucosa.</p><p><strong>Results: </strong>Gastric preparation and examination was well accepted by subjects and there were no adverse events. The examination in the stomach takes 43.8±10.0min (27-60). The cleanliness was evaluated as good in the 30 (88.2%) subjects and as moderate in 4 (11.8%) subjects. The distention of gastric cavity was evaluated as good in the 29 (85.3%) subjects and moderate in 5 (14.7%) subjects. Maneuverability of the MCE to movements of the guidance magnet robot was graded as good in 29 (85.3%) subjects and moderate in 5 (14.7%) subjects. More than 75% gastric mucosa was visualized in 27 (79.4%) subjects and 50% to 75% in 7 (20.6%) subjects. Visualization of the gastric cardia, fundus, body, angulus, antrum and pylorus was subjectively assessed as complete in 82.4%, 85.3%, 100.0%, 100.0%, 100.0% and 100.0%, respectively. Polyp and erosive lesions were found in 7 subjects.</p><p><strong>Conclusion: </strong>Magnetic-controlled capsule endoscopy used for examination of the human stomach is feasible and safe.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"155-160"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655386/pdf/jig0204_0155.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441725","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":"Gastroduodenal stents are associated with more durable patency as compared to percutaneous endoscopic gastrojejunostomy in the palliation of malignant gastric outlet obstruction.","authors":"Daniel S Strand,&nbsp;Ju-En C Thlick,&nbsp;James T Patrie,&nbsp;Monica R Gaidhane,&nbsp;Michel Kahaleh,&nbsp;Andrew Y Wang","doi":"10.4161/jig.23749","DOIUrl":"https://doi.org/10.4161/jig.23749","url":null,"abstract":"<p><strong>Background: </strong>Gastroduodenal outlet obstruction (GOO) is a critical complication of cancers localized within and adjacent to the upper gastrointestinal tract. Approaches to the relief of GOO include surgical bypass with gastrojejunostomy (GJ), endoluminal placement of a self-expandable metallic stent (SEMS), and percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). To date no studies have compared the outcome of utilizing PEG-J with other modalities of therapy.</p><p><strong>Objectives: </strong>To determine if there is a difference in complications or effectiveness when survival and/or device patency of PEG-J is compared to that of gastroduodenal SEMS in patients with malignant GOO.</p><p><strong>Methods: </strong>Patients who underwent placement of either PEG-J or gastroduodenal SEMS for unresectable malignant GOO were included in a retrospective cohort study.</p><p><strong>Results: </strong>24 patients (12 men) with a median age of 68.5 years underwent either PEG-J (n=12) or gastroduodenal SEMS (n=12) placement. Patients undergoing SEMS placement experienced longer overall device patency and/or survival as compared to those undergoing PEG-J (median 70 versus 35 days). Complications, including the need for re-intervention, were similar among both groups. Patients who underwent PEG-J as compared to those that had SEMS placement had a hazard ratio of 3.85 (CI 1.28-11.11) for decreased overall survival.</p><p><strong>Conclusion: </strong>In patients with malignant GOO, placement of a palliative SEMS for gastric decompression and nutrition was associated with longer aggregate device patency and survival as compared to PEG-J. Both modalities were similar with respect to complications and the need for re-intervention.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"150-154"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655385/pdf/jig0204_0150.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442279","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":"Is the use of prophylactic hemoclips in the endoscopic resection of large pedunculated polyps useful? A prospective and randomized study.","authors":"Elvira Quintanilla,&nbsp;José Luis Castro,&nbsp;Luis Ramón Rábago,&nbsp;Inmaculada Chico,&nbsp;Ana Olivares,&nbsp;Alejandro Ortega,&nbsp;Cristina Vicente,&nbsp;Jorge Carbó,&nbsp;Francisco Gea","doi":"10.4161/jig.23741","DOIUrl":"https://doi.org/10.4161/jig.23741","url":null,"abstract":"<p><strong>Background: </strong>The methods for preventing post-polypectomy bleeding (PPB) are not standardised and there are groups that use hemoclips for this purpose.</p><p><strong>Objective: </strong>To study whether the use of hemoclips reduces PPB complications.</p><p><strong>Materials and methods: </strong>Prospective, randomised study of patients with pedunculated polyps larger than 10 mm. The patients were included in two groups (hemoclip before polypectomy -HC- and standard polypectomy -SP-). This study has been registered with the trial registration number NCT01565993.</p><p><strong>Results: </strong>105 polypectomies were performed (98 patients), 66 (62.9%) in the HC group. The total rate of complications was 10,6% in the HC group (4.5% early bleeding, 1.5% severe delayed bleeding, 4,5% mucosal burns, 1.5% perforation). In the SP group, the rate of total complications was 7,7%, (7,7% early bleeding, no significant differences). In view of the unexpected increase in the morbidity of the hemoclip group, the study was suspended without reaching the sample size. In an ad hoc analysis, which includes the standard polypectomy patients who refused to participate in the study (35 polyps), the total morbidity was 5,7% (no perforations and 2 patients with premature bleeding).When we compared the morbidity of the HC group to the morbidity of SP group plus R group (74 polyps), we also failed to detect any significant differences in terms of PPB, but did in terms of perforation.</p><p><strong>Conclusion: </strong>The prophylactic use of hemoclips in polypectomies of large pedunculated polyps leads to a further risk of mucosal burns and perforation that is not acceptable, and does not reduce the risk of PPB.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655391/pdf/jig0204_0183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442284","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":"Sacral nerve stimulation in the treatment of fecal incontinence - the experience of a pelvic floor center : short term results.","authors":"Roberto Paolo Iachetta,&nbsp;Alessandra Cola,&nbsp;Roberto Dino Villani","doi":"10.4161/jig.23745","DOIUrl":"https://doi.org/10.4161/jig.23745","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this paper is to present the data pertinent to the experiences of our Pelvic Floor Center on the utilisation of SNS in the treatment of fecal incontinence and compare these data to the data of current literature.</p><p><strong>Methods: </strong>All patients who had had SNS treatment for fecal incontinence between the dates of 1st April 2008 and 1st April 2011 were enrolled in the study. We considered a 50% reduction of fecal incontinence episodes as a success of the test phase. The score used for assessment was the Cleveland Clinic Florida-Fecal Incontinence score (CCF-FI).</p><p><strong>Results: </strong>The 21 patients treated for fecal incontinence (19 ♀ and 2 ♂, average age 59.7 [ 26-73] years) were sub-divided on the basis of the presence or absence of sphincter damage (group A1 had damage while group A2 did not). A patient (group A1) was excluded from the study as the result of the external connector breaking during the test phase. Of the 20 remaining patients (9 from group A1 and 11 from A2), 14 (70%) felt benefit and subsequently underwent definitive stimulator implantation. The variation between the pre-operative CCF-FI and the value at 6 months was statistically significant both in group A1 (p=0.009) and in group A2 (p=0.003). The only complication reported was one case (7.1%) of infection of the definitive stimulator.</p><p><strong>Conclusion: </strong>SNS represents an effective treatment for patients with fecal incontinence. The results have been encouraging, and in line with current literature.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"189-192"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655392/pdf/jig0204_0189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441724","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":"Introduction to volume 2, fourth issue.","authors":"","doi":"10.4161/jig.23766","DOIUrl":"https://doi.org/10.4161/jig.23766","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"149"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655384/pdf/jig0204_0149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442277","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":"The water exchange method and difficult colonoscopy.","authors":"Felix W Leung,&nbsp;Yanglin Pan,&nbsp;Surinder K Mann,&nbsp;Joseph W Leung,&nbsp;Rodelei M Siao-Salera,&nbsp;Guy Jackson","doi":"10.4161/jig.23727","DOIUrl":"https://doi.org/10.4161/jig.23727","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 3","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655360/pdf/jig0203_0103.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31537188","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":"Water exchange method for colonoscopy: learning curve of an experienced colonoscopist in a U.S. community practice setting.","authors":"Leonard S Fischer,&nbsp;Antoinette Lumsden,&nbsp;Felix W Leung","doi":"10.4161/jig.23734","DOIUrl":"https://doi.org/10.4161/jig.23734","url":null,"abstract":"<p><strong>Background: </strong>Water exchange colonoscopy has been reported to reduce examination discomfort and to provide salvage cleansing in unsedated or minimally sedated patients. The prolonged insertion time and perceived difficulty of insertion associated with water exchange have been cited as a barrier to its widespread use.</p><p><strong>Aim: </strong>To assess the feasibility of learning and using the water exchange method of colonoscopy in a U.S. community practice setting.</p><p><strong>Setting: </strong>Quality improvement program in nonacademic community endoscopy centers.</p><p><strong>Subjects: </strong>Patients undergoing sedated diagnostic, surveillance, or screening colonoscopy.</p><p><strong>Methods: </strong>After direct coaching by a knowledgeable trainer, an experienced colonoscopist initiated colonoscopy using the water method. Whenever >5 min elapsed without advancing the colonoscope, conversion to air insufflation was made to ensure timely completion of the examination.</p><p><strong>Primary outcome: </strong>Water Method Intention-to-treat (ITT) cecal intubation rate (CIR).</p><p><strong>Results: </strong>Female patients had a significantly higher rate of past abdominal surgery and a significantly lower ITTCIR. The ITTCIR showed a progressive increase over time in both males and females to 85-90%. Mean insertion time was maintained at 9 to 10 min. The overall CIR was 99%.</p><p><strong>Conclusion: </strong>Use of water exchange did not preclude cecal intubation upon conversion to usual air insufflation in sedated patients examined by an experienced colonoscopist. With practice ITTCIR increased over time in both male and female patients. Larger volumes of water exchanged were associated with higher ITTCIR and better quality scores of bowel preparation. The data suggest that learning water exchange by a busy colonoscopist in a community practice setting is feasible and outcomes conform to accepted quality standards.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 3","pages":"128-132"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655367/pdf/jig0203_0128.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31538187","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":"Introduction to volume 2, third issue.","authors":"","doi":"10.4161/jig.23725","DOIUrl":"https://doi.org/10.4161/jig.23725","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 3","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655358/pdf/jig0203_0099.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31537185","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":"Can old dogs learn new tricks?","authors":"Kjetil Garborg,&nbsp;Michael Bretthauer","doi":"10.4161/jig.23733","DOIUrl":"https://doi.org/10.4161/jig.23733","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 3","pages":"126-127"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655366/pdf/jig0203_0126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31538186","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":"Indigocarmine added to the water exchange method enhances adenoma detection - a RCT.","authors":"Joseph Leung,&nbsp;Surinder Mann,&nbsp;Rodelei Siao-Salera,&nbsp;Catherine Ngo,&nbsp;Randy McCreery,&nbsp;Wilhemina Canete,&nbsp;Felix Leung","doi":"10.4161/jig.23728","DOIUrl":"https://doi.org/10.4161/jig.23728","url":null,"abstract":"<p><strong>Purpose: </strong>Chromoendoscopy with dye spray and the water method both increase adenoma detection.</p><p><strong>Hypothesis: </strong>Adding indigocarmine to the water method will enhance further the effectiveness of the latter in adenoma detection.</p><p><strong>Methods: </strong>Screening colonoscopy was performed with the water method (control) or with 0.008% indigocarmine added (study) by two endoscopists. Randomization was based on computer-generated codes contained in blocks of pre-arranged opaque sealed envelopes. High resolution colonoscopes were used. Upon insertion into the rectum, air was suctioned. With the air pump turned off, water was infused using a blunt needle adaptor connected to the scope channel and a foot pump to facilitate scope insertion until the cecum was reached. Residual stool causing cloudiness was suctioned followed by infusion of clear or colored water (water exchange) to facilitate scope passage with minimal distention of the colonic lumen. Upon seeing the appendix opening under water, water was suctioned and air was insufflated to facilitate inspection on scope withdrawal.</p><p><strong>Statistics: </strong>Sample size calculation revealed 168 patients (84/group) needed to be randomized. Study was IRB-approved and registered (NCT01383265).</p><p><strong>Results: </strong>There were no significant differences in mean age, gender distribution, BMI, and family history of colon cancer. Cecal intubation success rate was 100% in both groups. The overall adenoma detection rate was 44% (water only) versus 62% (water with indigocarmine), respectively (p=0.03). One cancer was detected in each group.</p><p><strong>Conclusion: </strong>In a RCT, indigocarmine at 0.008% concentration, added to the water method, significantly enhanced further the effectiveness of the latter in detecting adenomas.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 3","pages":"106-111"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655361/pdf/jig0203_0106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31538181","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}