Journal of interventional gastroenterology最新文献

{"title":"Comparison of diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration with 22- and 25-gauge needles in the same patients.","authors":"Mitsuhiro Kida,&nbsp;Masao Araki,&nbsp;Shiro Miyazawa,&nbsp;Hiroko Ikeda,&nbsp;Miyoko Takezawa,&nbsp;Hidehiko Kikuchi,&nbsp;Maya Watanabe,&nbsp;Hiroshi Imaizumi,&nbsp;Wasaburo Koizumi","doi":"10.4161/jig.1.3.18508","DOIUrl":"https://doi.org/10.4161/jig.1.3.18508","url":null,"abstract":"<p><p>BACKGROUND: Various factors, such as the optimal number of passes, aspiration pressure, and the use of 19-gauge and Trucut biopsy needles, have been studied to improve the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). We retrospectively compared the diagnostic accuracy of EUS-FNA between 25- and 22-gauge needles, which have been widely used recently. SUBJECTS AND METHODS: The study group comprised 47 consecutive patients who underwent EUS-FNA with both 22- and 25-gauge needles from October 2007 through March 2010. Their underlying diseases were pancreatic cancer in 24 patients, submucosal tumors in 11, other pancreatic tumors in 4, chronic pancreatitis in 4, enlarged lymph nodes in 3, and gall bladder cancer in 1. Tissue specimens, which were pushed out of the puncture needle, were placed into physiological saline solution. Gray-whitish, worm-like specimens were used for histologic diagnosis. The remaining specimen was centrifuged, and the sediment was plated on slides and examined by a cytopathologist to obtain the cytologic diagnosis. RESULTS: A total of 75 punctures (mean, 1.6) were performed with 25-gauge needles, and 69 punctures (mean, 1.4) were performed with 22-gauge needles. The overall tissue-sampling rate for cytology was 100% (47/47), which was significantly (p=0.01) superior to 83% (39/47) for histology. The overall diagnostic accuracy on the cytologic and histologic examinations was 79% (37/47) and 85% (33/39) (p=0.48). According to needle type, the tissue-sampling rate for cytology and histology on each puncture was 97% (73/75) and 56% (42/75) with 25-guage needles, and was 97% (67/69) and 58% (40/69) with 22-guage needles, the accuracy of cytologic diagnosis on each puncture was 73% (53/73) with 25-gauge needles and 66% (44/67) with 22-gauge needles (p=0.37); the accuracy of histologic diagnosis on each puncture was 60% (25/42) and 75% (30/40) (p=0.14), respectively. No patient had complications. CONCLUSIONS: The tissue-sampling rate and diagnostic accuracy did not differ significantly between 22- and 25-gauge needles in patients with pancreatic or gastrointestinal diseases who underwent EUS-FNA.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234693/pdf/jig0103_0102.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319918","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":"Removal of infused water predominantly during insertion (water exchange) is consistently associated with an increase in adenoma detection rate - review of data in randomized controlled trials (RCTs) of water-related methods.","authors":"Fw Leung,&nbsp;Jo Harker,&nbsp;Jw Leung,&nbsp;Rm Siao-Salera,&nbsp;Sk Mann,&nbsp;Fc Ramirez,&nbsp;S Friedland,&nbsp;A Amato,&nbsp;F Radaelli,&nbsp;S Paggi,&nbsp;V Terruzzi,&nbsp;Yh Hsieh","doi":"10.4161/jig.1.3.18517","DOIUrl":"https://doi.org/10.4161/jig.1.3.18517","url":null,"abstract":"<p><p>INTRODUCTION: Variation in outcomes in RcTs comparing water-related methods and air insufflation raises challenging questions regarding the new approach. This report reviews impact of water exchange - simultaneous infusion and removal of infused water during insertion on adenoma detection rate (ADR) defined as proportion of patients with a least one adenoma of any size. METHODS: Medline (2008-2011) searches, abstract of 2011 Digestive Disease Week (DDW) meeting and personal communications were considered to identify RcTs that compared water-related methods and air insufflation to aid insertion of colonoscope. RESULTS: Since 2008, eleven reports of RcTs (6 published, 1 submitted and 4 abstracts, n=1728) described ADR in patients randomized to be examined by air and water-related methods. The water-related methods differed in timing of removal of the infused water -predominantly during insertion (water exchange) (n=825) or predominantly during withdrawal (water immersion) (n=903). Water immersion was associated with both increases and decreases in ADR compared to respective air method patients and the net overall change (-7%) was significant. On the other hand water exchange was associated with increases in ADR consistently and the net changes (overall, 8%; proximal overall, 11%; and proximal <10 mm, 12%) were all significant. CONCLUSION: Comparative data generated the hypothesis that significantly larger increases in overall and proximal colon ADRs were associated with water exchange than water immersion or air insufflation during insertion. The hypothesis should be evaluated by RCTs to elucidate the mechanism of water exchange on adenoma detection.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"121-126"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234696/pdf/jig0103_0121.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319921","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":"Pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema after colorectal endoscopic submucosal dissection (ESD) with air insufflation.","authors":"Koichiro Sato,&nbsp;Sayo Itoh,&nbsp;Fumiko Shigiyama,&nbsp;Tomoyuki Kitagawa,&nbsp;Iruru Maetani","doi":"10.4161/jig.1.3.18513","DOIUrl":"https://doi.org/10.4161/jig.1.3.18513","url":null,"abstract":"136 J Interv Gastroenterol Volume 1 Issue 3 *Correspondence to: Koichiro Sato; Email: koichiro.sato.0320@gmail.com Submitted: May/14/2011; Revised: May/20/2011; Accepted: May/28/2011 Previously published online: www.landesbioscience.com/journals/jig DOI: 10.4161/jig.1.3.18513 Endoscopic submucosal dissection (ESD) for colorectal neoplasia is feasible by en block resection for accurate pathological diagnosis and for reducing the risk of recurrence. While effective and far less invasive then surgery, colorectal ESD carries a perforation risk of approximately 5%. That rate is high in comparison with other conventional treatments such as snare polypectomy or endoscopic mucosal resection (EMR). In this paper, we report on a case of pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema which occurred following perforation during ESD.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"136-138"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4161/jig.1.3.18513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319924","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":"A head-to-head hands-on comparison of ERCP mechanical simulator (EMS) and Ex-vivo Porcine Stomach Model (PSM).","authors":"Joseph W Leung,&nbsp;Dong Wang,&nbsp;Bing Hu,&nbsp;Brian Lim,&nbsp;Felix W Leung","doi":"10.4161/jig.1.3.18509","DOIUrl":"https://doi.org/10.4161/jig.1.3.18509","url":null,"abstract":"<p><p>BACKGROUND: ERCP mechanical simulator (EMS) and ex-vivo porcine stomach model (PSM) have been described. No direct comparison was reported on endoscopists' perception regarding their efficacy for ERCP training OBJECTIVE: Comparative assessment of EMS and PSM. DESIGN: Questionnaire survey before and after practice. SETTING: Hands-on practice workshops. SUBJECTS: 22 endoscopists with prior experience in 111±225 (mean±SD) ERCP. INTERVENTIONS: Participants performed scope insertion, selective bile duct cannulation with guide wire and insertion of a single biliary stent. Simulated fluoroscopy with external pin-hole camera (EMS), or with additional transillumination (PSM) was used to monitor exchange of accessories. MAIN OUTCOME MEASURE: Participants rated their understanding and confidence before and after hands-on practice, and credibility of each simulator for ERCP training. Comparative efficacy of EMS and PSM for ERCP education was scored (1=not, 10=very) based on pre and post practice surveys: realism (tissue pliability, papilla anatomy, visual/cannulation realism, wire manipulation, simulated fluoroscopy, overall experience); usefulness (assessment of results, supplementing clinical experience, easy for trainees to learn new skills) and application (overall ease of use, prepare trainees to use real instrument and ease of incorporation into training). RESULTS: Before hands-on practice, both EMS and PSM received high scores. After practice, there was a significantly greater increase in confidence score for EMS than PSM (p<0.003). Participants found EMS more useful for training (p=0.017). LIMITATIONS: Subjective scores. CONCLUSIONS: Based on head-to-head hands-on comparison, endoscopists considered both EMS and PSM credible options for improving understanding and supplementing clinical ERCP training. EMS is more useful for basic learning.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4161/jig.1.3.18509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319919","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 method for aiding colonoscope insertion: the learning curve of an experienced colonoscopist.","authors":"Francisco C Ramirez,&nbsp;Felix W Leung","doi":"10.4161/jig.1.3.18507","DOIUrl":"https://doi.org/10.4161/jig.1.3.18507","url":null,"abstract":"<p><p>BACKGROUND: The water method has promising features for colonoscopy but the learning curve to master the technique is unknown. AIMS: To describe the learning phase, and pitfalls of the water method and its impact on procedural outcomes by an experienced colonoscopist. DESIGN: Review of prospectively collected data in a performance improvement project SETTING: endoscopy Unit at a VA medical center PATIENTS: 200 consecutive veterans undergoing colonoscopy METHODS: An experienced colonoscopist examined 4 consecutive groups of 25 patients each using the water method to define the learning curve. Outcomes were compared to a historical cohort (n=100) examined by the same colonoscopist using usual air insufflation. MAIN OUTCOME MEASURES: Intent-to-treat (ITT) cecal intubation rate. RESULTS: ITT cecal intubation rate increased from 76% (first) to 96% (fourth quartile). Cecal intubation time in the first 2 quartiles was significantly longer (8.9±1.0 and 8.2±0.8 min, respectively) than that in the historical cohort (5.8±0.4 min) but decreased and became comparable to control values in the next 2 quartiles (7.2±0.9 and 6.6±0.6 min, respectively). Overall adenoma detection rate as a group (55%), compared favorably to the historical cohort (46%). CONCLUSIONS: The water method is relatively easy to learn for an experienced colonoscopist. Mastery of the method resulted in cecal intubation rate and overall adenoma detection rate meeting quality performance standards.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234692/pdf/jig0103_0097.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319961","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":"EUS-guided transgastric drainage of caudate lobe liver abscesses.","authors":"John Keohane,&nbsp;Christopher J Dimaio,&nbsp;Mark A Schattner,&nbsp;Hans Gerdes","doi":"10.4161/jig.1.3.18514","DOIUrl":"https://doi.org/10.4161/jig.1.3.18514","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"139-141"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4161/jig.1.3.18514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319925","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":"Meet the Executive Editor-in-Chief.","authors":"Zhao-Shen Li","doi":"10.4161/jig.1.3.18506","DOIUrl":"https://doi.org/10.4161/jig.1.3.18506","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"95"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234690/pdf/jig0103_0095.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319959","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 the third issue.","authors":"Felix W Leung,&nbsp;Joseph W Leung","doi":"10.4161/jig.1.3.18516","DOIUrl":"https://doi.org/10.4161/jig.1.3.18516","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234691/pdf/jig0103_0096.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319960","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":"Erratum.","authors":"","doi":"10.4161/jig.1.3.18539","DOIUrl":"https://doi.org/10.4161/jig.1.3.18539","url":null,"abstract":"<p><p>[This corrects the article on p. 78 in vol. 1, PMID: 21776430.].</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"141"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234701/pdf/jig0103_0141.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319926","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 removal of a migrated cystogastrostomy double pigtail stent through a pancreatico-duodenal fistula tract.","authors":"Il Hyung Chung,&nbsp;Hee Wook Kim,&nbsp;Dong Ki Lee","doi":"10.4161/jig.1.3.18515","DOIUrl":"https://doi.org/10.4161/jig.1.3.18515","url":null,"abstract":"<p><p>A common complication of pancreatitis is pseudocyst formation. Endoscopic drainage is a widely used treatment for pancreatic pseudocysts, and offers a definitive solution in approximately 75% of cases. Drainage-related complications may be related directly to the procedure or may occur later as stents and drains migrate or erode into adjacent structures. Procedure-related complications included bleeding, pancreatitis, and infection while stent-related complications may involve dislocation or clogging with subsequent infection. This report is the first description of the successful endoscopic removal of a migrated cystogastrostomy double pigtail stent through a pancreatico-duodenal fistula tract that developed more than six years after the stent was originally misplaced into a pseudocyst.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 3","pages":"142-144"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234702/pdf/jig0103_0142.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30319927","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}