Clinical Endoscopy

  • 제44권1호
  • /
  • Pages.27-32
  • /
  • 2011
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지
DOI QR코드

DOI QR Code

Efficacy of I-scan Endoscopy in the Diagnosis of Gastroesophageal Reflux Disease with Minimal Change

  • Kim, Min-Sik (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Choi, Seok-Reyol (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Roh, Myung-Hwan (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Jong-Hun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Jang, Jin-Seok (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Byung-Geun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Sang-Ock (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Ha, Ji-Sun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Hsing, Chien-Ter (Department of Internal Medicine, Dong-A University College of Medicine)
  • 발행 : 2011.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved. Methods: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change. Results: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25). Conclusions: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.

키워드

참고문헌

  1. DeVault KR, Castell DO; American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2005;100:190-200. https://doi.org/10.1111/j.1572-0241.2005.41217.x
  2. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population- based study in Olmsted County, Minnesota. Gastroenterology 1997;112:1448-1456. https://doi.org/10.1016/S0016-5085(97)70025-8
  3. Kim HY, Kim N, Kim SM, et al. Clinical spectrum and risk factors of erosive and non-erosive GERD in health check-up subjects. Korean J Med 2006;71:491-500.
  4. Youn YH, Kang YW, Ahn SH, Park SK. Prevalence alteration of reflux esophagitis in recent years. Korean J Gastrointest Endosc 2001;23:144-148.
  5. Jeon SG, Sohn CI, Kim JE, et al. Prevalence of gastroesophageal reflux in routine check-up subjects. Korean J Med 2000;58:145-151.
  6. Rhee PI. Evidence based guideline for diagnosis and treatment: diagnostic guideline for GERD. Korean J Neurogastroenterol Motil 2005; 11:5-12.
  7. Jones R. Gastro-oesophageal reflux disease in general practice. Scand J Gastroenterol Suppl 1995;211:35-38.
  8. Kim WJ, Cho JY, Jeong SW, et al. Comparison of autofluorescence imaging endoscopic findings with pathologic findings after endoscopic submucosal dissection of gastric neoplasms. Gut Liver 2008;2:186-192. https://doi.org/10.5009/gnl.2008.2.3.186
  9. Chaiteerakij R, Rerknimitr R, Kullavanijaya P. Role of digital chromoendoscopy in detecting minimal change esophageal reflux disease. World J Gastrointest Endosc 2010;2:121-129.
  10. Sharma P, Wani S, Bansal A, et al. A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. Gastroenterology 2007;133:454-464. https://doi.org/10.1053/j.gastro.2007.06.006
  11. Hoffman A, Basting N, Goetz M, et al. High-definition endoscopy with i-Scan and Lugol's solution for more precise detection of mucosal breaks in patients with reflux symptoms. Endoscopy 2009;41:107-112. https://doi.org/10.1055/s-0028-1119469
  12. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172-180. https://doi.org/10.1136/gut.45.2.172
  13. Hongo M. Minimal changes in reflux esophagitis: red ones and white ones. J Gastroenterol 2006;41:95-99. https://doi.org/10.1007/s00535-006-1775-4
  14. Nakamura T, Shirakawa K, Masuyama H, Sugaya H, Hiraishi H, Terano A. Minimal change oesophagitis: a disease with characteristic differences to erosive oesophagitis. Aliment Pharmacol Ther 2005;21 Suppl 2:19-26.
  15. Fass R, Ofman JJ. Gastroesophageal reflux disease--should we adopt a new conceptual framework? Am J Gastroenterol 2002;97:1901-1909.

피인용 문헌

  1. Screening for Precancerous Lesions of Upper Gastrointestinal Tract: From the Endoscopists' Viewpoint vol.2013, pp.None, 2013, https://doi.org/10.1155/2013/681439
  2. Present and future perspectives of virtual chromoendoscopy with i‐scan and optical enhancement technology vol.26, pp.1, 2011, https://doi.org/10.1111/den.12190
  3. Advanced Imaging Technology Other than Narrow Band Imaging vol.48, pp.6, 2011, https://doi.org/10.5946/ce.2015.48.6.503
  4. Minimal Change Esophagitis vol.67, pp.1, 2016, https://doi.org/10.4166/kjg.2016.67.1.4
  5. Identifying Minimal Changes in Nonerosive Reflux Disease: Is the Pay Worth the Labor? vol.50, pp.1, 2011, https://doi.org/10.1097/mcg.0000000000000423
  6. High‐definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group vol.29, pp.2, 2011, https://doi.org/10.1111/dote.12308
  7. Ambulatory 24-hour multichannel intraluminal impedance-pH monitoring and high resolution endoscopy distinguish patients with non-erosive reflux disease from those with functional heartburn vol.12, pp.4, 2011, https://doi.org/10.1371/journal.pone.0175263
  8. Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease vol.53, pp.3, 2011, https://doi.org/10.1080/00365521.2018.1430847
  9. Narrowed-spectrum Technologies in Endoscopic Imaging of The Upper Gastrointestinal Tract vol.23, pp.1, 2021, https://doi.org/10.1016/j.tige.2020.10.002