• Title/Summary/Keyword: Digestive endoscopy

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Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment

  • Giuseppe Galloro;Angelo Zullo;Gaetano Luglio;Alessia Chini;Donato Alessandro Telesca;Rosa Maione;Matteo Pollastro;Giovanni Domenico De Palma;Raffaele Manta
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.339-346
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    • 2022
  • Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

Schistosomiasis Combined with Colorectal Carcinoma Diagnosed Based on Endoscopic Findings and Clinicopathological Characteristics: A Report on 32 Cases

  • Liu, Wei;Zeng, Hong-Ze;Wang, Qi-Ming;Yi, Hang;Mou, Yi;Wu, Chun-Cheng;Hu, Bing;Tang, Cheng-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4839-4842
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    • 2013
  • Aims and Background: To improve understanding of the relationship between schistosome-related enteropathy and colorectal carcinoma with particular focus on endoscopic findings and clinicopathological characteristics of colonic schistosomiasis. Materials and Methods: All cases of intestinal schistosomiasis diagnosed at West China Hospital, Chengdu, China, between October 2006 and October 2012 were included in this study. A total of 179 cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected for analysis and the demographics, symptoms, endoscopic findings and clinicopathological characteristics were retrospectively evaluated. Results: Of the 179 colonic schistosomiasis patients, 32 combined with colorectal cancer (CRC) were found, between the ages of 44 and 85 years (24 males, 75%). These 32 lesions were classified as 12 endophytic/ulcerative (37.5%), 10 exophytic/fungating (31.2%), 4 annular (12.5%), 3 giant polypus (9.4%), and 3 IIc (superficial depressed type) (9.4%). The segments of rectum and sigmoid colon were involved in 19 patients (59.4%) and 6 patients (18.8%), respectively. The histopathologic types were classified as follows: 30 welldifferentiated adenocarcinomas, one mucinous adenocarcinoma and one poorly differentiated adenocarcinoma. The pathological findings suggest colorectal malignancy with deposited schistosome ova. Conclusions: Chronic schistosomal infestation has a probable etiological role in promoting genesis of colorectal neoplasms.

Endoscopic submucosal dissection in colorectal neoplasia performed with a waterjet system-assisted knife: higher en-bloc resection rate than conventional technique

  • Paolo Cecinato;Matteo Lucarini;Francesco Azzolini;Mariachiara Campanale;Fabio Bassi;Annalisa Cippitelli;Romano Sassatelli
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.775-783
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    • 2022
  • Background/Aims: Colorectal endoscopic submucosal dissection (ESD) is burdened by its associated high risk of adverse events and long procedure time. Recently, a waterjet-assisted knife was introduced to simplify and speed up the procedure. The aim of this study was to evaluate the efficacy and safety of waterjet-assisted ESD (WESD) compared to that of the conventional ESD (CESD) technique. Methods: The charts of 254 consecutive patients who underwent colorectal ESD between January 2014 and February 2021 for colorectal neoplasms were analyzed. The primary outcome was the en-bloc resection rate. Secondary outcomes were complete and curative resection rates, the need to switch to a hybrid ESD, procedure speed, the adverse event rates, and the recurrence rates. Results: Approximately 174 neoplasias were considered, of which, 123 were removed by WESD and 51 by CESD. The en-bloc resection rate was higher in the WESD group (94.3% vs. 84.3%). Complete resection rates and curative resection rates were similar. The need to switch to a hybrid ESD was greater during CESD (39.2% vs. 13.8%). Procedure speed and adverse event rates were similar. During follow-up, one recurrence occurred after a WESD. Conclusions: WESD allows a high rate of en-bloc resections and less frequently requires a rescue switch to the hybrid ESD compared to CESD.

Role of Image-Enhanced Endoscopy in Pancreatobiliary Diseases

  • Lee, Yun Nah;Moon, Jong Ho;Choi, Hyun Jong
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.541-546
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    • 2018
  • Recent advances in cholangiopancreatoscopy technology permit image-enhanced endoscopy (IEE) for pancreatobiliary diseases. There are limitations in endoscopy performance and in the study of the clinical role of IEE in bile duct or pancreatic duct diseases. However, currently available IEEs during cholangiopancreatoscopy including traditional dye-aided chromoendoscopy, autofluorescence imaging, narrow-band imaging, and i-Scan have been evaluated and reported previously. Although the clinical role of IEE in pancreatobiliary diseases should be verified in future studies, IEE is a useful promising tool in the evaluation of bile duct or pancreatic duct mucosal lesions.

Endoscopy Finding of Patients Who Complained of the Upper Digestive Symptoms after Taking Oriental Herb Decoctions

  • Kim, Dong-Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.987-992
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    • 2008
  • This study was carried out to understand the macroscopic aspects of the digestive system symptoms occurring after taking oriental herb complex decoction as observing morphological changes in esophagus, stomach and duodenal bulb by endoscopy of upper gastrointestinal tract when these symptoms developed. The subjects of this study were 46 patients (male 22, female 24, mean age : $54.72{\pm}14.26$ years) who were chosen among ones who took oriental herb complex decoction for medical care and developed symptoms related to the gastrointestinal tract while taking an oriental herb decoction, which were assumed that the digestive symptoms were newly developed because of administration. The subjects were given morphological examination by endoscopy of the upper gastrointestinal tract. As a result of the endoscopy operated due to the digestive symptoms developed during the administration of oriental herb decoction, there were 2 cases of esophagitis, 5 cases of acute gastritis, 1 case of chronic gastritis A type, 15 cases of chronic gastritis B type, 1 case of duodenitis, 1 case of gastric ulcer, 1 case of gastric polyp, 2 cases of intestinal metaplasia, 1 case of gastric ptosis and 17 cases of normal findings which didn't have any abnormality macroscopically with endoscopy. With regards to the patients who complained of the digestive symptoms after taking oriental herb decoction, it has been found that the symptoms occurred as the oriental herbal medicine taken by the patients who had the digestive symptoms at ordinary times influenced on the gastrointestinal tract. Especially, many of them were had chronic gastritis and functional dyspepsia in the past. The disease accompanying macroscopic lesions at endoscopy which occurred due to the oriental herb decoction as direct cause, was acute gastritis, and it was the prescription to cure the pains and inflammations of skeletomuscular disease.

A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection

  • Paraskevas Gkolfakis;Marc-Andre Bureau;Marianna Arvanitakis;Jacques Deviere;Daniel Blero
    • Clinical Endoscopy
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    • v.55 no.1
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    • pp.141-145
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    • 2022
  • A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions of endoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initial stent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragm was diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent was placed. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stenting duration, and persistence of low-grade inflammation could explain the patient's symptoms and provide a mechanism for gradual muscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management of post-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.

Application of Artificial Intelligence in Capsule Endoscopy: Where Are We Now?

  • Hwang, Youngbae;Park, Junseok;Lim, Yun Jeong;Chun, Hoon Jai
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.547-551
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    • 2018
  • Unlike wired endoscopy, capsule endoscopy requires additional time for a clinical specialist to review the operation and examine the lesions. To reduce the tedious review time and increase the accuracy of medical examinations, various approaches have been reported based on artificial intelligence for computer-aided diagnosis. Recently, deep learning-based approaches have been applied to many possible areas, showing greatly improved performance, especially for image-based recognition and classification. By reviewing recent deep learning-based approaches for clinical applications, we present the current status and future direction of artificial intelligence for capsule endoscopy.