• Title/Summary/Keyword: Endoscopy, gastrointestinal

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Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett's esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis

  • Igor Logetto Caetite Gomes;Diogo Turiani Hourneaux de Moura;Igor Braga Ribeiro;Sergio Barbosa Marques;Alexandre de Sousa Carlos;Beanie Conceicao Medeiros Nunes;Bruno Salomao Hirsch;Guilherme Henrique Peixoto de Oliveira;Roberto Paolo Trasolini;Wanderley Marques Bernardo;Eduardo Guimaraes Hourneaux de Moura
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.181-190
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    • 2024
  • Background/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett's esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported. Methods: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

Submucosal endoscopy: the present and future

  • Zaheer Nabi;Duvvur Nageshwar Reddy
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.23-37
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    • 2023
  • Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

Endoscopic management of postoperative bleeding

  • Sung Hyeok Ryou;Ki Bae Bang
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.706-715
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    • 2023
  • Postoperative gastrointestinal bleeding is a rare but serious complication that can lead to prolonged hospitalization and significant morbidity and mortality. It can be managed by reoperation, endoscopy, or radiological intervention. Although reoperation carries risks, particularly in critically ill postoperative patients, minimally invasive interventions, such as endoscopy or radiological intervention, confer advantages. Endoscopy allows localization of the bleeding focus and hemostatic management at the same time. Although there have been concerns regarding the potential risk of creating an anastomotic disruption or perforation during early postoperative endoscopy, endoscopic management has become more popular over time. However, there is currently no consensus on the best endoscopic management for postoperative gastrointestinal bleeding because most practices are based on retrospective case series. Furthermore, there is a wide range of individual complexities in anatomical and clinical settings after surgery. This review focused on the safety and effectiveness of endoscopic management in various surgical settings.

Analysis on Actual State of Selective Upper Gastrointestinal Study in Medical Examination (종합건강진단시 위장검사의 선택 실태에 관한 분석)

  • Kang, Seong-Ho;Son, Soon-Yong;Joo, Mi-Hwa;Kim, Chang-Bok;Kim, Keon-Chung
    • Journal of radiological science and technology
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    • v.22 no.2
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    • pp.61-68
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    • 1999
  • The purpose of this study is to present controversial point and reform measurements by analysing factors haying important effect on selection of upper gastrointestinal study in total health promotion. We examined 200 persons for this study, who visited for upper gastrointestinal study from January to February in 1999. We classified this group into Endoscopy, Upper gastrointestinal series, and sleeping endoscopy. We also investigated standard of satisfaction and factors having effect on selection of each study. As a results, in the motive of selection, Item of 'making accurate observation' and 'without pain' was 39.3% and 34.7%, respectively. In this study, sleeping endoscopy was 45.7%, but on the other side upper gastrointestinal series was low 22.6%(P<0.05). In the standard of preference of study, the man was 55.7% in the endoscopy, and the woman was 61.8% in the upper gastrointestinal series(P<0.05). The standard of preference of upper gastrointestinal series show that it was satisfied on the whole irrespective of sex, dwelling place, age, occupation, and level of education. In the selection of study, one's own will was showed the highest frequency, and family inducement was showed second(P<0.05). Persons over 60% were examined before the same study. Selection of upper gastrointestinal series was 47.9% of person with normal findings, and endoscopy and sleeping endoscopy was over 70% with gastritis, gastric and duodenal(P<0.01). For one's accurate selection of examination, it is important that objective and credible information should be given to a recipient for examination.

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Role of linked color imaging for upper gastrointestinal disease: present and future

  • Sang Pyo Lee
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.546-552
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    • 2023
  • Techniques for upper gastrointestinal endoscopy are advancing to facilitate lesion detection and improve prognosis. However, most early tumors in the upper gastrointestinal tract exhibit subtle color changes or morphological features that are difficult to detect using white light imaging. Linked color imaging (LCI) has been developed to overcome these shortcomings; it expands or reduces color information to clarify color differences, thereby facilitating the detection and observation of lesions. This article summarizes the characteristics of LCI and advances in LCI-related research in the upper gastrointestinal tract field.