• Clinical Endoscopy
• /
• 제55권2호
• /
• pp.167-182
• /
• 2022

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

• Clinical Endoscopy
• /
• 제51권6호
• /
• pp.547-551
• /
• 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.

• Clinical Endoscopy
• /
• 제55권2호
• /
• pp.215-225
• /
• 2022

Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

• Clinical Endoscopy
• /
• 제55권3호
• /
• pp.401-407
• /
• 2022

Background/Aims: Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population. Methods: From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion. Results: Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion. Conclusions: Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage.

• Clinical Endoscopy
• /
• 제51권6호
• /
• pp.503-504
• /
• 2018

• Clinical Endoscopy
• /
• 제56권2호
• /
• pp.185-187
• /
• 2023

• Clinical Endoscopy
• /
• 제56권3호
• /
• pp.384-387
• /
• 2023

• Clinical Endoscopy
• /
• 제56권3호
• /
• pp.388-390
• /
• 2023

• Clinical Endoscopy
• /
• 제56권2호
• /
• pp.256-257
• /
• 2023

• Clinical Endoscopy
• /
• 제56권4호
• /
• pp.534-536
• /
• 2023