• Title/Summary/Keyword: Upper gastrointestinal endoscopy

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A Case Report on the Distribution of Sasang Costitution in Dyspepsia Patients who had Undergone Upper Gastrointestinal Endoscopy (내시경 검사를 시행한 소화불량 환자 100례에 대한 사상의학적 분포 연구)

  • Jang, Bo-Hyoung;Ro, Im-Sun;Kim, Eun-Gon;Kweon, Hyug-Sung;Kweon, O-Seob;Lee, Jung-Hee
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.337-345
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    • 2004
  • Objective : The purpose of this study is to determine a distribution of sasang constitution among dyspepsia patients, and to weigh their symptoms score. Methods : We surveyed symptoms of dyspepsia and QSCCII in one hundred dyspepsia patients who had undergone upper gastrointestinal endoscopy. Results : In distribution of sasang constitution in total dyspepsia patients group and distribution according to the result of endoscopy, ratio and symptoms score of So-Eum-tn were higher than the others. However the differences were not statistically significant. According to symptoms score by age, symptoms score of Tae-Eum-In in patients above 35 years old group was higher than the others. In patients group under 35 years old, symptoms score of So- Yang-In is higher than the others. However in neither group was this statistically significant.

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The Effect of Behavioral Relaxation Training on Distress and Cancer Screening Intention of Patients with Upper Gastrointestinal Endoscopy (행동이완훈련이 비진정 상부위장관 내시경검사자의 불편감과 수검의도에 미치는 효과)

  • Nam, Hyo Yeon;Shim, Hyung Wha
    • The Journal of Korean Academic Society of Nursing Education
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    • v.25 no.4
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    • pp.414-423
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    • 2019
  • Purpose: This study evaluates the effect of behavioral relaxation training on distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Methods: The research was conducted in a non-equivalent control group posttest design. Data were collected from endoscopy subjects in B city from October to November of 2018. Fifteen minutes of behavioral relaxation training were provided to the experimental group (n=40) and traditional relaxation therapy methods were provided to the control group (n=40). Outcome measures were distress and cancer screening intention of patients with upper gastrointestinal endoscopy. Data were analyzed with a ${\chi}^2$-test, independent t-test, Fisher's exact test with SPSS/PC version 23.0. Results: The objective discomfort (t=8.81, p<.001) of the experimental group was lower than that of the control group; there were no significant differences in the subjective discomfort (t=1.73, p=.088). The cancer screening intention (t=-5.85, p<.001) of the experimental group was significantly higher than that of the control group. Conclusion: Behavioral relaxation training was effective in heightening cancer screening intention. Therefore it can be usefully applied to increase cancer screening intention.

Preclinical Efficacy and Clinical Feasibility of a Novel Aerosol-Exposure Protection Mask for Esophagogastroduodenoscopy

  • Mai Ego Makiguchi;Seiichiro Abe;Yutaka Okagawa;Satoru Nonaka;Haruhisa Suzuki;Shigetaka Yoshinaga;Ichiro Oda;Okamoto Ryuta;Yutaka Saito
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.226-233
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    • 2022
  • Background/Aims: This study aimed to assess the efficacy of a novel aerosol-exposure protection (AP) mask in preventing coronavirus disease in healthcare professionals during upper gastrointestinal endoscopy and to evaluate its clinical feasibility. Methods: In Study 1, three healthy volunteers volitionally coughed with and without the AP mask in a cleanroom. Microparticles were visualized and counted with a specific measurement system and compared with and without the AP mask. In Study 2, 30 patients underwent endoscopic resection with the AP mask covering the face, and the SpO2 was measured throughout the procedure. Results: In Study 1, the median number of microparticles in volunteers 1, 2, and 3 with and without the AP mask was 8.5 and 110.0, 7.0 and 51.5, and 8.0 and 95.0, respectively (p<0.01). Using the AP mask, microparticles were reduced by approximately 92%. The median distances of microparticle scattering without the AP mask were 60, 0, and 68 in volunteers 1, 2, and 3, respectively. In Study 2, the mean SpO2 was 96.3%, and desaturation occurred in three patients. Conclusion: The AP mask could provide protection from aerosol exposure and can be safely used for endoscopy in clinical practice.

Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions

  • Seigo Nakatani;Kosuke Okuwaki;Masafumi Watanabe;Hiroshi Imaizumi;Tomohisa Iwai;Takaaki Matsumoto;Rikiya Hasegawa;Hironori Masutani;Takahiro Kurosu;Akihiro Tamaki;Junro Ishizaki;Ayana Ishizaki;Mitsuhiro Kida;Chika Kusano
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.89-95
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    • 2024
  • Background/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs). Methods: In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA's diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs. Results: The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture. Conclusions: Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

Role of endoscopy in gastroesophageal reflux disease

  • Daniel Martin Simadibrata;Elvira Lesmana;Ronnie Fass
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.681-692
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    • 2023
  • In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett's esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

Necessity of pharyngeal anesthesia during transoral gastrointestinal endoscopy: a randomized clinical trial

  • Tomoyuki Hayashi;Yoshiro Asahina;Yasuhito Takeda;Masaki Miyazawa;Hajime Takatori;Hidenori Kido;Jun Seishima;Noriho Iida;Kazuya Kitamura;Takeshi Terashima;Sakae Miyagi;Tadashi Toyama;Eishiro Mizukoshi;Taro Yamashita
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.594-603
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    • 2023
  • Background/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation. Methods: This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA- groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA- group in terms of the pharyngeal observation success rate. Results: The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA-) groups were 84.0% and 72.0%, respectively. The PA- group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0-10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA- group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups. Conclusions: Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.

Upper Gastrointestinal Tract Polyps: What Do We Know About Them?

  • Buyukasik, Kenan;Sevinc, Mert Mahsuni;Gunduz, Umut Riza;Ari, Aziz;Gurbulak, Bunyamin;Toros, Ahmet Burak;Bektas, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2999-3001
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    • 2015
  • Background: This study aimed to evaluate upper gastrointestinal polyps detected during esophago-gastroduodenoscopy tests. Materials and Methods: We conducted a retrospective analysis on data regarding 55,987 upper gastrointestinal endoscopy tests performed at the endoscopy unit of Istanbul Education and Research Hospital between January 2006 and June 2012. Results: A total of 66 upper gastrointestinal polyps from 59 patients were analyzed. The most common clinical symptom was dyspepsia, observed in 41 cases (69.5%). The localizations of the polyps were as follows: 29 in the antrum (43.9%), 15 in the corpus (22.7%), 11 in the cardia (16.7%), 3 in the fundus (4.54%), 3 in the second portion of the duodenum (4.54%), 2 in the bulbus (3.03%) and 3 in the lower end of the esophagus (4.54%). Histopathological types of polyps included hyperplastic polyps (44) (66.7%), faveolar hyperplasia (8) (12.1%), fundic gland polyps (4) (6.06%), squamous cell polyps (4) (6.06%), hamartomatous polyps (3) (4.54%), and pyloric gland adenoma (3) (4.54%). Histopathological analysis of the gastric mucosa showed chronic atrophic gastritis in 30 cases (50.84%), HP infection in 33 cases (55.9%) and intestinal metaplasia in 19 cases (32.20%). In 3 cases with multiple polyps, adenocarcinoma was detected in hyperplastic polyps. Conclusions: Among polypoid lesions of the upper gastrointestinal tract, the most common histological type is hyperplastic polyps. Generally, HP infection is associated with chronic atrophic gastritis and intestinal metaplasia. The incidence of adenocarcinoma tends to be higher in patients with multiple hyperplastic polyps.

Endoscopy after Gastric Surgery: For Each Reconstruction Method, Operator's Point of View (위 수술 전후의 내시경 시술: 재건법에 따른 접근, 수술의 관점)

  • Yilseok Joo;Hyunjin Cho;Sooin Choi
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.66-76
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    • 2023
  • Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.

Quality indicators in esophagogastroduodenoscopy

  • Sang Yoon Kim;Jae Myung Park
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.319-331
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    • 2022
  • Esophagogastroduodenoscopy (EGD) has been used to diagnose a wide variety of upper gastrointestinal diseases. In particular, EGD is used to screen high-risk subjects of gastric cancer. Quality control of EGD is important because the diagnostic rate is examiner-dependent. However, there is still no representative quality indicator that can be uniformly applied in EGD. There has been growing awareness of the importance of quality control in improving EGD performance. Therefore, we aimed to review the available and emerging quality indicators for diagnostic EGD.