Clinical Endoscopy

Original Articles

Value of Fecal Calprotectin Measurement During the Initial Period of Therapeutic Anti-Tubercular Trial: Hyeong Ho Jo, Eun Young Kim, Jin Tae Jung, Joong Goo Kwon, Eun Soo Kim, Hyun Seok Lee, Yoo Jin Lee, Kyeong Ok Kim, Byung Ik Jang, the Crohn’s and Colitis Association in Daegu-Gyeongbuk; Clin Endosc 2022;55(2):256-262. Published online November 5, 2021; DOI: https://doi.org/10.5946/ce.2021.061

Background
/Aims: The diagnosis of intestinal tuberculosis (ITB) is often challenging. Therapeutic anti-tubercular trial (TATT) is sometimes used for the diagnosis of ITB. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT in patients with ITB.
Methods
A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 and November 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FC measurement reports.
Results
The mean age of the participants was 48.8 years. The final diagnosis of ITB was confirmed in 30 patients based on complete mucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the ITB patients was 170.2 μg/g (range, 11.5-646.5). It dropped to 25.4 μg/g (range, 11.5-75.3) and then 23.3 μg/g (range, 11.5-172.2) after one and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant (p<0.001), and FC levels decreased to below 100 μg/g in all patients after one month of TATT.
Conclusions
All ITB patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosal healing in the follow-up colonoscopy after 2 months of TATT.

Citations

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Primary Gastric Tuberculosis in an Immunocompetent Patient: The Truth Lying beneath the Surface
Fábio Pereira Correia, Luísa Martins Figueiredo, Luís Carvalho Lourenço, Sofia Santos, Rita Theias Manso, David Horta
GE - Portuguese Journal of Gastroenterology.2024; 31(3): 191. CrossRef
New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024;[Epub] CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Fecal Calprotectin as a Surrogate Marker for Mucosal Healing After Initiating the Therapeutic Anti-Tubercular Trial
Satimai Aniwan
Clinical Endoscopy.2022; 55(2): 210. CrossRef

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Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam: Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang, the Committees of Quality Management and Conscious Sedation of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2022;55(2):234-239. Published online October 12, 2021; DOI: https://doi.org/10.5946/ce.2021.126

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Background
/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxical reactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients who previously experienced paradoxical reactions.
Methods
This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions to midazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation) or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction.
Results
A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II (n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did not differ between groups.
Conclusions
Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam was readministered.

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Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clinical Endoscopy.2024; 57(4): 476. CrossRef
Efficacy and safety of remimazolam-based sedation for intensive care unit patients undergoing upper gastrointestinal endoscopy: a cohort study
Yuan-rui Zhao, Ke-sheng Huang, Guo Hou, Lan Yao, Li-ping Lu, Song Xu, Ying-tao Lian, Zhun Yao, Zhui Yu
World Journal of Emergency Medicine.2023; 14(1): 31. CrossRef
Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method
Yuling Zheng, Yafei Xu, Bixin Huang, Ying Mai, Yiwen Zhang, Zhongqi Zhang
Frontiers in Pharmacology.2022;[Epub] CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

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A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE): Seon-Young Park, Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Chang-Hwan Park, Jae-Yong Jang, Byung-Wook Kim, Byung Ik Jang, the Quality management and Endoscopic sedation committee of Korean Society of Gastrointestinal Endoscopy (KSGE); Clin Endosc 2021;54(6):843-850. Published online July 14, 2021; DOI: https://doi.org/10.5946/ce.2021.014

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Background
/Aims: This study aimed to determine the current status of facilities, equipment, and personnel for endoscopic sedation from endoscopy units of representative hospitals in South Korea.
Methods
A questionnaire survey was conducted on 50 qualified endoscopy units accredited by the Korean Society of Gastrointestinal Endoscopy.
Results
All included endoscopy units had regulations and educational programs regarding sedation training for endoscopists and nursing personnel. There present one assisting nurse during endoscopy in 35 units (70%) and at least two nurses in 12 units (24.0%). All endoscopy units had examination rooms equipped with oxygen supply and suction systems. Endoscopist-directed sedation was performed in 48 units (96.0%). Propofol-based sedation was the most used sedation method. All units had a separate recovery bay. The daily number of patients per bed was greater than 10 in 17 units (34.0%). In 26 (52.0%) units, a single nurse cared for ≥10 patients per day. All the units fulfilled the discharge criteria.
Conclusions
This study presents data regarding endoscopic sedation clinical practice in 50 endoscopy units in South Korea. This study presents the current status of endoscopic sedation clinical practice in 50 qualified endoscopy units accredited by the KSGE, which provide excellent quality management.

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Awareness of Endoscopy Nurses About Anesthesia Management in the Pediatric Gastrointestinal Endoscopy Unit; A Survey Study
Feyza SEVER, Şamil HIZLI
Turkish Journal of Pediatric Disease.2023; : 412. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

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Review

Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories: Dae Young Cheung, Byung Ik Jang, Sang Wook Kim, Jie-Hyun Kim, Hyung Keun Kim, Jeong Eun Shin, Won Jae Yoon, Yong Kang Lee, Kwang Hyun Chung, Soo-Jeong Cho, Hyun Phil Shin, Sun Young Cho, Woon Geon Shin, Kee Don Choi, Byung-Wook Kim, Joong Goo Kwon, Hee Chan Yang, Tae-Geun Gweon, Hyun Gun Kim, Dong-Won Ahn, Kwang Bum Cho, Sun Hee Kim, Kyong Hwa Hwang, Hee Hyuk Im; Clin Endosc 2020;53(3):276-285. Published online May 29, 2020; DOI: https://doi.org/10.5946/ce.2020.106

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The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.

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Dong Jun Oh, Yea Je Lee, Sang Hoon Kim, Joowon Chung, Hyun Seok Lee, Ji Hyung Nam, Yun Jeong Lim, Thomas Lui Ka Luen
PLOS ONE.2024; 19(5): e0295774. CrossRef
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Sahib Singh, Saurabh Chandan, Sumant Inamdar, Kambiz S. Kadkhodayan, Jahnvi Dhar, Jayanta Samanta, Antonio Facciorusso
Journal of Clinical Medicine.2024; 13(16): 4835. CrossRef
Current status of the gastric cancer screening program in Korea
Young-Il Kim, Il Ju Choi
Journal of the Korean Medical Association.2022; 65(5): 250. CrossRef
Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement
Enrique Rodríguez de Santiago, Mario Dinis-Ribeiro, Heiko Pohl, Deepak Agrawal, Marianna Arvanitakis, Robin Baddeley, Elzbieta Bak, Pradeep Bhandari, Michael Bretthauer, Patricia Burga, Leigh Donnelly, Axel Eickhoff, Bu'Hussain Hayee, Michal F. Kaminski,
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Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening toHelicobacter pyloriEradication in Korea
Young-Il Kim, Il Ju Choi
Journal of Gastric Cancer.2022; 22(3): 169. CrossRef
General guideline in the endoscopy room to avoid air-borne infection during the COVID-19 pandemic
Kwang Hyun Chung, Soo-Jeong Cho
Clinical Endoscopy.2022; 55(5): 688. CrossRef
Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial
Kwang Hyun Chung, Jeong Don Chae, Wonho Choe, Hyo Young Lee, Il Hwan Oh, Byoung Kwan Son
Clinical Endoscopy.2022; 55(5): 674. CrossRef
Endoscopes that Complete Pre-Cleaning may be Stored Overnight until Next Morning for the Subsequent Reprocessing
Soo-Jeong Cho
Clinical Endoscopy.2021; 54(4): 449. CrossRef
Accreditation program for gastrointestinal endoscopes reprocessing in Italy: An on-site survey
Giancarlo Spinzi, Angelo Milano, Piero Brosolo, Paola Da Massa Carrara, Maurizio Labardi, Alberto Merighi, Luisa Riccardi, Francesco Torresan, Maurizio Capelli
Endoscopy International Open.2021; 09(11): E1627. CrossRef
Sans Standardization: Effective Endoscope Reprocessing
Sameer K. Avasarala, Lawrence F. Muscarella, Atul C. Mehta
Respiration.2021; 100(12): 1208. CrossRef

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Special Review: Korean Society of Gastrointestinal Endoscopy “Accreditations of Qualified Endoscopy Unit” Guideline: Update 2019

Updates on the Disinfection and Infection Control Process of the Accredited Endoscopy Unit: Jeong Eun Shin, Yunho Jung, Jeong Hoon Lee, Byoung Kwan Son, Jae-Young Jang, Hyung-Keun Kim, Byung Ik Jang, The Quality Management Committee and the Disinfection Management Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2019;52(5):443-450. Published online September 30, 2019; DOI: https://doi.org/10.5946/ce.2019.173

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A thorough disinfection and infection control process associated with gastrointestinal endoscopy is highly important for the health and safety of the examinee and the medical staff involved in the procedure. Endoscopic reprocessing and disinfection are two of the most important steps in quality control of endoscopy. In 2019, the Korean Society of Gastrointestinal Endoscopy updated the Accreditation of Qualified Endoscopy Unit assessment items for these quality indicators. Assessment of disinfection and infection control comprises 28 mandatory items in the categories of disinfection education, pre-cleaning, cleaning, disinfection, rinsing, drying, reprocessing, storage, endoscopic accessories, water bottle and connectors, space/facilities, personal protective equipment, disinfection ledger, and regulations regarding infection control and disinfection.
The updated Accreditation of Qualified Endoscopy Unit assessment items are useful for improving the quality of endoscopy by ensuring thorough inspection of endoscopic disinfection and infection control.

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Hui Chen, Jiawei Liu, Aiying Zeng, Nian Qin
Review of Scientific Instruments.2024;[Epub] CrossRef
Infection control in the bronchoscopy suite: effective reprocessing and disinfection of reusable bronchoscopes
Mamta S. Chhabria, Fabien Maldonado, Atul C. Mehta
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Endoscopy in surgery
María Rita Rodríguez-Luna, Silvana Perretta
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Safety of Gastrointestinal Endoscopy in Korea: A Nationwide Survey and Population-Based Study
Yunho Jung, Jung-Wook Kim, Jong Pil Im, Yu Kyung Cho, Tae Hee Lee, Jae-Young Jang
Journal of Korean Medical Science.2022;[Epub] CrossRef
A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea
Hye Young Shin, Da Hun Jang, Jae Kwan Jun
American Journal of Infection Control.2021; 49(8): 1031. CrossRef
Effectiveness Between Daily and After-Each-Case Room Disinfection of the Endoscopy Unit
Bo Jin, Yue Hu, Liang Huang, Xiaoyun Cheng, Jin Zhao, Xuejing Yang, Xiling Sun, Tieer Gan, Bin Lu
Frontiers in Public Health.2021;[Epub] CrossRef
Sans Standardization: Effective Endoscope Reprocessing
Sameer K. Avasarala, Lawrence F. Muscarella, Atul C. Mehta
Respiration.2021; 100(12): 1208. CrossRef
Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak
Jimin Han, Eun Young Kim
Clinical Endoscopy.2020; 53(2): 243. CrossRef

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Updates on the Sedation for Gastrointestinal Endoscopy: Jun Kyu Lee, Yoo Jin Lee, Jun Hyung Cho, Jong Pil Im, Chang-Hwan Park, Jae-Young Jang, Byung Ik Jang, the Quality Management Committee and the Disinfection Management/Conscious Sedation Committee of Korean Society of Gastrointestinal Endoscopy (KSGE); Clin Endosc 2019;52(5):451-457. Published online September 30, 2019; DOI: https://doi.org/10.5946/ce.2019.172

Abstract PDF Supplementary Material PubReader ePub

Sedation, defined as the depressed level of consciousness, induced by drug administration, is widely used for gastrointestinal endoscopy to relieve a patient’s anxiety and discomfort. In addition, successful procedure is anticipated with control of unintended movements. Endoscopic sedation, however, cannot be free from the risk of serious adverse events, e.g., cardiopulmonary compromise. Therefore, principles on personnel, facility and equipment, as well as performance itself, should be followed to prevent unfavorable incidents. In this article, sedation guidelines for the Accreditation of Qualified Endoscopy Units, issued by the Korean Society of Gastrointestinal Endoscopy, are presented.

Citations

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Sedation reversal trends at outpatient ambulatory endoscopic center vs in-hospital ambulatory procedure center using a triage protocol
Saqib Walayat, Peter Stadmeyer, Azfar Hameed, Minahil Sarfaraz, Paul Estrada, Mark Benson, Anurag Soni, Patrick Pfau, Paul Hayes, Brittney Kile, Toni Cruz, Deepak Gopal
World Journal of Gastrointestinal Endoscopy.2024; 16(7): 413. CrossRef
Nurse-Administered Propofol Sedation Training Curricula and Propofol Administration in Digestive Endoscopy Procedures
Andrea Minciullo, Lucia Filomeno
Gastroenterology Nursing.2023;[Epub] CrossRef
Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam
Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2022; 55(2): 234. CrossRef
Endoscopist-Driven Sedation Practices in South Korea: Re-evaluation Considering the Nationwide Survey in 2019
Seon-Young Park, Jun Kyu Lee, Chang-Hwan Park, Byung-Wook Kim, Chang Kyun Lee, Hong Jun Park, Byung Ik Jang, Dong Uk Kim, Jin Myung Park, Jae Min Lee, Young Sin Cho, Hyung Ku Chon, Seung Young Seo, Woo Hyun Paik
Gut and Liver.2022; 16(6): 899. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef
Pain Intensity at Injection Site during Esophagogastroduodenoscopy Using Long- and Medium-Chain versus Long-Chain Triglyceride Propofol: A Randomized Controlled Double-Blind Study
Joon Seop Lee, Eun Soo Kim, Kwang Bum Cho, Kyung Sik Park, Yoo Jin Lee, Ju Yup Lee
Gut and Liver.2021; 15(4): 562. CrossRef
A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE)
Seon-Young Park, Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Chang-Hwan Park, Jae-Yong Jang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2021; 54(6): 843. CrossRef
Risk Factors for Prolonged Hospital Stay after Endoscopy
Toshihiro Nishizawa, Shuntaro Yoshida, Osamu Toyoshima, Tatsuya Matsuno, Masataka Irokawa, Toru Arano, Hirotoshi Ebinuma, Hidekazu Suzuki, Takanori Kanai, Kazuhiko Koike
Clinical Endoscopy.2021; 54(6): 851. CrossRef

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Commentary

What is the Best Sampling Method to Monitor the Effect of Endoscopy Reprocessing?: Kwang Hyun Chung, Byung Ik Jang; Clin Endosc 2018;51(5):397-398. Published online September 21, 2018; DOI: https://doi.org/10.5946/ce.2018.146

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Review

Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing: Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang, The Disinfection Management and Conscious Sedation Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2017;50(2):143-147. Published online March 17, 2017; DOI: https://doi.org/10.5946/ce.2017.029

Abstract PDF PubReader ePub

The Korean Society of Gastrointestinal Endoscopy (KSGE) issued guidelines for endoscope reprocessing for the first time in 1995, and the version of the guidelines was updated in August 2009, August 2012, and March 2015. Guidelines for endoscope reprocessing should be revised continuously, because new disinfectants and devices are developed and introduced. The current official version of the KSGE guidelines for endoscope reprocessing is explained herein to assist the reader in understanding the KSGE requirements for cleaning and disinfecting endoscopes.

Citations

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Efficacy of spray flushing in the reprocessing of flexible endoscopes: A randomized controlled trial
Jiang Du, Miao Zhang, Si-Yuan Tao, Lian-Song Ye, Hui Gong, Bing Hu, Qiong-Ying Zhang, Fu Qiao
World Journal of Gastroenterology.2024; 30(31): 3680. CrossRef
Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing
Xue-Yue Ji, Pei-Yong Ning, Chun-Nan Fei, Jia Song, Xue-Mei Dou, Nan-Nan Zhang, Jun Liu, He Liu
Saudi Journal of Gastroenterology.2022; 28(1): 46. CrossRef
Altered Gastric Microbiota and Inflammatory Cytokine Responses in Patients with Helicobacter pylori-Negative Gastric Cancer
Han-Na Kim, Min-Jeong Kim, Jonathan P. Jacobs, Hyo-Joon Yang
Nutrients.2022; 14(23): 4981. CrossRef
Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial
Kwang Hyun Chung, Jeong Don Chae, Wonho Choe, Hyo Young Lee, Il Hwan Oh, Byoung Kwan Son
Clinical Endoscopy.2022; 55(5): 674. CrossRef
Guidelines for accreditation of endoscopy units: quality measures from the Korean Society of Coloproctology
Rumi Shin, Seongdae Lee, Kyung-Su Han, Dae Kyung Sohn, Sang Hui Moon, Dong Hyun Choi, Bong-Hyeon Kye, Hae-Jung Son, Sun Il Lee, Sumin Si, Won-Kyung Kang
Annals of Surgical Treatment and Research.2021; 100(3): 154. CrossRef
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Cancer Research and Treatment.2021; 53(2): 323. CrossRef
The Effectiveness of Drying on Residual Droplets, Microorganisms, and Biofilms in Gastrointestinal Endoscope Reprocessing: A Systematic Review
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Ambient air pollution in gastrointestinal endoscopy unit
Chang Seok Bang, Keunwook Lee, Young Joo Yang, Gwang Ho Baik
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Jeong Eun Shin, Yunho Jung, Jeong Hoon Lee, Byoung Kwan Son, Jae-Young Jang, Hyung-Keun Kim, Byung Ik Jang
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Original Article

Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry: Yun Jeong Lim, Oh Young Lee, Yoon Tae Jeen, Chi Yeon Lim, Dae Young Cheung, Jae Hee Cheon, Byong Duk Ye, Hyun Joo Song, Jin Su Kim, Jae Hyuk Do, Kwang Jae Lee, Ki-Nam Shim, Dong Kyung Chang, Cheol Hee Park, Byung Ik Jang, Jeong Seop Moon, Hoon Jai Chun, Myung-Gyu Choi, Jin Oh Kim, Korean Gut Image Study Group; Clin Endosc 2015;48(5):399-404. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.399

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Background/Aims

Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry.

Methods

Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed.

Results

A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age.

Conclusions

CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.

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Stefano Fantasia, Pablo Cortegoso Valdivia, Stefano Kayali, George Koulaouzidis, Marco Pennazio, Anastasios Koulaouzidis
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Reviews

Guidelines for Video Capsule Endoscopy: Emphasis on Crohn's Disease: Soo-Kyung Park, Byong Duk Ye, Kyeong Ok Kim, Cheol Hee Park, Wan-Sik Lee, Byung Ik Jang, Yoon Tae Jeen, Myung-Gyu Choi, Hyun Jung Kim, The Korean Gut Image Study Group; Clin Endosc 2015;48(2):128-135. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.128

Abstract PDF PubReader ePub

Video capsule endoscopy (VCE) is an ingestible video camera that transmits high-quality images of the small intestinal mucosa. This makes the small intestine more readily accessible to physicians investigating the presence of small bowel disorders, such as Crohn's disease (CD). Although VCE is frequently performed in Korea, there are no evidence-based guidelines on the appropriate use of VCE in the diagnosis of CD. To provide accurate information and suggest correct testing approaches for small bowel diseases, the Korean Gut Image Study Group, part of the Korean Society of Gastrointestinal Endoscopy, developed guidelines on VCE. Teams were set up to develop guidelines on VCE. Four areas were selected: diagnosis of obscure gastrointestinal bleeding, small bowel preparation for VCE, diagnosis of CD, and diagnosis of small bowel tumors. Three key questions were selected regarding the role of VCE in CD. In preparing these guidelines, a systematic literature search, evaluation, selection, and meta-analysis were performed. After writing a draft of the guidelines, the opinions of various experts were solicited before producing the final document. These guidelines are expected to play a role in the diagnosis of CD. They will need to be updated as new data and evidence become available.

Citations

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Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors: Gwang Ha Kim, Sam Ryong Jee, Jae Young Jang, Sung Kwan Shin, Kee Don Choi, Jun Haeng Lee, Sang Gyun Kim, Jae Kyu Sung, Suck Chei Choi, Seong Woo Jeon, Byung Ik Jang, Kyu Chan Huh, Dong Kyung Chang, Sung-Ae Jung, Bora Keum, Jin Woong Cho, Il Ju Choi, Hwoon-Yong Jung, Korean ESD Study Group; Clin Endosc 2014;47(6):516-522. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.516

Abstract PDF PubReader ePub

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.

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Original Article

Learning Curve of Capsule Endoscopy: Korean Gut Image Study Group, Yun Jeong Lim, Young Sung Joo, Dae Young Jung, Byong Duk Ye, Ji Hyun Kim, Jae Hee Cheon, Seong Eun Kim, Jae Hyuk Do, Byung Ik Jang, Jeong Seop Moon, Jin Oh Kim, Hoon Jae Chun, Myung-Gyu Choi; Clin Endosc 2013;46(6):633-636. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.633

Abstract PDF PubReader ePub

Background/Aims

Capsule endoscopy (CE) has become an important tool for the diagnosis of small bowel disease. Although CE does not require the skill of endoscope insertion, the images should be interpreted by a person with experience in assessing images of the gastrointestinal mucosa. This investigation aimed to document the number of cases needed by trainees to gain the necessary experience for CE competency.

Methods

Fifteen cases were distributed to 12 trainees with no previous experience of CE during their gastroenterology training as clinical fellows. Twelve trainees and an expert were asked to read CE images from one patient each week for 15 weeks. The diagnosis was reported using five categories (no abnormalities detected, small bowel erosion or ulcer, small bowel tumor, Crohn disease, and active small bowel bleeding with no identifiable source). We then examined, using the κ coefficient, how the degree of mean agreements between the trainees and the expert changed as the training progressed each week.

Results

The agreement rate of CE diagnosis increased as the frequencies of interpretation increased. Most of the mean κ coefficients were >0.60 and >0.80 after week 9 and 11, respectively.

Conclusions

Experience with approximately 10 cases of CE is appropriate for trainees to attain CE competency.

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Anastasios Koulaouzidis, Dimitris K Iakovidis, Alexandros Karargyris, John N Plevris
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J.G. Albert, O. Humbla, M.E. McAlindon, C. Davison, U. Seitz, C. Fraser, F. Hagenmüller, E. Noetzel, C. Spada, M.E. Riccioni, J. Barnert, N. Filmann, M. Keuchel
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Perfecting Video Capsule Endoscopy: Is There Need for Training?
Jae Hee Cheon, Ki Baik Hahm
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Special Issue Article of IDEN 2013

Lower Gastrointestinal Bleeding: Is Urgent Colonoscopy Necessary for All Hematochezia?: Byung Ik Jang; Clin Endosc 2013;46(5):476-479. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.476

Abstract PDF PubReader ePub

Lower gastrointestinal bleeding (LGIB) is defined as acute or chronic abnormal blood loss distal to the ligament of Treitz. The incidence of LGIB is only one fifth of that of the upper gastrointestinal tract and is estimated to be 21 to 27 cases per 100,000 adults per year. Acute bleeding is arbitrarily defined as bleeding of <3 days' duration resulting in instability of vital signs, anemia, and/or need for blood transfusion. Chronic bleeding is defined as slow blood loss over a period of several days or longer presenting with symptoms of occult fecal blood, intermittent melena, or scant hematochezia. Bleeding means that the amounts of blood in the feces are too small to be seen but detectable by chemical tests. LGIB is usually chronic and stops spontaneously. Bleeding stop (80%), but male gender and older patients suffer from more severe LGIB. The optimal timing of colonoscopic intervention for LGIB remains uncertain. Urgent colonoscopy may serve to decrease hospital stay. However, urgent colonoscopy is difficult to control, and showed no evidence of improving clinical outcomes or lowering costs as compared with routine elective colonoscopy.

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КЛИНИКАЛЫҚ ЖАҒДАЙ: ЖІҢІШКЕ ІШЕК ТАМЫРЛАРЫНЫҢ ТАМЫРЛЫ АҚАУЫ НЕМЕСЕ АНГИОДИСПЛАЗИЯСЫ
Е.А. ДЖУСИПБЕКОВ, Д.У. СМАГУЛОВА, Г.Т. СУЛТАНКУЛОВА, Д.Ж. КУАТБЕКОВ
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Francesca IACOBELLIS, Barbara SESSA, Matteo VINCENZI, Maria L. DE CICCO, Chiara ANDREOLI, Marco DI SERAFINO, Marco MAZZOLI, Benedetta RIGONI, Alessandra BRANDALISE, Andrea DELLI PIZZI, Massimo CAULO, Paolo RICCI, Anna Maria IERARDI, Michele LAPORTA, Anton
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Diagnostic and Interventional Imaging.2017; 98(6): 499. CrossRef
Elevated C-reactive protein level predicts lower gastrointestinal tract bleeding
MINORU TOMIZAWA, FUMINOBU SHINOZAKI, RUMIKO HASEGAWA, YOSHINORI SHIRAI, YASUFUMI MOTOYOSHI, TAKAO SUGIYAMA, SHIGENORI YAMAMOTO, NAOKI ISHIGE
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Emergency video capsule endoscopy in patients with acute severe GI bleeding and negative upper endoscopy results
Christoph Schlag, Christoph Menzel, Simon Nennstiel, Bruno Neu, Veit Phillip, Tibor Schuster, Roland M. Schmid, Stefan von Delius
Gastrointestinal Endoscopy.2015; 81(4): 889. CrossRef

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Focused Review Series: A Perspective: Endoscopy and Imaging in Inflammatory Bowel Disease

The Role of Colonoscopy in Inflammatory Bowel Disease: Yong Gil Kim, Byung Ik Jang; Clin Endosc 2013;46(4):317-320. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.317

Abstract PDF PubReader ePub

An endoscopic evaluation, particularly ileocolic mucosal and histological findings, is essential for the diagnosis of inflammatory bowel disease (IBD). The introduction of antitumor necrosis factor agents has changed the therapeutic paradigm of patients with IBD, but an endoscopic evaluation is more important to guide therapeutic decision-making. In the future, endoscopy with a histological evaluation will be increasingly used in patients with IBD. Both Crohn colitis and ulcerative colitis result in an increased incidence of colorectal carcinoma. Thus, surveillance colonoscopy is important to detect early neoplastic lesions. Surveillance ileocolonoscopy has also changed recently from multiple random biopsies to pancolonic dye spraying with targeted biopsies of abnormal areas.

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Xiaowen Li, Qiqiao Wu, Yuanwen Chen, Yang Jin, Jianxia Ma, Jianguo Yang
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Special Issue Articles of IDEN 2012

Lessons from Korean Capsule Endoscopy Multicenter Studies: Kyeong Ok Kim, Byung Ik Jang; Clin Endosc 2012;45(3):290-294. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.290

Abstract PDF PubReader ePub

Since its development, video capsule endoscopy (VCE) introduced a new area in the study of small bowel disease. We reviewed and discussed current issues from Korean capsule endoscopy multicenter studies. Main results are as follows: First, there was no significant difference in diagnostic yield according to the method of bowel preparation. Second, VCE represents a reliable and influential screening measure in patients with chronic unexplained abdominal pain and this technique could successfully alter the clinical course especially for patients with small bowel tumor. Third, the inter-observer variation in the expert group was lower than that in trainee group. Fourth, studies about the spontaneous capsule passage after retention showed 2.5% of retention rate and the size of lumen was an important factor of spontaneous passage. We need larger scale studies on the effect of bowel preparation methods on the diagnostic yield and further studies about the learning curve or unique capsule endoscopic findings for small intestinal diseases in Korean patients.

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Na Rae Lim, Keep Yung Hong, Woo Chul Chung
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Lawrence Hookey, Jacob Louw, Michelle Wiepjes, Natalie Rubinger, Stijn Van Weyenberg, Andrew G. Day, William Paterson
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Mona Rezapour, Chidi Amadi, Lauren B. Gerson
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Small Bowel Endoscopy in Inflammatory Bowel Disease
Hirokazu Yamagami, Kenji Watanabe, Noriko Kamata, Mitsue Sogawa, Tetsuo Arakawa
Clinical Endoscopy.2013; 46(4): 321. CrossRef

6,742 View
43 Download
4 Crossref

Commentary

Benign Colonic ¹⁸F-FDG Uptake on Whole-Body FDG-PET Scan: Byung Ik Jang; Clin Endosc 2012;45(2):109-110. Published online June 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.2.109

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Birte Molvik Gideonse, Magnus Birkeland, Mie Holm Vilstrup, Peter Grupe, Mohammad Naghavi-Behzad, Christina H. Ruhlmann, Oke Gerke, Malene Grubbe Hildebrandt
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Lesion Location in Clinical Significance of Incidental Colorectal FDG Uptake
Joseph C. Lee, Gemma F. Hartnett, Aravind S. Ravi Kumar
Clinical Endoscopy.2012; 45(4): 451. CrossRef

5,622 View
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