Clinical Endoscopy

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

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

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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.

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Drugs used for sedation in gastrointestinal endoscopy
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Risk Factors for Prolonged Hospital Stay after Endoscopy
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Reviews

Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea: Jun Ki Min, Jae Myung Cha, Yu Kyung Cho, Jie-Hyun Kim, Soon Man Yoon, Jong Pil Im, Yunho Jung, Jeong Seop Moon, Jin-Oh Kim, Yoon Tae Jeen; Clin Endosc 2018;51(3):239-252. Published online May 31, 2018; DOI: https://doi.org/10.5946/ce.2018.075

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Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

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Lei Xin, Ye Gao, Zhiyuan Cheng, Tianjiao Wang, Han Lin, Yanan Pang, Chang Sun, Zengjun Fu, Zhaoshen Li, Xudong Ma, Luowei Wang
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Colon Capsule Endoscopy: Where Are We and Where Are We Going: Yoo Min Han, Jong Pil Im; Clin Endosc 2016;49(5):449-453. Published online September 22, 2016; DOI: https://doi.org/10.5946/ce.2016.095

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Colon capsule endoscopy (CCE) is a noninvasive technique for diagnostic imaging of the colon. It does not require air inflation or sedation and allows minimally invasive and painless colonic evaluation. The role of CCE is rapidly evolving; for example, for colorectal screening (colorectal cancer [CRC]) in average-risk patients, in patients with an incomplete colonoscopy, in patients refusing a conventional colonoscopy, and in patients with contraindications for conventional colonoscopy. In this paper, we comprehensively review the technical characteristics and procedure of CCE and compare CCE with conventional methods such as conventional colonoscopy or computed tomographic colonography. Future expansion of CCE in the area of CRC screening for the surveillance of polyps and adenomatous lesions and for assessment of inflammatory bowel disease is also discussed.

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A Head-to-Head Comparison of Computed Tomography Colonography, Optical Colonoscopy, and Colon Endoscopic Capsule for the Detection of Polyps After Partial Colectomy or Rectosigmoidectomy for Colorectal Cancer: A Pilot Study
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Cureus.2023;[Epub] CrossRef
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Briton Lee, Kevin Lin, Peter S. Liang
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Siti Hawa Ngalim, Norwahida Yusoff, Rayzel Renitha Johnson, Siti Razila Abdul Razak, Xinyue Chen, Jamie K. Hobbs, Yeong Yeh Lee
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X-ray Imaging for Gastrointestinal Tracking of Microscale Oral Drug Delivery Devices
Rolf Bech Kjeldsen, Maja Nørgaard Kristensen, Carsten Gundlach, Lasse Højlund Eklund Thamdrup, Anette Müllertz, Thomas Rades, Line Hagner Nielsen, Kinga Zór, Anja Boisen
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Original Article

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea: Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2016;49(6):542-547. Published online March 2, 2016; DOI: https://doi.org/10.5946/ce.2015.113

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Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

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Shu‐Hui Chen, Theophile Liu, Huei‐Wen Lai, Hui‐Lan Chang, Hsu‐Heng Yen
Advances in Digestive Medicine.2022; 9(2): 103. CrossRef
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Hye Young Shin, Da Hun Jang, Jae Kwan Jun
American Journal of Infection Control.2021; 49(8): 1031. CrossRef
Polyp missing rate and its associated risk factors of referring hospitals for endoscopic resection of advanced colorectal neoplasia
Jae Gyu Shin, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Medicine.2017; 96(19): e6742. CrossRef
Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
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Yu Kyung Cho
Clinical Endoscopy.2016; 49(4): 312. CrossRef
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Dong-Hoon Yang
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Clinical Endoscopy.2016; 49(6): 495. CrossRef

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Case Reports

Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding: Jooyoung Lee, Sung Wook Hwang, Jihye Kim, Jinwoo Kang, Gyeong Hoon Kang, Kyu Joo Park, Jong Pil Im, Joo Sung Kim; Clin Endosc 2016;49(1):91-96. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.91

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Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.

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Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review
Emily Fellows, Joy Harris, Tania Kibble, Nicholas M. McDonald, Nabeel Azeem, James V. Harmon
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Ileal angiodysplasia presentation as a bowel obstruction: A case report
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
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Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum
Abhishek D. Polavarapu, Mayurathan Kesavan, Vivek V. Gumaste, Monika Wrzolek, Elias Purow
ACG Case Reports Journal.2017; 4(1): e83. CrossRef

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Simultaneous Esophageal and Gastric Metastases from Lung Cancer: Jae Yong Park, Seung Wook Hong, Joo Young Lee, Ji Hye Kim, Jin Woo Kang, Hyun Woo Lee, Jong Pil Im; Clin Endosc 2015;48(4):332-335. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.332

Abstract PDF PubReader ePub

We report of a patient with metastatic adenocarcinoma of the esophagus and stomach from lung cancer. The patient was a 68-year-old man receiving radiotherapy and chemotherapy for stage IV lung cancer, without metastases to the gastrointestinal (GI) tract at the time of the initial diagnosis. During the treatment period, dysphagia and melena newly developed. Upper GI endoscopy revealed geographic erosion at the distal esophagus and multiple volcano-shaped ulcers on the stomach body. Endoscopic biopsy was performed for each lesion. To determine whether the lesions were primary esophageal and gastric cancer masses or metastases from the lung cancer, histopathological testing including immunohistochemical staining was performed, and metastasis from lung cancer was confirmed. The disease progressed despite chemotherapy, and the patient died 5 months after the diagnosis of lung cancer. This is a case report of metastatic adenocarcinoma in the esophagus and stomach, which are very rare sites of spread for lung cancer.

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Gastric Metastasis of Primary Lung Cancer: Case Report and Systematic Review With Pooled Analysis
Dong Tang, Jianjian Lv, Zhijing Liu, Shuhui Zhan, Yuqiang Gao
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Lung cancer metastasis to the gastrointestinal system: An enigmatic occurrence
Kanthi Rekha Badipatla, Niharika Yadavalli, Trupti Vakde, Masooma Niazi, Harish K Patel
World Journal of Gastrointestinal Oncology.2017; 9(3): 129. CrossRef

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