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Original Articles
Endoscopic resection of gastric gastrointestinal stromal tumor using clip-and-cut endoscopic full-thickness resection: a single-center, retrospective cohort in Korea
Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Seokin Kang, Ho June Song, Kee Don Choi, Do Hoon Kim, Jeong Hoon Lee, Hee Kyong Na, Young Soo Park
Clin Endosc 2024;57(3):350-363.   Published online February 15, 2024
DOI: https://doi.org/10.5946/ce.2023.144
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs.
Methods
Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed.
Results
Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group.
Conclusions
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

Citations

Citations to this article as recorded by  
  • Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
    Jin Woong Cho
    Clinical Endoscopy.2024; 57(3): 329.     CrossRef
  • 3,022 View
  • 90 Download
  • 1 Web of Science
  • 1 Crossref
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Clinical outcomes of nonvariceal upper gastrointestinal bleeding in nonagenarians and octogenarians: a comparative nationwide analysis
Khaled Elfert, James Love, Esraa Elromisy, Fouad Jaber, Suresh Nayudu, Sammy Ho, Michel Kahaleh
Clin Endosc 2024;57(3):342-349.   Published online February 7, 2024
DOI: https://doi.org/10.5946/ce.2023.130
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group.
Methods
The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).
Results
Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3–1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83–0.89) than those of octogenarians.
Conclusions
Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.
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Review
Simulator-based training method in gastrointestinal endoscopy training and currently available simulators
Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung
Clin Endosc 2023;56(1):1-13.   Published online January 6, 2023
DOI: https://doi.org/10.5946/ce.2022.191
AbstractAbstract PDFPubReaderePub
The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Citations

Citations to this article as recorded by  
  • Impact and assessment of training models in interventional endoscopic ultrasound
    Bogdan Miutescu, Vinay Dhir
    Digestive Endoscopy.2024; 36(1): 59.     CrossRef
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Exploring Endoscopic Competence in Gastroenterology Training: A Simulation-Based Comparative Analysis of GAGES, DOPS, and ACE Assessment Tools
    Faisal Wasim Ismail, Azam Afzal, Rafia Durrani, Rayyan Qureshi, Safia Awan, Michelle R Brown
    Advances in Medical Education and Practice.2024; Volume 15: 75.     CrossRef
  • Assemblage of a functional and versatile endoscopy trainer reusing medical waste: Step‐by‐step video tutorial
    Riccardo Vasapolli, Jörg Schirra, Christian Schulz
    Digestive Endoscopy.2024; 36(5): 634.     CrossRef
  • Navigating the learning landscape: Comprehensive training in third space endoscopy - training, techniques, and practical recommendations
    D. Roser, S. Nagl, A. Ebigbo
    Best Practice & Research Clinical Gastroenterology.2024; : 101918.     CrossRef
  • EUS and ERCP training in Europe: Time for simulation, optimization, and standardization
    Selma J. Lekkerkerker, Rogier P. Voermans
    United European Gastroenterology Journal.2023; 11(5): 407.     CrossRef
  • There is no royal road: a shortcut for endoscopic submucosal dissection training
    Seong Woo Jeon
    Clinical Endoscopy.2023; 56(5): 590.     CrossRef
  • Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
    Caesar Ferrari, Micheal Tadros
    Gastroenterology Insights.2023; 15(1): 1.     CrossRef
  • 2,993 View
  • 223 Download
  • 7 Web of Science
  • 8 Crossref
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Systematic Review and Meta-Analysis
Endoscopic diagnosis of gastric metastases from malignant melanoma: systematic review
Helena Campoli Reggiani, Ana Clara Aguiar Pongeluppi, Vitória Froes Miraglia Martins Ferreira, Isadora Pinheiro Felix, Paulo Moacir de Oliveira Campoli
Clin Endosc 2022;55(4):507-515.   Published online June 28, 2022
DOI: https://doi.org/10.5946/ce.2022.035
AbstractAbstract PDFPubReaderePub
Background
/Aims: Metastases of malignant melanoma (MM) are rare and associated with poor prognosis. The objective of this study was to analyze the clinical and endoscopic characteristics of gastric metastases of MM by systematically reviewing cases and case series involving patients diagnosed using upper gastrointestinal endoscopy.
Methods
The PubMed and LILACS databases were searched. Reports containing individual patient data were included. Outcomes such as clinical data, endoscopic findings, treatments, and survival were analyzed.
Results
A total of 88 studies with individual data from 113 patients with gastric metastases of MM were included. The primary sites of MM were the skin (62%), eyes (10%), and mucous membranes (6%). Most patients (56%) had multiple metastases in the stomach, located predominantly in the gastric body (approximately 80%). The overall survival rate at 2 years was 4%. There was a significant reduction in the survival of patients with multiple gastric metastases compared to that of patients with single metastasis (hazard ratio, 0.459; 95% confidence interval, 0.235−0.895; p=0.022).
Conclusions
Gastric metastases of MM have a poor prognosis, especially in patients with multiple implants in the stomach. Additional studies are needed to verify whether ocular and mucosal melanomas are associated with a higher risk of gastric metastases than that of cutaneous melanomas.

Citations

Citations to this article as recorded by  
  • A Rare Case of Gastric Metastasis from a Rare Case of Mucosal Malignant Melanoma
    Zaim Gashi, Astrit Hamza, Blerina Ukimeri, Valon Hamza, Marigona Zubaku-Rakovic
    Open Access Macedonian Journal of Medical Sciences.2024; 12(2): 362.     CrossRef
  • Case report: Malignant melanoma of the lower limb with gastric metastasis
    Qiang Hu, Fengru Zhou, Yuanshui Sun
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • 2,509 View
  • 176 Download
  • 1 Web of Science
  • 2 Crossref
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Review
Quality indicators in esophagogastroduodenoscopy
Sang Yoon Kim, Jae Myung Park
Clin Endosc 2022;55(3):319-331.   Published online May 16, 2022
DOI: https://doi.org/10.5946/ce.2022.094
AbstractAbstract PDFPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • Current status of quality control in screening esophagogastroduodenoscopy and the emerging role of artificial intelligence
    Lihui Zhang, Liwen Yao, Zihua Lu, Honggang Yu
    Digestive Endoscopy.2024; 36(1): 5.     CrossRef
  • Relationship between observation time and detection rate of focal lesions in Esophagogastroduodenoscopy: a single-center, retrospective study
    Li Dong, Xiaodan Zhang, Yuting Xuan, Peiling Xiong, Yumei Ning, Bing Zhang, Fan Wang, Qiu Zhao, Jun Fang
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • The Effect of Esophagogastroduodenoscopy on Intraocular Pressure
    Maddalena De Bernardo, Antonella Santonicola, Marco Gioia, Livio Vitiello, Ferdinando Cione, Sergio Pagliarulo, Paola Iovino, Nicola Rosa
    Journal of Clinical Medicine.2024; 13(5): 1224.     CrossRef
  • The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
    Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
    Gut and Liver.2024; 18(3): 444.     CrossRef
  • Optimal number of images and 2-year interval affect cancer detection in screening esophagogastroduodenoscopy: An observational study
    Kazuhiro Ksahiwagi, Toshifumi Yoshida, Kayoko Fukuhara, Rieko Bessho, Hitoshi Ichikawa, Nagamu Inoue, Hiromasa Takaishi, Yasushi Iwao, Takanori Kanai
    Medicine.2024; 103(26): e38774.     CrossRef
  • Sistema de auditoría automática para la exploración endoscópica del estómago con Inteligencia Artificial – Gastro UNAL: Gastroendoscopy UNit for Automatic Labeling
    Martín Alonso Gómez Zuleta, Diego Fernando Bravo Higuera, Josué Andre Ruano Balseca, María Jaramillo González, Fabio Augusto González Osorio, Edgar Eduardo Romero Castro
    Revista colombiana de Gastroenterología.2024; 39(2): 133.     CrossRef
  • Endoscopic Imaging for the Diagnosis of Neoplastic and Pre-Neoplastic Conditions of the Stomach
    Bruno Costa Martins, Renata Nobre Moura, Angelo So Taa Kum, Carolina Ogawa Matsubayashi, Sergio Barbosa Marques, Adriana Vaz Safatle-Ribeiro
    Cancers.2023; 15(9): 2445.     CrossRef
  • The effect of short-term training about depth predicting score on the diagnostic ability of invasion depth for differentiated early gastric Cancer among non-expert endoscopists
    Hui Li, Hui Hu, Ping Geng, Panhui Guo, Yuanrong Zhu, Lulu Zeng, Jun Liu, Xiangpeng Hu
    BMC Medical Education.2023;[Epub]     CrossRef
  • Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists
    Daisuke Murakami, Masayuki Yamato, Yuji Amano, Takayoshi Nishino, Makoto Arai
    BMJ Open Gastroenterology.2023; 10(1): e001143.     CrossRef
  • Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
    Jae Myung Park
    Clinical Endoscopy.2023; 56(4): 453.     CrossRef
  • Simethicone and N-acetyl cysteine in improving mucosal visibility: Towards a “clearer view” during endoscopy
    Akash Roy, Mahesh K. Goenka
    Indian Journal of Gastroenterology.2023;[Epub]     CrossRef
  • Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
    Caesar Ferrari, Micheal Tadros
    Gastroenterology Insights.2023; 15(1): 1.     CrossRef
  • Antispasmodic Agent Administration Improves Gastric Neoplasm Detection Rates during Esophagogastroduodenoscopy
    Sang Yoon Kim, Jae Myung Park
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 246.     CrossRef
  • Clinical features of gastric adenoma detected within 3 years after negative screening endoscopy in Korea
    Hyun Young Kim
    Gastroenterology Report.2022;[Epub]     CrossRef
  • 9,140 View
  • 532 Download
  • 13 Web of Science
  • 14 Crossref
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Original Articles
Effectiveness of Solution with 5% Detergent for Cleaning Transnasal Esophagogastroduodenoscopy Lens
Yoshinori Komazawa, Mika Yuki, Nobuhiko Fukuba, Yoshiya Kobayashi, Hitomi Ishitobi, Sayaka Nakashima, Makoto Nagaoka, Yoshiko Takahashi, Toshihiro Shizuku
Clin Endosc 2021;54(2):236-241.   Published online January 19, 2021
DOI: https://doi.org/10.5946/ce.2020.062
AbstractAbstract PDFPubReaderePub
Background
/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens.
Methods
Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined.
Results
Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001).
Conclusions
For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.
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Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey
Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki Endo, Haruka Okano, Daichi Komabayashi, Takeshi Shimizu, Shohei Suzuki, Kei Ito
Clin Endosc 2021;54(3):340-347.   Published online December 11, 2020
DOI: https://doi.org/10.5946/ce.2020.138
AbstractAbstract PDFPubReaderePub
Background
/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy.
Methods
In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated.
Results
Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations.
Conclusions
Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.

Citations

Citations to this article as recorded by  
  • How to implement adverse events as a quality indicator in gastrointestinal endoscopy
    Tom G. Moreels
    Digestive Endoscopy.2024; 36(1): 89.     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
  • Drugs used for sedation in gastrointestinal endoscopy
    Jun Kyu Lee
    Journal of the Korean Medical Association.2022; 65(11): 735.     CrossRef
  • 4,115 View
  • 126 Download
  • 3 Web of Science
  • 3 Crossref
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Focused Review Series: Endoscopy in Children
Sedation in Pediatric Esophagogastroduodenoscopy
Seak Hee Oh
Clin Endosc 2018;51(2):120-128.   Published online March 30, 2018
DOI: https://doi.org/10.5946/ce.2018.028
AbstractAbstract PDFPubReaderePub
Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

Citations

Citations to this article as recorded by  
  • Propofol Sedation in Pediatric Upper Endoscopy: A Study of Pharmacodynamics and the Effects of Gastroenterologists, Anesthesiologists, and Supervised Participants on the Procedure Time and Sedation Time
    Ahila Manivannan, Shailender Madani, Michael Woodall, George McKelvey , Sharon Kemper
    Cureus.2024;[Epub]     CrossRef
  • Comparison of Ketamine and Propofol-Based Regimens for Deep Sedation in Children Undergoing Esophagogastroduodenoscopy
    Olugbenga Akingbola, Sudesh K. Srivastav, Michelle Nguyen, Dinesh Singh, Edwin M. Frieberg, Amy Thibodeaux
    Journal of Pediatric Intensive Care.2022; 11(01): 019.     CrossRef
  • Usefulness of endoscopic ultrasound in children with pancreatobiliary and gastrointestinal symptoms
    Ankit Dalal, Nagesh Kamat, Gaurav Patil, Rajen Daftary, Amit Maydeo
    Endoscopy International Open.2022; 10(02): E192.     CrossRef
  • A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection
    Chi-Wen Hung, Solomon Chih-Chen Chen, Li-Jung Elizabeth Ku, Bor-Shyang Sheu, Yao-Jong Yang
    Frontiers in Pediatrics.2022;[Epub]     CrossRef
  • Low‐dose adjuvant dexmedetomidine did not decrease propofol sedation requirements in children undergoing gastrointestinal endoscopy
    Eric G. Johnson, Sarah G. Weaver, Kelsey L. Batt, Robert H. Weaver, Aric Schadler, Sarah J. Hall
    Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2022; 42(10): 792.     CrossRef
  • Gastrointestinal endoscopy in children and adults: How do they differ?
    Sara Isoldi, Salvatore Cucchiara, Alessandro Repici, Diana G. Lerner, Mike Thomson, Salvatore Oliva
    Digestive and Liver Disease.2021; 53(6): 697.     CrossRef
  • Safety and Competency are the Main Priorities in Pediatric Endoscopy
    Byung-Ho Choe
    Clinical Endoscopy.2020; 53(4): 379.     CrossRef
  • Letter to the Editor: Is Propofol Good Choice for Procedural Sedation? Evaluation of Propofol in Comparison with Other General Anesthetics for Surgery in Children Younger than 3 Years
    Soon Chul Kim
    Journal of Korean Medical Science.2019;[Epub]     CrossRef
  • Dexamethasone Reduces Postoperative Nausea in Pediatric Upper Endoscopy With Deep Sedation
    Hamed Moheimani, Mehdi Yaseri
    Journal of Pediatric Gastroenterology and Nutrition.2019; 69(3): 281.     CrossRef
  • 8,511 View
  • 229 Download
  • 10 Web of Science
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A Case of Splenic Artery Aneurysm Mimicking Gastric Submucosal Tumor
Byeong Chool Park, M.D., Sei Jin Youn, M.D., Seon Mee Park, M.D., Won Joong Jeon, M.D., Jee In Jeong, M.D., Hee Bok Chae, M.D. and Ro Hyun Sung, M.D.*
Korean J Gastrointest Endosc 2009;38(3):142-146.   Published online March 30, 2009
AbstractAbstract PDF
Splenic artery aneurysm is an uncommon clinical entity. Most of these aneurysms are asymptomatic, but if an aneurysm ruptures, it can be fatal and its mortality rate reaches 70 percent. Regardless of the presence of symptoms, if the size of the asymptomatic aneurysm is larger than 2 cm in diameter or the patient is pregnant, then the anurysm should be treated. A 74-year-old female visited our hospital complaining of nonspecific epigastric discomfort. Endoscopic examination of the stomach revealed a submucosal tumor like protruding mass in the body and it was finally diagnosed as a splenic artery aneurysm by computed tomography. We report here on a case of a splenic artery aneurysm that mimicked a submucosal tumor, and this aneurysm was treated with surgery. (Korean J Gastrointest Endosc 2009;38:142-146)
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The Efficacy of Cimetropium Bromide as a Premedication before Esophagogastroduodenoscopy
Jue Yong Lee, M.D., Sung Jung Kim, M.D., Chang Soon Choi, M.D., Young Mook Kim, M.D., Hyun Joo Jeong, M.D., Jung Eun Lee, M.D., Gwang Ho Baik, M.D., Jin Bong Kim, M.D. and Dong Joon Kim, M.D.
Korean J Gastrointest Endosc 2008;37(6):403-408.   Published online December 30, 2008
AbstractAbstract PDF
Background/Aims: Cimetropium bromide has been used widely as a premedication for endoscopy; however, there are no subjective data pertaining to the effects of cimetropum bromide as a premedication. Thus, the current study was undertaken to compare the effects of cimetropum bromide with placebo as a premedication for esophagogastroduodenoscopy (EGD). Methods: Two hundred ninety-nine consecutive outpatients who had undergone EGD were enrolled in this study. Thirty minutes before EGD, the patients were randomly given an intramuscular injection of cimetropium bromide (5 mg) or saline using a placebo-controlled, double-blind, randomized technique. Immediately after EGD, all the patients and endoscopists were requested to fill out the questionnaire form. Results: One-hundred patients were injected with cimetropium bromide and 150 patients were injected with placebo. There was no statistically significant difference in the degree of residual gastric secretions, the peristaltic activity detected by endoscopists, and the comfort experienced by the patients in each study group. Conclusions: The intramuscular injection of cimetropium bromide (5 mg) as a premedication for EGD was not significantly superior to placebo, at least with respect to subjective parameters, in spite of its broad use. (Korean J Gastrointest Endosc 2008;37:403-408)
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A Case of a Localized Abscess in the Neck after Esophagogastroduodenoscopy
Hyun-Jae Woo, M.D., Chang Hoon Bae, M.D., Yong-Dae Kim, M.D. and Si-Youn Song, M.D.
Korean J Gastrointest Endosc 2008;37(3):203-206.   Published online September 30, 2008
AbstractAbstract PDF
Perforations of the upper gastrointestinal tract are uncommon complications after performing an esophagogastroduodenoscopy (EGD). Perforations after an EGD procedure are likely to occur in the hypopharynx and cervical esophagus, where endoscope passage is anatomically difficult. Life-threatening complications including mediastinitis, a mediastinal abscess, pericarditis and sepsis can develop in most cases of a perforation. However, without such fatal complications, an abscess that is localized at the neck is extremely rare following an esophageal perforation. We experienced a case of a localized abscess in the neck after EGD and successfully treated the abscess without surgical management. We emphasize the importance of early detection for neck space infections caused by EGD-induced injuries. (Korean J Gastrointest Endosc 2008;37:203-206)
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Serial Endoscopic Observation in a Case of Spontaneous Submucosal Dissection of the Esophagus
Chang Soo Jang, M.D., Seok Jeong, M.D., Yong Sun Jeon, M.D.*, Sung Tae Ryu, M.D., Jung Il Lee, M.D., Jin-Woo Lee, M.D., Kye Sook Kwon, M.D., Don Haeng Lee, M.D., Pum-Soo Kim, M.D., Hyung Gil Kim, M.D., Yong Woon Shin, M.D. and Young Soo Kim, M.D.
Korean J Gastrointest Endosc 2005;30(1):19-23.   Published online January 30, 2005
AbstractAbstract PDF
Spontaneous submucosal esophageal dissection is a rare disorder, characterized by a longitudinal dissection along the axis of the esophagus between submucosa and muscle layer without an obvious cause. The diagnosis is made by typical esophagographic or endoscopic findings which are double-barreled esophagus in esophagography or mucosal defect in upper esophagus and false lumen running along the distal side of the esophagus on esophagoscopy. The condition usually follows a benign course with good prognosis requiring a supportive treatment, but rarely treated by endoscopy or surgery. A 74-year-old man was admitted to our hospital complaining of chest pain and odynophagia after upper respiratory infection. We diagnosed a case of spontaneous submucosal dissection of the esophagus and observed its healing process by series of endoscopy with a conservative treatment. (Korean J Gastrointest Endosc 2005;30:19⁣23)
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Significance of Endoscopy in the Investigation of Iron Deficiency Anemia
Dong Il Park, M.D., Hee Jung Son, M.D.†‡, Hong Ghi Lee, M.D., Suk Joong Oh, M.D*, Hyun Joo Suh, M.D., Jung Won Yun, M.D., Jeong Wook Kim, M.D., Yong Kyun Cho, M.D., In Kyung Sung, M.D., Chong Il Sohn, M.D., Woo Kyu Jeon,
Korean J Gastrointest Endosc 2004;29(3):114-118.   Published online September 30, 2004
AbstractAbstract PDF
Background
/Aims: There is no consensus for the role of endoscopy in the etiologic investigation of iron deficiency anemia (IDA) in Korea. We carried out a retrospective study to evaluate the role of esophagogastroduodenoscopy (EGD) and colonoscopy for their etiologic diagnosis in IDA. Methods: Between January 1998 and September 2003, 129 patients (male:female=19:110, mean age=43.6) had been grew EGD and colonoscopy for exam for the investigation of IDA at Kangbuk Samsung Hospital and Samsung Medical Center Medical records were retrospectively reviewed: Results: Significant findings were found in 8.5% (11 cases: grade B reflux esophagitis by L.A. classification (1), angiodysplasia (1), severe erosive gastritis (2), and gastric ulcer (2) and duodenal ulcer (5), while 70% (89 cases) showed some abnormality in EGD examination. Significant findings were seen in 11% (14 cases: polyps >1 cm (2), angiodysplasia (1), bleeding hemorrhoids (5), inflammatory bowel disease (4) and colon cancer (2)), among 36% (46 cases) of patients with some abnormality in colonoscopy. Conclusions: Gastrointestinal lesions were frequently found in patients with IDA and significant proportion of them could be the source of blood loss. Therefore, EGD and colonoscopy should be included in the evaluation of IDA in Korea. (Korean J Gastrointest Endosc 2004;29: 114⁣118)
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원저 : 식도 위장관 ; 상부 위장관 내시경 검사시 전처치로서의 Midazolam 의 효과 ( Original Articles : Esophagus , Stomach & Intestine ; Midazolam as Premedication for Upper Gastrointestinal Endoscopy )
Korean J Gastrointest Endosc 1996;16(2):181-190.   Published online November 30, 1995
AbstractAbstract PDF
The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p<0.05), and midazolam group would accept the same sedation for repeated endoscopies(p<0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy. (Korean J Gastrointest Endoec 16: 181-190, 1996)
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