Clinical Endoscopy

Impact of real-time artificial intelligence integration on detection of gastric lesions: an exploratory single-center before-and-after study using low-definition routine endoscopy: Hwijun Lee, Huynh Cong Bang, Seokho Cho, Jungmin Ha, Tran Thien Khiem, Le Viet Tung, La Vinh Phuc, Duong Trong Si, Tran The Du, Diem Thi-Ngoc Vo, Vo Nguyen Trung; Clin Endosc 2026;59(3):408-416. Published online April 22, 2026; DOI: https://doi.org/10.5946/ce.2025.272

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Background
/Aims: Early detection of gastric neoplasia, particularly subcentimeter lesions, using upper gastrointestinal (GI) endoscopy remains challenging. This study evaluated the impact of a real-time artificial intelligence (AI) detection system on the lesion detection rate (LDR) during routine upper GI endoscopy performed using a low-definition platform commonly used in resource-limited settings, with a focus on lesions ≤0.5 cm.
Methods
Diagnostic upper GI endoscopies performed between September 2024 and May 2025 were analyzed. LDRs were compared between the pre- and post-AI periods, including subgroup analyses by lesion size and type.
Results
A total of 2,329 patients were included (1,491 pre-AI, 838 post-AI). After AI implementation, overall LDR per person increased from 1.15±0.45 to 1.20±0.57 (p<0.05). Detection of lesions ≤0.5 cm increased from 18.0% to 19.8% (p<0.05), while detection of larger lesions remained unchanged. The biopsy rate decreased from 13.8% to 8.5% (p<0.05).
Conclusions
Real-time AI modestly improved the detection of diminutive gastric lesions while reducing unnecessary biopsies without compromising malignancy detection, thereby supporting its utility in routine endoscopy under resource-limited conditions.

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Expanding role of artificial intelligence in gastric neoplasms: moving beyond resource limitations
Hannah Lee, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Jung Ho Kim
Clinical Endoscopy.2026; 59(3): 400. CrossRef

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Impact of a simple non-invasive nasal mask device on intraprocedural hypoxemia in overweight individuals undergoing upper gastrointestinal endoscopy with sedation provided by a non-anesthesiologist provider: Jan Drews, Jonas Harder, Hannah Kaiser, Miriam Soenarjo, Dorothee Spahlinger, Peter Wohlmuth, Sebastian Wirtz, Ralf Eberhardt, Florian Bornitz, Torsten Bunde, Thomas von Hahn; Clin Endosc 2024;57(2):196-202. Published online June 27, 2023; DOI: https://doi.org/10.5946/ce.2023.010

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Background
/Aims: Hypoxemia is a common side effect of propofol sedation during endoscopy. Applying mild positive airway pressure (PAP) using a nasal mask may offer a simple way to reduce such events and optimize the conditions for diagnostic and therapeutic upper gastrointestinal endoscopies.
Methods
We compared overweight patients (body mass index >25 kg/m2) with a nasal PAP mask or standard nasal cannula undergoing upper gastrointestinal endoscopies by non-anesthesiologists who provided propofol sedation. Outcome parameters included the frequency and severity of hypoxemic episodes.
Results
We analyzed 102 procedures in 51 patients with nasal PAP masks and 51 controls. Episodes of hypoxemia (oxygen saturation [SpO2] <90% at any time during sedation) occurred in 25 (49.0%) controls compared to 8 (15.7%) patients with nasal PAP masks (p<0.001). Severe hypoxemia (SpO2 <80%) occurred in three individuals (5.9%) in both groups. The mean delta between baseline SpO2 and the lowest SpO2 recorded was significantly decreased among patients with nasal PAP mask compared to controls (3.7 and 8.2 percentage points difference, respectively). There were significantly fewer airway interventions performed in the nasal PAP mask group (15.7% vs. 41.2%, p=0.008).
Conclusions
Using a nasal PAP mask may be a simple means of increasing patient safety and ease of examination.

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Effects of anesthetic nasal masks on hypoxemia in overweight/obese patients undergoing gastroscopy: a randomized controlled trial
Huan Liu, Peipei Guo, Lijian Chen, Xuesheng Liu, Huisheng Wu
European Journal of Medical Research.2025;[Epub] CrossRef
Sedation for GI Endoscopy in the Morbidly Obese: Challenges and Possible Solutions
Lalitha Sundararaman, Basavana Goudra
Journal of Clinical Medicine.2024; 13(16): 4635. CrossRef

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Management of aerosol generation during upper gastrointestinal endoscopy: Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Thawatchai Akaraviputh; Clin Endosc 2022;55(5):588-593. Published online August 24, 2022; DOI: https://doi.org/10.5946/ce.2022.062

Abstract PDF

In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

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Experimental comparison between general and local exhaust systems for aerosol and droplet particle removal in endoscopy rooms
Marcelo Luiz Pereira, Rogério Vilain, Arlindo Tribess
International Journal of Ventilation.2026; 25(3): 358. CrossRef
Best practice of gastrointestinal endoscopy during Mpox upsurge: an Indonesian Society for Digestive Endoscopy recommendation
Rabbinu Rangga Pribadi, Ahmad Fariz Malvi Zamzam Zein, Raisa Wibowo, Achmad Fauzi, Abdul Aziz Rani, Marcellus Simadibrata, Dadang Makmun, Murdani Abdullah, Ari Fahrial Syam, Muhammad Miftahussurur, Agasjtya Wisjnu Wardhana, Amanda Pitarini Utari, Andi Muh
Clinical Endoscopy.2025; 58(5): 662. CrossRef
Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn,
Clinical Endoscopy.2024; 57(3): 335. CrossRef
Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019
Shahnaz Sultan
Gastroenterology Clinics of North America.2023; 52(1): 157. CrossRef
Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?
Shintaro Fujihara, Hideki Kobara, Noriko Nishiyama, Naoya Tada, Yasuhiro Goda, Kazuhiro Kozuka, Takanori Matsui, Taiga Chiyo, Nobuya Kobayashi, Tatsuo Yachida, Tsutomu Masaki
Journal of Clinical Medicine.2023; 12(7): 2574. CrossRef

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Clinical Efficacy of Endocytoscopy for Gastrointestinal Endoscopy: Masashi Misawa, Shin-ei Kudo, Yuki Takashina, Yoshika Akimoto, Yasuharu Maeda, Yuichi Mori, Toyoki Kudo, Kunihiko Wakamura, Hideyuki Miyachi, Fumio Ishida, Haruhiro Inoue; Clin Endosc 2021;54(4):455-463. Published online July 7, 2021; DOI: https://doi.org/10.5946/ce.2021.165

Abstract PDF Supplementary Material

Endocytoscopy (EC) is a contact-type optical endoscope that allows in vivo cellular observation during gastrointestinal endoscopy and is now commercially available not only in Japan but also in Asian, European Union, and Middle Eastern countries. EC helps conduct a highly accurate pathological prediction without biopsy. Initially, EC was reported to be effective for esophageal diseases. Subsequently, its efficacy for stomach and colorectal diseases has been reported. In this narrative review, we searched for clinical studies that investigated the efficacy of EC. EC seems to accurately diagnose gastrointestinal diseases without biopsy. Most of the studies aimed to clarify the relationship between endocytoscopic findings of gastrointestinal neoplasia and pathological diagnosis. Some studies have investigated non-epithelial lesions or diseases, such as inflammatory bowel disease or infectious diseases. However, there are few high-level pieces of evidence, such as randomized trials; thus, further studies are needed.

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White Light, Magnifying Endoscopy, Endocytoscopy, and Artificial Intelligence in Diagnosis of Early Colorectal Cancer: A Comparative Study
Eri Tamura, Shin‐ei Kudo, Shunto Iwasaki, Shigenori Semba, Tomoya Shibuya, Shun Kato, Takanori Kuroki, Yuta Sato, Tatsuya Sakurai, Yushi Ogawa, Yuta Kouyama, Yasuharu Maeda, Katsuro Ichimasa, Noriyuki Ogata, Takemasa Hayashi, Kunihiko Wakamura, Hideyuki M
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Jiaying He, Jiayao Zhou, Jiayi Huo, Xuxiang Ni, Bo Yuan, Liqiang Wang
Biomedical Optics Express.2026; 17(5): 2734. CrossRef
Gastrointestinal endoscopy for physiological assessment in functional gastrointestinal disorders: a perspective
Jing-rong Dong, Shan-shan Guo, Bin Hu, Wen-shuang Zou
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Advanced Endoscopic Imaging for Assessing Mucosal Healing and Histologic Remission in Inflammatory Bowel Diseases
Tommaso Pessarelli, Gian Eugenio Tontini, Helmut Neumann
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 159. CrossRef
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Yasuharu Maeda, Shin-ei Kudo, Takanori Kuroki, Marietta Iacucci
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 213. CrossRef
Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
Riccardo Vasapolli, Johannes Raphael Westphal, Christian Schulz
Diagnostics.2025; 15(15): 1925. CrossRef
Endocitoscopia de la muscular propia en acalasia de rápida evolución y recidiva de acalasia post-Heller
Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
Gastroenterología y Hepatología.2024; 47(7): 761. CrossRef
Endocytoscopy of muscularis propria in rapidly evolving achalasia and recurrence of post-Heller achalasia
Hugo Uchima, Raquel Muñoz-González, Íngrid Marín, Noemí Caballero, Claudia Cepero, Ignacio Iborra, Juan Colán-Hernández, Edgar Castillo, Vicente Moreno
Gastroenterología y Hepatología (English Edition).2024; 47(7): 761. CrossRef
The diagnostic utility of endocytoscopy for the detection of gastric cancer: a systematic review and meta-analysis
Andrew CANAKIS, Shivanand BOMMAN, Benjamin TWERY, Nevin VARGHESE, Byung JI, Justin CANAKIS, Eric M. GOLDBERG
Minerva Gastroenterology.2024;[Epub] CrossRef
The diagnostic utility of endocytoscopy for the detection of esophageal lesions: A systematic review and meta-analysis
Lu Wang, Bofu Tang, Feifei Liu, Zhenyu Jiang, Xianmei Meng
Gastroenterology & Endoscopy.2023; 1(1): 12. CrossRef
A Review of Colonoscopy in Intestinal Diseases
Seung Hong, Dong Baek
Diagnostics.2023; 13(7): 1262. 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
A comparative study of magnifying endoscopy with narrow-band image and endocytoscopy in the diagnosis of gastric neoplasm: a pilot study
In Kyung Yoo, Jun Chul Park, Hyuk Lee, Abdullah Ozgur Yeniova, Jeong Hoon Lee, Dong Keon Yon, Joo Young Cho, Wan-Sik Lee
European Journal of Gastroenterology & Hepatology.2023; 35(5): 530. CrossRef
Advances and challenges in gastrointestinal endoscopy: a comprehensive review
Sun Gyo Lim
Journal of Innovative Medical Technology.2023; 1(1): 10. CrossRef
The development and clinical application of microscopic endoscopy for in vivo optical biopsies: Endocytoscopy and confocal laser endomicroscopy
Huahui Zhang, Zhongyu He, Ziyi Jin, Qinglai Yan, Peng Wang, Xuesong Ye
Photodiagnosis and Photodynamic Therapy.2022; 38: 102826. CrossRef
Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
Hee Seok Moon
Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef

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Introduction to Starting Upper Gastrointestinal Endoscopy: Proper Insertion, Complete Observation, and Appropriate Photographing: Kyung Sik Park; Clin Endosc 2015;48(4):279-284. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.279

Abstract PDF

Diagnostic upper gastrointestinal endoscopy is the most basic of endoscopy procedures and is the technique that trainee doctors first learn. Mastering the basics of endoscopy is very important because when this process is imprecise or performed incorrectly, it can severely affect a patient's health or life. Although there are several guidelines and studies that consider these basics, there are still no standard recommendations for endoscopy in Korea. In this review, basic points, including proper endoscope insertion, precise observation without blind spots, and appropriate photographing, for upper gastrointestinal endoscopy will be discussed.

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Oral Breathing Facilitates Endoscopic Operability Compared With Nasal Breathing in Peroral Endoscopy: A Randomized Controlled Trial
Keitaro Takahashi, Takuya Iwama, Momotaro Muto, Kazuyuki Tanaka, Yu Kobayashi, Katsuyoshi Ando, Shin Kashima, Nobuhiro Ueno, Kentaro Moriichi, Hiroki Tanabe, Kazumichi Harada, Takashi Teramoto, Mikihiro Fujiya
American Journal of Gastroenterology.2025; 120(4): 799. CrossRef
Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
Caesar Ferrari, Micheal Tadros
Gastroenterology Insights.2023; 15(1): 1. CrossRef
Gastrointestinal Endoscopy Performed by Gastroenterologists: Opportunistic Screening Strategy for Newly Diagnosed Head and Neck Cancers
Chih-Wei Yang, Yueng-Hsiang Chu, Hsin-Chien Chen, Wei-Chen Huang, Peng-Jen Chen, Wei-Kuo Chang
Frontiers in Oncology.2022;[Epub] CrossRef
Redundant Electromagnetic Control of an Endoscopic Magnetic Capsule Driven by Multiple Electromagnets Configuration
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IEEE Transactions on Industrial Electronics.2022; 69(11): 11370. CrossRef
Simulation-based mastery learning in gastrointestinal endoscopy training
Hasan Maulahela, Nagita Gianty Annisa, Tiffany Konstantin, Ari Fahrial Syam, Roy Soetikno
World Journal of Gastrointestinal Endoscopy.2022; 14(9): 512. CrossRef
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Azucena Arévalo-Galvis, William A. Otero-Regino, Gloria N. Ovalle-Celis, Eliana R. Rodríguez-Gómez, Alba A. Trespalacios-Rangel, Jed N. Lampe
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Highlights from the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy
Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Ki Baik Hahm
Clinical Endoscopy.2015; 48(4): 269. CrossRef

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A Deep Neck Infection Due to Esophageal Perforation That Was Caused by Upper Gastrointestinal Endoscopy: Sung Gon Shim, M.D., Hang Rak Lee, M.D., Kang Nyeong Lee, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Ho Soon Choi, M.D., Joon Soo Hahm, M.D. and Kyung Tae, M.D.*; Korean J Gastrointest Endosc 2009;38(4):205-209. Published online April 30, 2009

Abstract PDF: Diagnostic upper gastrointestinal endoscopy is a very commonly performed procedure. Physicians use it as a safe diagnostic tool to evaluate patients with a wide range of problems and complaints, but it can cause several complications in few cases. Esophageal perforation is a rare complication of upper gastrointestinal endoscopy, but it is associated with a relatively high mortality rate. Surgical management is required in most such cases. However, medical treatment can be considered for selected patients who are without a large perforation or systemic effects such as sepsis. Deep neck abscess can develop in patients who have had difficult intubations, and this may be related to retropharyngeal trauma or unapparent perforations. We experienced a case of deep neck infection due to an esophageal perforation that developed as a complication of diagnostic upper gastrointestinal endoscopy, and we successfully treated this patient with incision and drainage. (Korean J Gastrointest Endosc 2009;38:205-209)

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The Evalution of Patient Anxiety Associated with Upper Gastrointestinal Endoscopy: Jin Su Jang, M.D., Moon Kyung Joo, M.D., Jin Nam Kim, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D. and Ho Sang Ryu, M.D.; Korean J Gastrointest Endosc 2007;34(2):65-70. Published online March 2, 2007

Abstract PDF: Background
/Aims: Upper gastrointestinal (UGI) endoscopy is a necessary procedure for making the diagnosis of UGI diseases. However, it may evoke anxiety due to the procedural discomfort before endoscopy. There have been few detailed studies that have evaluated the anxiety of patients who undergo UGI endoscopy in Korea. The aim of this study is to evaluate the patient's anxiety associated with UGI endoscopy and to determine the methods to improve the tolerance of patients to UGI endoscopy. Methods: From May to September 2004, we assessed 38 patients who received UGI endoscopy for the first time as outpatients at Korea University, Anam Hospital. One group was examined with UGI endoscopy after being sedated. The patient's anxiety was rated at baseline and immediately before the procedure. Results: Endoscopy was associated with a significant increase in anxiety (prior to procedure, 48.53 vs. baseline, 43.58, p＜0.001) but not trait anxiety (43.92 vs. 43.63, p=0.70). The procedural anxiety was not influenced by gender, age or the education level, but it was correlated with conscious sedation (without CS, 5.67±0.23 vs. with CS, 4.06±0.16, p＜0.05). Conclusions: Sedating the patient during UGI endoscopy is an effective method to lower procedural anxiety.

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Two Cases of Vocal Cord Paralysis Complicated by Upper Gastrointestinal Endoscopy: Sung Won Jung, M.D.; Korean J Gastrointest Endosc 2006;33(1):32-36. Published online July 30, 2006

Abstract PDF: Upper Gastrointestinal endoscopy is extensively used these days and its various complications, including cardiopulmonary disease, bleeding, perforation and infection, have been reported on, but vocal cord paralysis as a complication of endoscopy has not been reported on. The pressure on the larynx by the endoscopic tip itself or the gag reflex during endoscopy could cause vocal cord paralysis as the endoscopic tip passes through the pyriform sinus, which is close to the recurrent laryngeal nerve and arytenoid cartilage. We experienced two cases of vocal cord paralysis as complications of upper Gastrointestinal endoscopy and we report on them here. (Korean J Gastrointest Endosc 2006;33:32⁣36)

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Ingestion of a Mouthpiece Fragment during Intravenous: Seung Ryong Lee, M.D., Byoung Sik Mun, M.D., Heok Soo Ahn, M.D. and Seung Ok Lee, M.D.; Korean J Gastrointest Endosc 2003;26(1):31-34. Published online January 30, 2003

Abstract PDF: The demand for intravenous sedated upper gastrointestianl endoscopy is currently increasing steeply. Despite this trend, patient status complication due to this procedure is largerly neglected by most physicians. Recently, in three patients, mouthpiece fragment were left within the patients' body after intravenous sedated upper gastrointestinal endoscopy. They were transferred to our institution for the removal of the fragment. The patients complained of an uneasy sensation from within their body, around their necks and chests. After conducting therapeutic endoscopy, the fragment could be located around the distal part of their esophagus and within their stomach. The fragment were removed successfully by using snare in two patients, and by using forceps in another patient. (Korean J Gastrointest Endosc 2003; 26:31⁣34)

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수면내시경 검사에서 Midazolam 전처치와 Flumazenil 길항작용에 대한 연구 ( Effectiveness of Flumazenil against Midazolam as Premedication for Upper Gastrointestinal Endoscopy ): Korean J Gastrointest Endosc 2000;21(1):518-524. Published online November 30, 1999

Abstract PDF: Background
/Aims : Midazolam is utilized as a premedication for uppoer gastrointestinal endoscopy. Midazolam has a more rapid onset of reaction than that of diazepam and its duration is shorter. But the Consciousness of premedicated patients has not been regained sooner. The Purpose of this study was to examine the effectiveness of flumazenil against midazolam as premedication for upper gastrointesinal endoscopy. Methods : Sixty patients underwent upper gastrointestinal endoscopy. These patients were divided to three groups: Group I included twenty patients without premedication; Group Ⅱ Included twenty patients with premedication of midazolam and then were not given an antisedative agent excluign of normal saline; and Group Ⅲ included the others with midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam and flumazenil as an antisedative agent. Results : There was no change in vital signs after midazolam injection, compared with presedation value. Modified Steward Coma Scale showed a significant increase after flumazenil injection as an antagonist of midazolam. The assessment of the endoscopist and the comfort of patients were satisfactory. When the 40 patients were asked about their willingness to undergo the same procedure in the future, thirty-four patients responded favorably. Conclusion : Midazolam was safe and effective for sedation for upper gastrointestinal endoscopy. There was rapid regaining of consciousness with flumazenil indection after midazolam, so the use of flumazenil against midazolam injection also appeared to be effective. ( Korean J Gastrointest Endosc 2000;21:518-524)

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상부 위장관 내시경 검사 시 전처치로서의 Propofol의 효과 ( Propofol as Premedication for Upper Gastrointestinal Endoscopy ): Korean J Gastrointest Endosc 2000;20(3):165-170. Published online November 30, 1999

Abstract PDF: Background
/Aims: Benzodiazepine is generally used when sedation is required for endoscopy, while propofol, a phenol-derived intravenous anesthetic agent, appears to have a more suitable phamacokinetic profile. The aim of this study was to evaluate the effectiveness and safety of propofol as premedication for upper gastrointestinal endoscopy. Methods: Between July 1998 and October 1998, 44 male patients and 70 female patients were involved in this study. The relative ease of upper gastrointestinal endoscopy, patient's tolerance, and amnestic effects on 64 patients with propofol was compared with 50 patients with non-sedation. Pulse rate and arterial oxygen saturation was monitored. The endoscopist and patients replied to a questionnaire. Results: Patients receiving propofol tolerated endoscopy much more than patients with non-sedation (p＜0.01). The change in pulse rate was less variable but arterial oxygen saturation showed a statistically significant decrease in patients receiving propofol (p＜0.01). Propofol induced complete amnesia in 93.7% of the patients and partial anesthesia in 4.7%. Most of the patients receiving propofol accepted the same sedative methods in their next endoscopy (p＜0.01). Conclusions: Propofol is highly effective, with a short recovery time and satisfaction of the patients, but careful monitoring is recommended because of its untoward effect of hypoxia. It is recommended that propofol be used as a premedication especially in patients who are apprehensive about a repeated endoscopy.

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Propofol 지속정주를 이용한 상부소화관 내시경 ( Gastrointestinal Endoscopy under Sedation with a Continuous Infusion of Propofol ): Korean J Gastrointest Endosc 1999;19(5):706-715. Published online November 30, 1998

Abstract PDF: Background
/Aims: Propofol is a short-acting intravenous sedative-hypnotic agent that can be used as a hypnotics for upper gastrointestinal endoscopy. A study was conducted to evaluate the effectiveness and safety of propofol as a hypnotic agent for upper gastrointestinal endoscopy. Methods: From June to October 1998, twenty eight patients undergoing upper gastrointestinal endoscopy were to receive propofol. Vital signs and peripheral oxygen saturation (SpO2) were monitored by pulse oximetry during continuous infusion of propofol. Propofol (1% solution) was initially infused by 26.7 mg/kg/hr until loss of eyelash reflex and then titrated to 6∼10 mg/kg/hr according to the patient's response and vital sign. Propofol infusion was discontinued while the endoscopic fiber was removed. Recovery time was defined from discontinuation of infusion to positive Romberg test. Evaluation was made from the endoscopists' assessment, patients' satisfaction, patients' recall of the procedure, and consciousness of the patients. Results: It was discovered that systolic, diastolic pressure and heart rate were significantly decreased, compared to control group. But clinically significant changes were not found. Apnea did not exist. And the respiration rate was significantly increased during propofol infusion. Peripheral oxygen saturation (SpO2) was transiently decreased during endoscopy. 14 patients (50%) complained of transient dizziness. Pain and redness over the infusion site was not found. The mean total dose of propofol was 133.6 mg. The mean infusion time of propofol was 6.2 minutes. Mean response and recovery time was 3.7 2.1, 20.9 5.4 minutes. Endoscopists' assessment and patients' comfort for endoscopy were satisfactory. When we asked 28 patients about willingness to undergo the same procedure in the future, 27 patients (96.4%) agreed. Degree of amnesia after examination revealed total amnesia in 27 patients (96.4%), partial amnesia in 1 patients (3.6%), and recall was not. Conclusions: Propofol has beneficial effects as hypnotic for upper gastrointestinal endoscopy without significant alteration in cardiopulmonary parameters. Patients' and endoscopists' assessment is good. This suggest that propofol may be used more frequently as a kind of premedication, especially in the cases of repeated endoscopy. (Korean J Gastrointest Endosc 19: 706∼715, 1999)

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원저 : 식도 위장관 ; 선천성 비후성 유문 협착증의 진단에 있어서 상부 위장관 내시경술의 역할 ( Original Articles : Esophagus , Stomach & Intestine ; The Role of an Upper Gastrointestinal Endoscopy in the Diagnosis of Congenital Hypertrophic Pyloric Stenosis ): Korean J Gastrointest Endosc 1998;18(3):319-323. Published online November 30, 1997

Abstract PDF: Background
/Aims: In 1977, Teele and Smith reported their positive experience using an ultrasonographic in the evaluation of Congenital Hypertrophic Pyloric Stenosis (CHPS). Since that time, ultrasonography has been advocated by some as the diagnostic procedure of choice, although a number of false-negative cases have been encountered at any rate, in 1994, Becker reported that an endoscopy was far more accurate than an ultrasonography, the diagnosis being made in 97% and 81% of the cases. Therefore, we performed a prospective study to evaluate the diagnostic value of an upper gastrointestinal endoscopy in CHPS patients. Methods: We reviewed the clinical records of 12 pediatric patients experiencing vomiting, who had visited Pusan National University Hospital from January 1993 to March 1997. We performed on upper gastrointestinal endoscopy and abdominal ultrasonography simultaneously in order to evaluate the diagnostic value of an upper gastrointestinal endoscopy in CHPS patients. Results: The male to female ratio was 11: 1. In 7 of 12 patients, 58%, vomited within 4 weeks after birth. Diagnostic sensitivity by abdominal ultrasonography was about 75%, and by upper GI endoscopy, almost 100%. Associated lesions were discovered in 5 cases, 3 esophagitis and 2 gastritis in the upper GI endoscopy. Conclusions: The upper GI endoscopy was more accurate in the diagnosis of CHPS than the ultrasonography, and was more effective in the diagnosis of associated lesions. (Korean J Gastrointest Endosc 18: 319-323, 1998)

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원저 : 식도 위장관 ; 상부 소화관 내시경에 있어서 산소 비포화도에 대한 고찰 ( Original Articles : Esophagus , Stomach & Intestine ; Arterial Oxygen Desaturation during Non-sedated Diagnostic Gastrointestinal Endoscopy ): Korean J Gastrointest Endosc 1996;16(1):25-29. Published online November 30, 1995

Abstract PDF: We studied arterial oxygen desaturation, using a pulse oximeter, in 132 patients undergoing diagnostic upper gastrointestinal endoscopy to obtain predictive factors of the change. The baseline arterial oxygen saturation (SaO2) level was 98.8+- 1.2%. During the procedure, oxygen desaturation (SaO2>95%) was found in 90.2% of the patients, Mild oxygen desaturation (95>SaO2>90%) was found in 9.8% of the patients, and there was no severe oxygen desaturation(SaO2<90%). Age(P=0.52), gender(P =0.48), smoking(P =0.71), body mass index(P =0.32), and endoscopy time(P = 0.68) was not related to the degree of oxygen desaturation. These results suggest that oxygen desaturation, which may rarely induce serious cardiopulmonary events, is not frequently observed during non-sedated diagnostic upper endoscopy. (Kor J Gastrointest Endosc 16: 25-29, 1096)

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