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Arrigo S, Alvisi P, Banzato C, Bramuzzo M, Celano R, Civitelli F, D'Arcangelo G, Dilillo A, Dipasquale V, Felici E, Fuoti M, Gatti S, Knafelz D, Lionetti P, Mario F, Marseglia A, Martelossi S, Moretti C, Norsa L, Panceri R, Renzo S, Romano C, Romeo E, Strisciuglio C, Martinelli M. Impact of COVID-19 pandemic on the management of paediatric inflammatory bowel disease: An Italian multicentre study on behalf of the SIGENP IBD Group. Dig Liver Dis 2021; 53:283-288. [PMID: 33388247 PMCID: PMC7832380 DOI: 10.1016/j.dld.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND IBD management has been significantly affected during the COVID-19 lockdown with potential clinical issues. AIMS The aim of this study was to analyse the impact of COVID-19 pandemic on the Italian paediatric IBD cohort. METHODS This was a multicentre, retrospective, cohort investigation including 21 different Italian IBD referral centres. An electronic data collection was performed among the participating centres including: clinical characteristics of IBD patients, number of COVID-19 cases and clinical outcomes, disease management during the lockdown and the previous 9 weeks. RESULTS 2291 children affected by IBD were enrolled. We experienced a significant reduction of the hospital admissions [604/2291 (26.3%) vs 1281/2291 (55.9%); p < 0.001]. More specifically, we observed a reduction of hospitalizations for new diagnosis (from n = 44 to n = 27) and endoscopic re-evaluations (from n = 46 to n = 8). Hospitalization for relapses and surgical procedures remained substantially unchanged. Biologic infusions did not significantly vary [393/2291 (17.1%) vs 368/2291 (16%); p = 0.3]. Telemedicine services for children with IBD were activated in 52.3% of the centres. In 42/2291(1.8%) children immunosuppressive therapies were adapted due to the concurrent COVID-19 pandemic. CONCLUSION Due to the several limitations of the lockdown, cares for children with IBD have been kept to minimal standards, giving priorities to the urgencies and to biologics' infusions and implementing telemedicine services.
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Affiliation(s)
- Serena Arrigo
- Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Claudia Banzato
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health, IRCCS Burlo Garofalo, Trieste, Italy
| | - Rosaria Celano
- Fondazione IRCCS Ca' Grande, Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy
| | - Fortunata Civitelli
- Department of Gender diseases, Child and Adolescent health, Pediatric unit, Sant'Eugenio Hospital, Rome, Italy
| | - Giulia D'Arcangelo
- Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Valeria Dipasquale
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age ``Gaetano Barresi'', University of Messina, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Maurizio Fuoti
- Pediatric Gastroenterology and GI Endoscopy, University Department of Pediatrics, Children's Hospital, Spedali Civili, Brescia, Italy
| | - Simona Gatti
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | - Daniela Knafelz
- Hepatology and Gastroenterology Unit, Bambino Gesù Hospital, Rome, Italy
| | | | | | - Antonio Marseglia
- Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy
| | | | - Chiara Moretti
- Paediatrics Division, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Norsa
- Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Roberto Panceri
- Department of Pediatrics, University of Milano-Bicocca, Foundation MBBM/San Gerardo Hospital, Monza, Italy
| | - Sara Renzo
- University of Florence-Meyer Hospital, Florence, Italy
| | - Claudio Romano
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age ``Gaetano Barresi'', University of Messina, Italy
| | - Erminia Romeo
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania ``Luigi Vanvitelli'', Naples, Italy
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Italy.
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Benites-Goñi H, Pascacio-Fiori M, Monge-Del Valle F, Plácido-Damián Z, Gonzales-Carazas E, Padilla-Espinoza M, Prado-Bustamante J, Llatas-Pérez J, Dávalos-Moscol M. Impact of the COVID-19 pandemic in the time to endoscopy in patients with upper gastrointestinal bleedin. Rev Gastroenterol Peru 2020; 40:219-223. [PMID: 33181807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic, endoscopic procedures are associated with a high risk of SARS-CoV-2 infection. However, in cases of upper gastrointestinal bleeding (UGIB), priority should be given to an early endoscopy. OBJECTIVE The main objective was to compare the time since arrival at the hospital and the performance of the endoscopy between both groups. MATERIALS AND METHODS We performed a retrospective study. Data contains information of patients who attended to the hospital with UGIB and underwent an endoscopy between October 19th, 2019 and June 6th, 2020. Patients were divided into 2 phases: pre-pandemic and pandemic. The time between arrival at the hospital and the performance of the endoscopy in both phases were compared as well as other indicators such hospital stay and in-hospital mortality. RESULTS With information from 219 patients, the median age was 69 years. 154 and 65 endoscopies were performed in pre-pandemic and pandemic phase, respectively. The time between arrival at the hospital and the performance of the endoscopy was significantly longer during the pandemic (10.00 vs. 13.08 hours, p-value = 0.019). Nevertheless, there were no significant differences in hospital stay or mortality. CONCLUSION The management of patients with UGIB during the COVID-19 pandemic is complex and requires the application of clinical judgment to decide the best timing to perform an endoscopy without affecting patient care.
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Barone M, Viggiani MT, Introna A, D'errico E, Scarafino A, Iannone A, Di Leo A, Simone IL. Nutritional prognostic factors for survival in amyotrophic lateral sclerosis patients undergone percutaneous endoscopic gastrostomy placement. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:490-496. [PMID: 31347407 DOI: 10.1080/21678421.2019.1643374] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: There are conflicting data on nutritional factors influencing survival in amyotrophic lateral sclerosis (ALS) patients after percutaneous endoscopic gastrostomy (PEG) placement. We performed an observational cross-sectional study evaluating body mass index (BMI) categories and cholesterol levels as prognostic factors for survival after PEG. Moreover, we assessed body composition in a subgroup of patients to better explain the influence of BMI on survival. Methods: Neurological and nutritional parameters were evaluated at the time of PEG implantation in 47 consecutive patients. Moreover, body composition was evaluated in a subgroup of 22 patients by bioelectrical impedance analysis. Survival was calculated as the time from the PEG placement to death. Results: Underweight patients had a significantly increased risk of death as compared to normal-weight patients using Cox regression analysis [HR = 3.37 (1.29-8.81); p = 0.04]. Similarly, older age at the onset of symptoms significantly increased the risk of death [HR = 1.07 (1.02-1.12); p = 0.001]. Neither overweight/obesity nor hypercholesterolemia affected survival. All ALS patients showed an altered body composition compared to the general population. In addition, a BMI <18.5 kg/m2 identified patients with a significant reduction of body cell mass (BCM) and phase angle (PhA) compared to patients with normal BMI taken as the reference value. Conclusions: In the later stages of the disease, only a BMI < 18.5 kg/m2 and older age at symptom onset had a prognostic value on survival. Dyslipidemia did not affect survival. The low BCM and PhA characterizing underweight patients support the role of BMI as a predictor of survival.
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Affiliation(s)
- Michele Barone
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Maria Teresa Viggiani
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Alessandro Introna
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Eustachio D'errico
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Antonio Scarafino
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
| | - Andrea Iannone
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Alfredo Di Leo
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari , Bari , Italy
| | - Isabella Laura Simone
- Neurological ALS Tertiary Centre, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari , Bari , Italy
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Gkouvatsos K, Mathys P, Bastid C, Frossard JL, Lepilliez V, Bichard P. [Innovations in endoscopy]. Rev Med Suisse 2019; 15:1478-1482. [PMID: 31496170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Digestive endoscopy has met an enormous progress over the last decade, both in terms of diagnosis and treatment of gastro-intestinal diseases. This review article presents the role of confocal endomicroscopy in the management of pancreatic cysts. Moreover, it resumes the most important novel therapeutic endoscopic techniques, some already available in expert centers such as G-POEM or biliary drainage by Axios stent system and spiral enteroscopy, as well as techniques undergoing validation such as the radiofrequency ablation of pancreatic tumors and the bariatric and metabolic endoscopy techniques.
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Affiliation(s)
| | - Philippe Mathys
- Service de gastroentérologie et hépatologie, HUG, 1211 Genève 14
| | - Caroline Bastid
- Service de gastroentérologie et hépatologie, HUG, 1211 Genève 14
| | | | - Vincent Lepilliez
- Service de gastroentérologie et hépatologie, HUG, 1211 Genève 14
- Hôpital privé Jean Mermoz, Ramsay Générale de Santé, 69008 Lyon, France
| | - Philippe Bichard
- Service de gastroentérologie et hépatologie, HUG, 1211 Genève 14
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McGoran JJ, McAlindon ME, Iyer PG, Seibel EJ, Haidry R, Lovat LB, Sami SS. Miniature gastrointestinal endoscopy: Now and the future. World J Gastroenterol 2019; 25:4051-4060. [PMID: 31435163 PMCID: PMC6700702 DOI: 10.3748/wjg.v25.i30.4051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/22/2019] [Accepted: 07/03/2019] [Indexed: 02/06/2023] Open
Abstract
Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy, acceptability and cost-effectiveness of this area of clinical practice. One method of achieving this has been to reduce the caliber of endoscopic devices. We propose the collective term “Miniature GI Endoscopy”. In this Opinion Review, the innovations in this field are explored and discussed. The progress and clinical use of the three main areas of miniature GI endoscopy (ultrathin endoscopy, wireless endoscopy and scanning fiber endoscopy) are described. The opportunities presented by these technologies are set out in a clinical context, as are their current limitations. Many of the positive aspects of miniature endoscopy are clear, in that smaller devices provide access to potentially all of the alimentary canal, while conferring high patient acceptability. This must be balanced with the costs of new technologies and recognition of device specific challenges. Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined. Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms, therapeutic intervention and screening. Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.
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Affiliation(s)
- John J McGoran
- Digestive Diseases Centre, Leicester Royal Infirmary, Leicester LE1 5WW, United Kingdom
| | - Mark E McAlindon
- Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield S10 2JF, United Kingdom
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN 55905, United States
| | - Eric J Seibel
- Department of Mechanical Engineering, University of Washington, 4000 Mason St, Seattle, WA 98195, United States
| | - Rehan Haidry
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
| | - Laurence B Lovat
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
| | - Sarmed S Sami
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, United Kingdom
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de Jong JJ, Lantinga MA, Drenth JPH. Prevention of overuse: A view on upper gastrointestinal endoscopy. World J Gastroenterol 2019; 25:178-189. [PMID: 30670908 PMCID: PMC6337020 DOI: 10.3748/wjg.v25.i2.178] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/06/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023] Open
Abstract
Many upper gastrointestinal (GI) endoscopies worldwide are performed for inappropriate indications. This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services. Dyspepsia is one of the most common inappropriate indications for upper GI endoscopy as diagnostic yield is low. Reasons for untimely referral are: unfamiliarity with dyspepsia guidelines, uncertainty about etiology of symptoms, and therapy failure. Unfiltered open-access referrals feed upper GI endoscopy overuse. This review highlights strategies applied to diminish use of upper GI endoscopies for dyspepsia. First, we describe the impact of active guideline implementation. We found improved guideline adherence, but resistance was encountered in the process. Secondly, we show several forms of clinical assessment. While algorithm use reduced upper GI endoscopy volume, effects of referral assessment of individual patients were minor. A third strategy proposed Helicobacter pylori test and treat for all dyspeptic patients. Many upper GI endoscopies can be avoided using this strategy, but outcomes may be prevalence dependent. Lastly, empirical treatment with Proton pump inhibitors achieved symptom relief for dyspepsia and avoided upper GI endoscopies in about two thirds of patients. Changing referral behavior is complex as contributing factors are manifold. A collaboration of multiple strategies is most likely to succeed.
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Affiliation(s)
- Judith J de Jong
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Marten A Lantinga
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Joost PH Drenth
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
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Affiliation(s)
- Iyad Khamaysi
- Advanced Endoscopy Unit, Department of Gastroenterology and Hepatology, Rambam Medical Center, Haifa 3109601, Israel; Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Khaled Matar
- Gastroenterology and Hepatology Department, European Gaza Hospital, Gaza
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Haluzík M, Kratochvílová H, Haluzíková D, Mráz M. Gut as an emerging organ for the treatment of diabetes: focus on mechanism of action of bariatric and endoscopic interventions. J Endocrinol 2018; 237:R1-R17. [PMID: 29378901 DOI: 10.1530/joe-17-0438] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/29/2018] [Indexed: 01/19/2023]
Abstract
Increasing worldwide prevalence of type 2 diabetes mellitus and its accompanying pathologies such as obesity, arterial hypertension and dyslipidemia represents one of the most important challenges of current medicine. Despite intensive efforts, high percentage of patients with type 2 diabetes does not achieve treatment goals and struggle with increasing body weight and poor glucose control. While novel classes of antidiabetic medications such as incretin-based therapies and gliflozins have some favorable characteristics compared to older antidiabetics, the only therapeutic option shown to substantially modify the progression of diabetes or to achieve its remission is bariatric surgery. Its efficacy in the treatment of diabetes is well established, but the exact underlying modes of action are still only partially described. They include restriction of food amount, enhanced passage of chymus into distal part of small intestine with subsequent modification of gastrointestinal hormones and bile acids secretion, neural mechanisms, changes in gut microbiota and many other possible mechanisms underscoring the importance of the gut in the regulation of glucose metabolism. In addition to bariatric surgery, less-invasive endoscopic methods based on the principles of bariatric surgery were introduced and showed promising results. This review highlights the role of the intestine in the regulation of glucose homeostasis focusing on the mechanisms of action of bariatric and especially endoscopic methods of the treatment of diabetes. A better understanding of these mechanisms may lead to less invasive endoscopic treatments of diabetes and obesity that may complement and widen current therapeutic options.
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Affiliation(s)
- Martin Haluzík
- Centre for Experimental MedicineInstitute for Clinical and Experimental Medicine, Prague, Czech Republic
- Diabetes CentreInstitute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Medical Biochemistry and Laboratory DiagnosticsGeneral University Hospital, Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic
| | - Helena Kratochvílová
- Centre for Experimental MedicineInstitute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Medical Biochemistry and Laboratory DiagnosticsGeneral University Hospital, Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic
| | - Denisa Haluzíková
- Department of Sports MedicineGeneral University Hospital, Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic
| | - Miloš Mráz
- Diabetes CentreInstitute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Medical Biochemistry and Laboratory DiagnosticsGeneral University Hospital, Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic
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Nkrumah KN, Archampong EQ. Fibreoptic gastro-intestinal endoscopy at the Korle Bu Teaching Hospital, Accra, Ghana: a historical perspective. Ghana Med J 2017; 51:187-190. [PMID: 29622833 PMCID: PMC5870782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Fibreoptic (or Flexible) endoscopy has revolutionized and completely transformed practice of gastroenterology, and many other medical specialties, over the past half century or so. At the Korle Bu Teaching Hospital, Accra the development of this facility has evolved gradually, especially involving specialists from the Departments of Medicine and Surgery since the 1970s. This article is an attempt to trace and record this journey and to highlight some of the problems and challenges yet to be overcome. It is an anecdotal account based on the authors' recollection with attempts at verification of important dates.
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Affiliation(s)
- Kofi N Nkrumah
- Department of Medicine & Therapeutics University of Ghana Medical School, PO Box GP 4236, Accra, Ghana
| | - Emmanuel Q Archampong
- Department of Surgery, University of Ghana Medical School, PO Box GP 4236, Accra, Ghana
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Abstract
BACKGROUND AND AIM Several bariatric surgery worldwide surveys have been previously published to illustrate the evolution of bariatric surgery in the last decades. The aim of this survey is to report an updated overview of all bariatric procedures performed in 2014.For the first time, a special section on endoluminal techniques was added. METHODS The 2014 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) survey form evaluating the number and the type of surgical and endoluminal bariatric procedures was emailed to all IFSO societies. Trend analyses from 2011 to 2014 were also performed. RESULTS There were 56/60 (93.3%) responders. The total number of bariatric/metabolic procedures performed in 2014 consisted of 579,517 (97.6%) surgical operations and 14,725 (2.4%) endoluminal procedures. The most commonly performed procedure in the world was sleeve gastrectomy (SG) that reached 45.9%, followed by Roux-en-Y gastric bypass (RYGB) (39.6%), and adjustable gastric banding (AGB) (7.4%). The annual percentage changes from 2013 revealed the increase of SG and decrease of RYGB in all the IFSO regions (USA/Canada, Europe, and Asia/Pacific) with the exception of Latin/South America, where SG decreased and RYGB represented the most frequent procedure. CONCLUSIONS There was a further increase in the total number of bariatric/metabolic procedures in 2014 and SG is currently the most frequent surgical procedure in the world. This is the first survey that describes the endoluminal procedures, but the accuracy of provided data should be hopefully improved in the next future. We encourage the creation of further national registries and their continuous updates taking into account all new bariatric procedures including the endoscopic procedures that will obtain increasing importance in the near future.
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Affiliation(s)
- L. Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - A. Santonicola
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy
| | - P. Iovino
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy
| | - A. Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - N. Zundel
- Minimally Invasive and Bariatric Surgery, FSFB, Bogata, Colombia
| | - H. Buchwald
- Departments of Surgery and Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455 USA
| | - N. Scopinaro
- Department of Surgery, School of Medicine, University of Genoa, Genoa, Italy
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12
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Stiefelhagen P. [Modern endoscopes open new perspectives]. MMW Fortschr Med 2016; 158:16. [PMID: 27071562 DOI: 10.1007/s15006-016-8034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The transformation of the submucosa into a working space provided a paradigm shift for endolumenal endoscopic intervention. The submucosal space can provide an undermining access to the removal of overlying mucosal disease. This space can also provide a protective mucosal barrier accommodating interventions into the deep layers of the gut wall and body cavities, such as the abdomen and mediastinum.
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Affiliation(s)
- Saurabh S Mukewar
- Division of Gastroenterology & Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Christopher J Gostout
- Division of Gastroenterology & Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Yamaguchi S, Sakata Y, Iwakiri R, Hara M, Akutagawa K, Shimoda R, Yamaguchi D, Hidaka H, Sakata H, Fujimoto K, Mizuguchi M, Shimoda Y, Irie H, Noshiro H. Increase in Endoscopic and Laparoscopic Surgery Regarding the Therapeutic Approach of Gastric Cancer Detected by Cancer Screening in Saga Prefecture, Japan. Intern Med 2016; 55:1247-53. [PMID: 27181528 DOI: 10.2169/internalmedicine.55.5339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Despite recent advances in endoscopic treatment and laparoscopic surgery for gastric cancers, an increase in the uptake of these therapeutic approaches has not yet been fully demonstrated. Therefore, the present study aimed to investigate the change in therapeutic approaches regarding the treatment of gastric cancers detected by cancer screening in Saga Prefecture, Japan between April 2002 and March 2011. Methods Gastric cancer screening by X-ray was performed on 311,074 subjects between April 2002 and March 2011. In total, 534 patients were thereafter diagnosed with gastric cancer. Eighteen subjects were excluded because precise details of their treatment were not available. To evaluate the changes in the therapeutic approach, the observation period was divided into three 3-year intervals: Period I: April 2002 to March 2005; Period II: April 2005 to March 2008; Period III: April 2008 to March 2011. Results The use of open laparotomy for the treatment of gastric cancer decreased, and laparoscopic surgery and endoscopic treatment increased markedly in a time-dependent manner. A 2.5-fold increase in endoscopic treatment, and a 18.4-fold increase in laparoscopic surgery were observed in Period III compared with Period I (after adjusting for age and tumor characteristics). Conclusion Endoscopic treatment and laparoscopic surgery for gastric cancer increased during the investigation period (2002-2011), although the tumor characteristics of the gastric cancers detected through cancer screening in Saga Prefecture, Japan did not show any changes.
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Belyaev AM, Karachun AM, Petrov AS, Samsonov DV. [Modern trends in surgery of gastrointestinal tract tumors]. Vopr Onkol 2016; 62:187-195. [PMID: 30452193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Development of cancer surgery in recent decades occurs on a background of continuing scientific and technical progress. New technologies after the completion of clinical trials maximally quickly are included in the routine practice of specialized medical centers. At present an escalation of indications for extensive advanced and combined operations in locally advanced and even metastatic tumors goes in parallel with the introduction of minimally invasive interventions, search categories of patients, for whom the radicalism of treatment can be achieved without significant surgical aggression. The study of modern trends of this process will allow seeing the promising areas of scientific research, assuming the image of the future of surgery for cancer.
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Affiliation(s)
- Sidney J Winawer
- Gastroenterology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, and Weill Cornell Medical College, New York, New York
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Artifon ELA. Endoscopic ultrasound: past, present and future. Rev Gastroenterol Peru 2015; 35:217. [PMID: 26397277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Everson L A Artifon
- Miembro del ComitÉ Editorial del de la Revista de GastroenterologÍa del PerÚ. Lima, PerÚ
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Abstract
Although ileocolonoscopy is the gold standard for diagnosis of inflammatory bowel disease and is useful for assessing the disease severity in the colon and terminal ileum, several alternative diagnostic techniques have been developed recently. For ulcerative colitis (UC), magnification colonoscopy, endocytoscopy, and confocal laser endomicroscopy enable assessment of histological inflammation without the need for biopsy. Capsule endoscopy is useful for detection of small intestinal and colonic lesions in both female and male patients. For UC, capsule endoscopy may be useful for evaluating colonic inflammation in patients with a previous poor colonoscopy experience, while it should be used only in Crohn's disease (CD) patients with unexplained symptoms when other examinations are negative. Magnetic resonance enterography (MRE) is particularly useful for detecting transmural inflammation, stenosis, and extraintestinal lesions, including abscesses and fistulas. MRE is also useful when evaluating small and large intestinal lesions, even in cases with severe strictures in which full evaluation of the small bowel would be virtually impossible using other devices. Therefore, the appropriate diagnostic devices for detecting CD lesions in the small and large intestine should be used.
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Affiliation(s)
- Makoto Naganuma
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Kanai
- Department of Gastroenterology and Hepatology, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
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Gyökeres T. [New trends and novel possibilities in the endoscopic diagnostics of gastrointestinal tumors]. Magy Onkol 2015; 59:62-67. [PMID: 25763915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
This publication shortly reviews the attributes of cornerstones of the latest technical developments in the field of endoscopy (virtual chromoendoscopy, optical biopsy, etc.), as well as some technical details of novel endoscopic methods (deep enteroscopy, capsule endoscopy). It evaluates the clinical consequences of the technical progress concerning several diseases that are important from the point of view of oncology. Some novel endoscopic innovations till now with uncertain clinical relevance are also mentioned. We can face the fact what a huge gap exists between our everyday possibilities at almost all our workplaces and the up-to-date endoscopic diagnostic modalities of the developed world.
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Affiliation(s)
- Tibor Gyökeres
- Gasztroenterológia, Magyar Honvédség Egészségügyi Központ, Budapest, Hungary.
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20
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Menshikova IL, Turbekova MN. [COMPETENCE OF INTRALUMINAL ENDOSCOPY SPECIALISTS: PROSPECTS AND CHALLENGES]. Eksp Klin Gastroenterol 2015:4-6. [PMID: 27249857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article shows the current status of the establishment of endoscopists in Kazakhstan, the need for which have grown because of implementation of a population-based screening for colorectal cancer and a screening pilot project to detect cancer of esophagus and stomach. Also the article reflects the opportunities and problems of the educational process, compares the world experience in this field with real situation in Kazakhstan.
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Kniazev MV, Duvanskiĭ VA. [Endoscopic treatment of gastro-intestinal neoplasia - evolution of the method]. Vestn Khir Im I I Grek 2015; 174:130-134. [PMID: 26234083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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22
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Fedorov ED, Ivanova EV, Plakhov RV, Buntseva OA. ["Wise up, is there an endpoint at the ends of the earth, and can the horizons be broaden?" Gastrointestinal Endoscopy--2014]. Eksp Klin Gastroenterol 2014:4-9. [PMID: 25518476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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23
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Zhang XL, Lu ZS, Tang P, Kong JY, Yang YS. Current application situation of gastrointestinal endoscopy in China. World J Gastroenterol 2013; 19:2950-2955. [PMID: 23704828 PMCID: PMC3660820 DOI: 10.3748/wjg.v19.i19.2950] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 03/27/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the current application situation of gastrointestinal (GI) endoscopy in mainland China.
METHODS: From 12 August, 2011 to 15 February, 2012, draft questionnaires were sent by e-mail to 289 hospital-based GI endoscopy units, including units with three levels (provincial, prefecture and county level) in mainland China. All the surveyed GI endoscopy units were state-owned and hospital-based. Proportions were compared using χ2 tests. Comparisons between groups were performed using the Mann-Whitney U test. A probability of P < 0.05 was considered to represent a statistically significant difference.
RESULTS: Based on satisfactory replies, 169/279 (60.6%) of units were enrolled in the survey, which covered 28 provinces (90.3%, 28/31) in mainland China. Compared with published survey data, the number of GI endoscopes per unit has increased by nearly three times (from 2.9 to 9.3) in the past decade. About 33 of 169 (19.5%) endoscopy units possessed an X-ray machine, which was mainly owned by provincial endoscopy units (43.2%, 19/44). Video capsule endoscopes, which were almost unavailable ten years ago, were owned by 20.7% (35/169) of GI endoscopy units. Endoscopic submucosal dissection could be performed by 36.4% (19/44) of the provincial units, which was significantly higher than the prefecture level (9.9%, P < 0.01) and county level (0.0%, P < 0.01) units, respectively.
CONCLUSION: Rapid development in GI endoscopy has been made in mainland China, and major diagnostic endoscopes and therapeutic endoscopy procedures are predominantly used in large endoscopy units.
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Shcherbakov PL. [Progress in endoscopy-based diagnosis of small bowel diseases]. TERAPEVT ARKH 2013; 85:93-95. [PMID: 23653948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The paper deals with new endoscopic imaging techniques for evaluating the mucosa of deep intestinal segments, mainly the small bowel. It shows the history of an enteroscopic method and its technical capabilities. Some pathological conditions for which deep enteroscopic techniques are best suited are characterized.
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Mendiratta P, Tilford JM, Prodhan P, Curseen K, Azhar G, Wei JY. Trends in percutaneous endoscopic gastrostomy placement in the elderly from 1993 to 2003. Am J Alzheimers Dis Other Demen 2012; 27:609-13. [PMID: 23038714 PMCID: PMC4011175 DOI: 10.1177/1533317512460563] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate national trends in percutaneous endoscopic gastrostomy (PEG) tube placement for hospitalized elderly patients from 1993 to 2003. METHODS Retrospective analysis of patients ≥ 65 years of age with PEG tube placement from 1993 to 2003 from the Nationwide Inpatient Sample (NIS) database was utilized to calculate PEG placement rates per 1000 people. RESULTS Placement of PEG tube increased by 38% in elderly patients during the study period, from 2.71 procedures during hospitalization per 1000 people to 3.75 procedures during hospitalization per 1,000 people. Placement of PEG tube in patients with Alzheimer's dementia doubled (5%-10%) over the study period. CONCLUSION Over a 10-year period, PEG tube use in hospitalized elderly patients increased significantly. More importantly, approximately 1 in 10 PEG tube placements occurred in patients with dementia.
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Affiliation(s)
- P. Mendiratta
- Donald W Reynolds Institute on Aging and Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences, and Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
| | - J. M. Tilford
- Department of Health Policy and Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - P. Prodhan
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - K. Curseen
- Donald W Reynolds Institute on Aging and Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences, and Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
| | - G. Azhar
- Donald W Reynolds Institute on Aging and Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences, and Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
| | - Jeanne Y. Wei
- Donald W Reynolds Institute on Aging and Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences, and Geriatric Research Education and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
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Loffeld RJLF, Liberov B, Dekkers PEP. The changing prevalence of upper gastrointestinal endoscopic diagnoses: a single-centre study. Neth J Med 2012; 70:222-226. [PMID: 22744923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Upper gastrointestinal (GI) endoscopy is increasingly applied in daily practice. Not many data are available on yearly changes in diagnostic yield, nor on changes in morbidity. AIM To study the possible changes in occurrence of abnormalities in the oesophagus, stomach and duodenum. METHODS All consecutive upper GI endoscopies performed over a period of 20 years were included. Important diagnoses were defined as: oesophagitis, metaplastic epithelium in the oesophagus, hiatal hernia or defective sphincter, ulcers, erosive or nodular gastritis, operated stomach, and cancer. RESULTS In the 20-year period, 29,218 upper GI endoscopies were performed. 'Open-access' endoscopy, i.e. at the request of the general practitioner, showed a clear increase in the first ten years and remained stable thereafter. A trend towards an increase in macroscopic abnormalities was seen. The presence of hiatal hernia and defective sphincter showed a significant increase over 20 years, while the number of patients with reflux oesophagitis showed a less impressive, but still significant increase (p<0.001) in the first ten years and remained stable thereafter. There was an impressive decrease in the incidence of peptic ulcer disease. Prevalence of oesophageal cancer showed a gradual increase, although the numbers were very low. CONCLUSIONS In a period of 20 years the diagnostic yield of upper GI endoscopy showed significant changes. Reflux disease increased in prevalence while peptic ulcer disease decreased.
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Affiliation(s)
- R J L F Loffeld
- Department of Internal Medicine and Gastroenterology, Zaans Medisch Centrum, Zaandam, the Netherlands.
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27
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Abstract
Advances in modern enteroscopy have been largely due to endoscope development but also through the improved availability of endoscopic accessories along with improved understanding in their application. Device assisted enteroscopy began with the double balloon system in 2001 and was quickly followed by single balloon enteroscopy and spiral enteroscopy. These tools revolutionised deep small bowel endoscopy and allowed for the delivery of virtually all known therapeutic endoscopy intervention to almost all segments of the small bowel. This review covers the types of interventions in regards to indications, methods and their safety profiles as well as reviewing the various device assisted endoscopes available and their attributes.
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Affiliation(s)
- Arthur John Kaffes
- Royal Prince Alfred Hospital, AW Morrow Gastroenterology and Liver Centre, Gastroenterologist, Missenden Rd, Camperdown, NSW 2050, Australia.
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28
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Forgione A, Zorron R. NOTES: basic and advanced surgical applications outside of the urological field. ARCH ESP UROL 2012; 65:423-433. [PMID: 22495284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ten years ago the American gastroenterologist Anthony Kalloo described for the first time the concept of Natural Orifice Transluminal Endoscopic Surgery - NOTES. His revolutionary vision generated such an unprecedented worldwide momentum of creativity and renovation in the surgical community to push the current limit of the research in the minimal invasive surgery field toward the unimaginable goal of non visible scar surgery. At present time several NOTES applications are continuously reported by many teams all around the world and the aim of the present paper was to illustrate the clinical evidence registered up to now as well as to inform about the ongoing research efforts made to perform non visible scar surgery to treat more complex surgical diseases.
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Affiliation(s)
- Antonello Forgione
- AIMS, Advanced International Mini-Invasive Surgery Academy, Milan, Italy.
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29
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van Turenhout ST, Terhaar sive Droste JS, Meijer GA, Masclée AA, Mulder CJJ. Anticipating implementation of colorectal cancer screening in The Netherlands: a nation wide survey on endoscopic supply and demand. BMC Cancer 2012; 12:46. [PMID: 22280408 PMCID: PMC3331810 DOI: 10.1186/1471-2407-12-46] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 01/26/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) screening requires sufficient endoscopic resources. The present study aims to determine the Dutch endoscopic production and manpower for 2009, evaluate trends since 2004, determine additional workload which would be caused by implementation of a CRC screening program, and inventory colonoscopy rates performed in other European countries. METHODS All Dutch endoscopy units (N = 101) were surveyed for manpower and the numbers of endoscopy procedures performed in 2009. Based on calculations in the report issued by the Dutch Health Council, future additional workload caused by faecal immunochemical test (FIT) screening was estimated. The number of colonoscopies performed in Europe was evaluated by a literature search and an email-inquiry. RESULTS Compared to 2004, there was a 24% increase in total endoscopies (N = 505,226 in 2009), and a 64% increase in colonoscopies (N = 191,339 in 2009) in The Netherlands. The number of endoscopists had increased by 4.6% (N = 583 in 2009). Five years after stepwise implementation of FIT-based CRC screening, endoscopic capacity needs to be increased an additional 15%. A lack of published data on the number of endoscopies performed in Europe was found. Based on our email-inquiry, the number of colonoscopies per 100,000 inhabitants ranged from 126 to 3,031 in 15 European countries. CONCLUSIONS Over the last years, endoscopic procedures increased markedly in The Netherlands without a corresponding increase in manpower. A FIT-based CRC screening program requires an estimated additional 15% increase in endoscopic procedures. It is very likely that current colonoscopy density varies widely across European countries.
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Affiliation(s)
- Sietze T van Turenhout
- Department of Gastroenterology and Hepatology, VU University Medical Centre, P.O. Box 7057, 1007, MB Amsterdam, The Netherlands
| | - Jochim S Terhaar sive Droste
- Department of Gastroenterology and Hepatology, VU University Medical Centre, P.O. Box 7057, 1007, MB Amsterdam, The Netherlands
| | - Gerrit A Meijer
- Pathology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Ad A Masclée
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Dutch Society of Gastroenterology, Haarlem, The Netherlands
| | - Chris JJ Mulder
- Department of Gastroenterology and Hepatology, VU University Medical Centre, P.O. Box 7057, 1007, MB Amsterdam, The Netherlands
- Dutch Society of Gastroenterology, Haarlem, The Netherlands
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30
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Abstract
The future of endoscopy will be dictated by rapid technological advances in the development of light sources, optical fibers, and miniature scanners that will allow for images to be collected in multiple spectral regimes, with greater tissue penetration, and in three dimensions. These engineering breakthroughs will be integrated with novel molecular probes that are highly specific for unique proteins to target diseased tissues. Applications include early cancer detection by imaging molecular changes that occur before gross morphological abnormalities, personalized medicine by visualizing molecular targets specific to individual patients, and image guided therapy by localizing tumor margins and monitoring for recurrence.
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Affiliation(s)
- Sakib F. Elahi
- Department of Biomedical Engineering, Ann Arbor, Michigan 48109
| | - Thomas D. Wang
- Department of Biomedical Engineering, Ann Arbor, Michigan 48109
- Department of Medicine, Division of Gastroenterology, Ann Arbor, Michigan 48109
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31
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Abstract
The future of endoscopy will be dictated by rapid technological advances in the development of light sources, optical fibers, and miniature scanners that will allow for images to be collected in multiple spectral regimes, with greater tissue penetration, and in three dimensions. These engineering breakthroughs will be integrated with novel molecular probes that are highly specific for unique proteins to target diseased tissues. Applications include early cancer detection by imaging molecular changes that occur before gross morphological abnormalities, personalized medicine by visualizing molecular targets specific to individual patients, and image guided therapy by localizing tumor margins and monitoring for recurrence.
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Affiliation(s)
- Sakib F Elahi
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan 48109, USA
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Aabakken L, Enochsson L. Mechanics of quality assurance - now and in the future. Best Pract Res Clin Gastroenterol 2011; 25:419-25. [PMID: 21764009 DOI: 10.1016/j.bpg.2011.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 05/20/2011] [Accepted: 05/20/2011] [Indexed: 01/31/2023]
Abstract
Quality assurance work requires acquisition of valid data, as well as mechanisms for enforcing quality criteria, detecting (non-)adherence to these criteria, and for improving inadequate performance. This chapter deals primarily with the various tools available to acquire information at the various steps of the patient journey. Different challenges arise in the prehospital phase, in the endoscopy room, and in the follow-up phase. The endoscopy report is a vital tool for much of the quality work, but other adjoining systems may be equally important to ensure completeness of the dataset required to ensure the requested quality. Future development is discussed briefly, since many of the present challenges may be solved with improved mechanics.
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Affiliation(s)
- Lars Aabakken
- Dept of Medicine, Oslo University Hospital Rikshospitalet, Norway.
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Jähne J. [Interventional therapy at the interface between surgery and gastroenterology]. Chirurg 2011; 82:477-8. [PMID: 21528376 DOI: 10.1007/s00104-010-2036-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Jähne
- Zentrum Chirurgie,Klinik für Allgemein- und Visceralchirurgie,Schwerpunkt für endokrine und onkologische Chirurgie, Diakoniekrankenhaus Henriettenstiftung Hannover gGmbH, Hannover, Deutschland.
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Sharma N. Endoscopy, but not as we know it. Br J Hosp Med (Lond) 2011; 72:115. [PMID: 21378623 DOI: 10.12968/hmed.2011.72.2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Manabe N, Haruma K, Kamada T, Kusunoki H, Inoue K, Murao T, Imamura H, Matsumoto H, Tarumi KI, Shiotani A, Hata J. Changes of upper gastrointestinal symptoms and endoscopic findings in Japan over 25 years. Intern Med 2011; 50:1357-63. [PMID: 21720053 DOI: 10.2169/internalmedicine.50.4731] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIMS In Japan, the prevalence of Helicobacter pylori infection has decreased recently, but there has been little longitudinal research on the changes of symptoms and endoscopic findings over many years. The aim of this study was to evaluate the changes in endoscopic findings and symptoms over time in patients undergoing upper gastrointestinal endoscopy for assessment of upper abdominal symptoms. METHODS Over a period of 25 years, between 1981 and 2005, we performed three investigations (1981-2, 1990-1 and 2004-5) on the symptoms and endoscopic findings of patients undergoing endoscopy at Kawasaki Medical School Hospital for the assessment of upper abdominal symptoms. RESULTS The most common complaint for all ages was "discomfort and/or pain". Over time, the percentage of patients complaining of "heartburn" increased almost 5-fold. With respect to endoscopic findings, the prevalence of peptic ulcers decreased, whereas the detection of no abnormalities and the detection of erosive esophagitis increased. CONCLUSION In the future in Japan, there will be fewer patients with peptic ulcers and more patients with gastro-esophageal reflux disease or dyspeptic patients who display no endoscopic abnormal findings.
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Affiliation(s)
- Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Japan.
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Kalff JC, Schäfer N. [Disappearing borders between visceral surgery and interventional endoscopy]. Chirurg 2010; 81:1073-6. [PMID: 21153461 DOI: 10.1007/s00104-010-1958-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The tremendous increase in medical knowledge over the last decades and technical progress in medicine have caused further professional specialization. Numerous medical fields have evolved through the process of separation from the parent specialization and the traditional distinction between surgical and medical disciplines has been blurred. As a result of this development organ-specific interdisciplinary units have been formed and new partners have united, such as surgeons and gastroenterologists in the field of interventional endoscopy. The fading boundaries brought with them resistance and even resentment and called for a mutual regulation by the professional associations which took place 10 years ago. Nowadays, surgeons and gastroenterologists in Germany are trained in interventional endoscopy and are the foundation of endoscopic interdisciplinary teamwork in emergency care, diagnostics, therapy, complication management and palliative treatment. Technical innovations striving for a minimization of operative trauma like NOTES depend on the cooperation of both fields of expertise. The driving force behind these efforts should be the shared interest in further improvement of patient care at the highest level of individual expertise, patient-oriented process optimization and adequate use of resources.
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Affiliation(s)
- J C Kalff
- Klinik und Poliklinik für Allgemein-, Viszeral-, Thorax- und Gefässchirurgie, Universitätsklinikum, Sigmund-Freud-Strasse 25, 53115, Bonn, Deutschland.
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Abstract
BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control the bleeding in 90% of patients while angiography is being accepted as a valuable alternative to endoscopy for inaccessible lesions. Currently, surgical intervention is kept for failure of therapeutic endoscopic or angiographic interventions and it should be guided by pre-operative localisation. CONCLUSIONS Advances in endoscopy have increased the detection of Dieulafoy's lesions and decreased the mortality from 80% to 8.6%. There are recent encouraging reports on the successful use of laparoscopic surgery in managing symptomatic Dieulafoy's lesions.
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Affiliation(s)
- M Baxter
- Laparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary, Aberdeen, UK
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Blancas Valencia JM. [ASGE plenary sessions. Enteroscopy]. Rev Gastroenterol Mex 2010; 75 Suppl 1:173-178. [PMID: 20959242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kudo SE, Toyoshima N, Ikehara N, Hayashi T, Hayashi S. [Present state and foresight of endoscopic therapy]. Nihon Rinsho 2010; 68:1224-1231. [PMID: 20662199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The advent of magnifying chromoendoscopy has enabled endoscopists to observe the mucosal structures in great detail for precise diagnosis; the pit patterns, irregular vascular patterns with narrow band imaging(NBI), and intra-epithelial papillary capillary loop (IPCL) pattern. The achievement of high resolution images has also improved accuracy of diagnosis for neoplasm in gastroenterology. Endocytoscopy is developed from magnifying chromoendoscopy, and is now under clinical investigation for use. Many of early gastrointestinal carcinoma has been treated endoscopically, and ESD (endoscopic submucosal dissection) technique, resection of the neoplasm en bloc, has disseminated recent years. The indication for ESD will be broadened in the near future, and the precise diagnosis for the neoplasm is essential, not to loose the interest of patients.
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Affiliation(s)
- Shin-ei Kudo
- Digestive Disease Center, Showa University Northern Hospital
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40
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Abstract
Numerous endoscopic imaging modalities have been developed and introduced into clinical practice to enhance diagnostic capabilities. In the past, detection of dysplasia and carcinoma of the esophagus has been dependent on biopsies taken during standard white-light endoscopy. Recent important developments in biophonotics have improved visualization of these subtle lesions sufficiently for cellular details to be seen in vivo during endoscopy. These improvements allow diagnosis to be made in gastrointestinal endoscopy units, thereby avoiding the cost, risk, and time delay involved in tissue biopsy and resection. Chromoendoscopy, narrow-band imaging, high-yield white-light endoscopy, Fujinon intelligent color enhancement, and point enhancement such as confocal laser endomicroscopy are examples of enhanced imaging technologies that are being used in daily practice. This article reviews endoscopic-based imaging techniques for the detection of esophageal dysplasia and carcinoma from the perspective of routine clinical practice.
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Affiliation(s)
- Muhammad W Shahid
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL 32224, USA
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Morrison G, Headon B, Gibson P. Update in inflammatory bowel disease. Aust Fam Physician 2009; 38:956-961. [PMID: 20369146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a common disease in Australia and frequently encountered in primary care. Major developments in investigation and management have taken place. OBJECTIVE This article aims to review some recent breakthroughs in IBD investigation and management. DISCUSSION Diagnosis involves a changing combination of enhanced traditional techniques with new diagnostic tools, typically blood and stool testing with improved endoscopy and new radiological tests. Management has seen the introduction of new powerful biologic therapies, greater understanding in the way we use older therapies, and a focus on preventing complications such as malignancy or infection. Treatment philosophy now attempts to alter the natural history of the disease and prevent long term complications. The importance of associated, previously overlooked factors is being increasingly recognised. Only by taking a long term, patient centred multidisciplinary approach will an optimal outlook for the majority of patients with IBD be achieved.
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Affiliation(s)
- Graham Morrison
- Department of Gastroenterology, Box Hill Hospital, Melbourne, Victoria.
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Friedman LS, Brandt LJ, Elta GH, Fitz JG, Gores GJ, Katz PO, Kuemmerle JF, Pardi DS, Vargo JJ, Stolar MH. Report of the Multisociety Task Force on GI training. Hepatology 2009; 50:1325-9. [PMID: 19876944 DOI: 10.1002/hep.23257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Kubicka S, Geissler M, Bruch HP, Trarbach T. [Laparoscopic surgery and adjuvant therapy for colon cancer]. Onkologie 2009; 32 Suppl 2:3-6. [PMID: 19546595 DOI: 10.1159/000213482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
At present, about 10% of all oncological procedures in the colon are carried out laparoscopically. Acceptance is increasing. After successful R0 resection, the rule for stage III patients is: adjuvant therapy is indicated regardless of age. Regimens containing oxaliplatin should be used. If there are contraindications for oxaliplatin, then fluoropyrimidine monotherapy is indicated, with oral fluoropyrimidines (capecitabine) being given precedence over infusional schemes. The use of 5-FU bolus regimens is regarded as obsolete. For stage II, the following applies: If an adjuvant chemotherapy is planned in these patients on the basis of the QUASAR data, then fluoropyrimidine monotherapy (e. g. capecitabine) can be given. Since patients whose tumours show a high frequency of microsatellite instability (MSI) do not benefit from a fluoropyrimidine monotherapy, the MSI status should be determined before choosing therapy.
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Affiliation(s)
- Stefan Kubicka
- Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Deutschland
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Abstract
Endoscopy has undergone explosive technological growth in recent years, and with the emergence of targeted imaging, its truly transformative power and impact on medicine lies just over the horizon. Today, our ability to see inside the digestive tract with medical endoscopy is headed toward exciting crossroads. The existing paradigm of making diagnostic decisions based on observing structural changes and identifying anatomic landmarks may soon be replaced by visualizing functional properties and imaging molecular expression. In this novel approach, the presence of intracellular and cell surface targets unique to disease are identified and used to predict the likelihood of mucosal transformation and response to therapy. This strategy could result in the development of new methods for early cancer detection, personalized therapy, and chemoprevention. This targeted approach will require further development of molecular probes and endoscopic instruments, and will need support from the US Food and Drug Administration for streamlined regulatory oversight. Overall, this molecular imaging modality promises to significantly broaden the capabilities of the gastroenterologist by providing a new approach to visualize the mucosa of the digestive tract in a manner that has never been seen before.
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Affiliation(s)
- Meng Li
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Michigan, Ann Arbor, MI USA, 48109
| | - Thomas D Wang
- Division of Gastroenterology and Hepatology, Department of Medicine, Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI USA, 48109
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Yano T, Yamamoto H, Sunada K, Arashiro M, Miyata T, Sugano K. [Advances in endoscopic treatment for small intestinal diseases]. Nihon Shokakibyo Gakkai Zasshi 2009; 106:19-25. [PMID: 19122419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Tomonori Yano
- Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University.
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Tanaka S, Fujimori S, Sakamoto C. [Breakthrough of enteroscopic diagnoses for small intestinal diseases]. Nihon Shokakibyo Gakkai Zasshi 2009; 106:9-18. [PMID: 19122418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Shu Tanaka
- Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School.
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Whiteford MH, Spaun GO. A colorectal surgeons viewpoint on natural orifice translumenal endoscopic surgery. MINERVA CHIR 2008; 63:385-388. [PMID: 18923349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Natural orifice translumenal endoscopic surgery (NOTES) represents a burgeoning but still largely experimental field. Most NOTES researchers have favored transgastric and transvaginal approaches to abdominal access. For surgeries involving the upper abdominal organs, transvaginal and transanal approach promise to provide a more direct route in contrast to the often cumbersome retroflexion typically required with the transgastric approach. The potential disadvantages of the transanal route are also significant and include issues of sterility, the risk of inadvertent trauma to adjacent organs during transmural puncture, and the risk of colonic wall shearing. This article reviews early development of NOTES, the evolution of transanal access to the peritoneal cavity, highlights the various techniques that have been used for transanal access, and discusses the relative advantages and disadvantages of this approach.
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Affiliation(s)
- M H Whiteford
- Oregon Health and Science University, Portland, OR, USA.
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Matsushita M, Shimatani M, Uchida K, Okazaki K. Association of hyperamylasemia and longer duration of peroral double-balloon enteroscopy: present and future. Gastrointest Endosc 2008; 68:811; author reply 811-2. [PMID: 18926192 DOI: 10.1016/j.gie.2008.02.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 02/23/2008] [Indexed: 12/15/2022]
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