1
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Denzer U, Beilenhoff U, Eickhoff A, Faiss S, Hüttl P, In der Smitten S, Jakobs R, Jenssen C, Keuchel M, Langer F, Lerch MM, Lynen Jansen P, May A, Menningen R, Moog G, Rösch T, Rosien U, Vowinkel T, Wehrmann T, Weickert U. [S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022]. Z Gastroenterol 2016; 53:E1-227. [PMID: 26783975 DOI: 10.1055/s-0041-109598] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- U Denzer
- Klinik und Poliklinik für Interdisziplinäre Endoskopie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | | | - A Eickhoff
- Medizinische Klinik II, Gastroenterologie und Infektiologie, Klinikum Hanau, Hanau
| | - S Faiss
- Asklepios Klinik Barmbek, Hamburg
| | - P Hüttl
- Dr. Heberer & Kollegen, München
| | | | - R Jakobs
- Med. Klinik C, Klinikum der Stadt Ludwigshafen, Ludwigshafen
| | - C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Klinik für Innere Medizin, Strausberg
| | - M Keuchel
- Klinik für Innere Medizin, Bethesda Krankenhaus Bergedorf, Hamburg
| | - F Langer
- II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum, Hubertus Wald Tumorzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M M Lerch
- Klinik für Innere Medizin A, Universitätsmedizin Greifswald
| | | | - A May
- Medizinische Klinik II/IV, Sana Klinikum, Offenbach
| | - R Menningen
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum, Münster
| | - G Moog
- Gastroenterologische Facharztpraxis, Kassel
| | - T Rösch
- Medizinischen Klinik, Israelitisches Krankenhaus, Hamburg
| | - U Rosien
- FB Gastroenterologie, DKD Helios-Klinik, Wiesbaden
| | - T Vowinkel
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum, Münster
| | - T Wehrmann
- Medizinischen Klinik II. Klinikum am Gesundbrunnen, Heilbronn
| | - U Weickert
- Medizinischen Klinik II. Klinikum am Gesundbrunnen, Heilbronn
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2
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. Update S3-guideline: "sedation for gastrointestinal endoscopy" 2014 (AWMF-register-no. 021/014). Z Gastroenterol 2016; 54:58-95. [PMID: 26751118 DOI: 10.1055/s-0041-109680] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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3
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Denzer U, Beilenhoff U, Eickhoff A, Faiss S, Hüttl P, In der Smitten S, Jakobs R, Jenssen C, Keuchel M, Langer F, Lerch MM, Lynen Jansen P, May A, Menningen R, Moog G, Rösch T, Rosien U, Vowinkel T, Wehrmann T, Weickert U. [S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022]. Z Gastroenterol 2015; 53:1496-530. [PMID: 26666284 DOI: 10.1055/s-0041-109520] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- U Denzer
- Klinik und Poliklinik für Interdisziplinäre Endoskopie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | | | - A Eickhoff
- Medizinische Klinik II, Gastroenterologie und Infektiologie, Klinikum Hanau, Hanau
| | - S Faiss
- Asklepios Klinik Barmbek, Hamburg
| | - P Hüttl
- Dr. Heberer & Kollegen, München
| | | | - R Jakobs
- Med. Klinik C, Klinikum der Stadt Ludwigshafen, Ludwigshafen
| | - C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Klinik für Innere Medizin, Strausberg
| | - M Keuchel
- Klinik für Innere Medizin, Bethesda Krankenhaus Bergedorf, Hamburg
| | - F Langer
- II. Medizinische Klinik und Poliklinik, Onkologisches Zentrum, Hubertus Wald Tumorzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M M Lerch
- Klinik für Innere Medizin A, Universitätsmedizin Greifswald
| | | | - A May
- Medizinische Klinik II/IV, Sana Klinikum, Offenbach
| | - R Menningen
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum, Münster
| | - G Moog
- Gastroenterologische Facharztpraxis, Kassel
| | - T Rösch
- Medizinischen Klinik, Israelitisches Krankenhaus, Hamburg
| | - U Rosien
- FB Gastroenterologie, DKD Helios-Klinik, Wiesbaden
| | - T Vowinkel
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum, Münster
| | - T Wehrmann
- Medizinischen Klinik II. Klinikum am Gesundbrunnen, Heilbronn
| | - U Weickert
- Medizinischen Klinik II. Klinikum am Gesundbrunnen, Heilbronn
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:E1. [PMID: 26447364 DOI: 10.1055/s-0035-1553971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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5
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:802-42. [PMID: 26284330 DOI: 10.1055/s-0035-1553458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Affiliation(s)
- U. Beilenhoff
- Scientific Secretariat, European Society of Gastroenterology and Endoscopy Nurses and Associates, Ulm, Germany
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Dumonceau JM, Riphaus A, Beilenhoff U, Vilmann P, Hornslet P, Aparicio JR, Dinis-Ribeiro M, Giostra E, Ortmann M, Knape JTA, Ladas S, Paspatis G, Ponsioen CY, Racz I, Wehrmann T, Walder B. European curriculum for sedation training in gastrointestinal endoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). Endoscopy 2013; 45:496-504. [PMID: 23702777 DOI: 10.1055/s-0033-1344142] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- J-M Dumonceau
- Division of Gastroenterologyand Hepatology Geneva University Hospitals Gabrielle Perret Gentil Str. 41211 Geneva, Switzerland.
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8
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Schilling D, Leicht K, Beilenhoff U, Kern Waechter E, Kallinowski B, Labenz J, Weiß C, Büttner S, Riphaus A. Impact of S3 training courses "Sedation and Emergency Management in Endoscopy for Endoscopy Nurses and Assisting Personnel" on the process and structure quality in gastroenterological endoscopy in practices and clinics - results of a nationwide survey. Z Gastroenterol 2013; 51:619-27. [PMID: 23576246 DOI: 10.1055/s-0032-1330677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION After the S3 Guideline Sedation in Gastrointestinal Endoscopy was published, a training curriculum for a three-day course for endoscopy nurses was developed. The aim of this study was to investigate what effect the course participation had on the daily routine process and structure quality by implementing a German-wide survey in gastroenterology practices and clinics. METHODS A questionnaire with a total of 44 individual questions on personnel, space, and equipment structure, sedation, peri- and post-interventional monitoring, as well as discharge and complication management in endoscopy departments was sent to a total of 2113 course participants (1056 Institutions). They had completed the seminar between December 2008/January 2009 and June 2010. RESULTS The response rate was 21.2 % (224 /1056). Fifty-four percent were from clinic endoscopy departments, 46 % from practices. Overall, some form of structural change occurred in 86.8 % of the clinics and in 84.5 % of the practices. New staff was hired in 28.1 % of the clinics and 12.6 % of the practices. Rosters were changed in 11.6 % of the clinics and 7.8 % of the practices. Almost all issues improved after course participation. However, they did not reach statistic significance with the exception of the availability of peri-interventional ECG-monitoring in practices. The "performance of sedation in threesomes" increased in clinics by more than 20 % and in practices by more than 15 %. The use of the ASA-classification to assess risk increased significantly in clinics (before 24 %, after 50 %) as well as practices (before 40 %, after 60 %) by more than 20 % (p = 0.0007 and p = 0.0385, respectively). The documentation of the discharge status (e. g. using checklists) more than doubled in clinics (before 19 %, after 41.3 %) and practices (before 17.5 %, after 38.8 %) after course completion. CONCLUSION The only nationwide endoscopy nurses' survey on structure and process quality in endoscopy so far, shows that since the publication of the S3 guideline in 2008 numerous processes and structures have improved with respect to patient safety.
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Affiliation(s)
- D Schilling
- Klinik für Innere Medizin, Diakoniekrankenhaus Mannheim, Mannheim, Germany.
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Abstract
Biliary stenting is widely used to palliate malignant obstruction or to treat benign biliary diseases. Recently, the most important changes have related to self-expandable metal stents (SEMSs), which are now available in a wide variety of designs, and to treatment techniques. This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic biliary stenting: a technology review describes the stent models and stenting techniques, and a separate clinical guideline states the evidence and recommendations regarding stenting.
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Affiliation(s)
- J-M Dumonceau
- Service of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland.
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10
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Dumonceau JM, Riphaus A, Aparicio JR, Beilenhoff U, Knape JTA, Ortmann M, Paspatis G, Ponsioen CY, Racz I, Schreiber F, Vilmann P, Wehrmann T, Wientjes C, Walder B. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy. Endoscopy 2010; 42:960-74. [PMID: 21072716 DOI: 10.1055/s-0030-1255728] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.
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Affiliation(s)
- J M Dumonceau
- Service of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland.
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Abstract
Electrosurgery is used in the majority of endoscopic therapeutic procedures. An understanding of the fundamental electrosurgical principles and various settings available on electrosurgical units is essential for the safe and effective use of electrosurgery during endoscopy. The aims of these technical guidelines are to: (1) expose physical principles relevant to the understanding of electrosurgery during endoscopy; (2) describe and provide practical recommendations regarding electrosurgical units that are commonly in use; (3) discuss the clinical relevance of technologies recently implemented in newer electrosurgical units; and (4) review factors relevant to commonly performed therapeutic procedures, including polypectomy, sphincterotomy, contact thermal hemostasis, and argon plasma coagulation.
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Affiliation(s)
- J F Rey
- Institut Arnault Tzanck, St. Laurent du Var, France
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12
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Riphaus A, Wehrmann T, Weber B, Arnold J, Beilenhoff U, Bitter H, von Delius S, Domagk D, Ehlers AF, Faiss S, Hartmann D, Heinrichs W, Hermans ML, Hofmann C, In der Smitten S, Jung M, Kähler G, Kraus M, Martin J, Meining A, Radke J, Rösch T, Seifert H, Sieg A, Wigginghaus B, Kopp I. [S3-guidelines--sedation in gastrointestinal endoscopy]. Z Gastroenterol 2008; 46:1298-330. [PMID: 19012203 DOI: 10.1055/s-2008-1027850] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- A Riphaus
- Medizinische Klinik I, Klinikum Region Hannover GmbH, Krankenhaus Silaoh, Hannover.
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Beilenhoff U, Neumann CS, Rey JF, Biering H, Blum R, Cimbro M, Kampf B, Rogers M, Schmidt V. ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy. Endoscopy 2008; 40:939-57. [PMID: 19009486 DOI: 10.1055/s-2008-1077722] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Beilenhoff U, Neumann CS, Rey JF, Biering H, Blum R, Schmidt V. ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy. Endoscopy 2007; 39:175-81. [PMID: 17327980 DOI: 10.1055/s-2006-945181] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- U Beilenhoff
- Clinical Investigation Unit, City Hospital NHS Trust, Birmingham, UK
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Beilenhoff U, Neumann CS, Biering H, Blum R, Schmidt V, Rey JF. ESGE/ESGENA guideline for process validation and routine testing for reprocessing endoscopes in washer-disinfectors, according to the European Standard prEN ISO 15883 parts 1, 4 and 5. Endoscopy 2007; 39:85-94. [PMID: 17252467 DOI: 10.1055/s-2006-945191] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- U Beilenhoff
- ESGENA Treasurer, ESGE Guidelines Committee chairman, Ulm, Germany
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16
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Axon AT, Beilenhoff U, James T, Ladas SD, Larsen E, Neumann CS, Nowak A, Schöfl R, Tveit KM. Legal and Ethical Considerations: Group 4 Report. ESGE/UEGF Colorectal Cancer--Public Awareness Campaign. The Public/Professional Interface Workshop: Oslo, Norway, June 20 - 22, 2003. Endoscopy 2004; 36:362-5. [PMID: 15057692 DOI: 10.1055/s-2004-814289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- A T Axon
- United Leeds Teaching Hospitals, Centre for Digestive Diseases, Department of Gastroenterology,The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, United Kingdom.
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Devière J, Ponchon T, Beilenhoff U, Neuhaus H, Costamagna G, Schmit A, Kruse A, Spicak J, Nowak A. Recommendations of the ESGE workshop on Ethical-Legal Issues Concerning Live Demonstrations in Digestive Endoscopy. First European Symposium on Ethics in Gastroenterology and Digestive Endoscopy, Kos, Greece, June 2003. Endoscopy 2003; 35:765-7. [PMID: 12929026 DOI: 10.1055/s-2003-41591] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J Devière
- Hepatogastroenterology Unit, Hospital E. Herriot, Place d'Arsonval, 69437 Lyon Cedex 03, Lyon, France.
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Affiliation(s)
- A Kruse
- Department of Surgical Gastroenterology, Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus, Denmark.
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Jung M, Beilenhoff U, Pietsch M, Kraft B, Rippin G. Standardized reprocessing of reusable colonoscopy biopsy forceps is effective: results of a German multicenter study. Endoscopy 2003; 35:197-202. [PMID: 12584636 DOI: 10.1055/s-2003-37270] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS National and international guidelines recommend that a standardized protocol consisting of cleaning, ultrasound cleaning, and sterilization should be used for the reprocessing of endoscopic accessories in order to reduce the risk of transmission of microorganisms. This German multicenter study investigated the efficacy of standardized reprocessing of reusable biopsy forceps used during colonoscopy. MATERIALS AND METHODS Ten endoscopy centers (eight hospitals and two private practices) used 330 biopsy forceps during routine colonoscopy. The forceps were used once, five times, or 20 times for colonoscopy, based on a randomization plan. The reprocessing protocol consisted of manual cleaning with an enzymatic agent, ultrasound cleaning with an enzymatic agent (30 min, 40 degrees C, 47 Hz), neutralization, drying, and sterilization (5 min, 134 degrees C). Aldehydes were not used, and the protocol did not include a disinfection step. The biopsy forceps were sent to three microbiological institutes, based on a randomization plan, to have them tested for the presence of organisms, including identification of bacteria. RESULTS A total of 318 of the 330 forceps were evaluable; 314 forceps (98.74 %) were sterile after use once, five times, or 20 times. Four forceps were contaminated with Staphylococcus epidermidis (n = 2), Bacillus licheniformis (n = 1) and Corynebacterium aquaticum (n = 2). All of 25 forceps were sterile after being used 20 times. CONCLUSION Colonoscopy biopsy forceps can be reliably reprocessed following this standardized protocol, even without aldehydes.
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Affiliation(s)
- M Jung
- Dept. of Internal Medicine, St. Hildegardis Hospital, Hildegardstrasse 2, 55131 Mainz, Germany.
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Leiss O, Beilenhoff U, Bader L, Jung M, Exner M. [Reprocessing of flexible endoscopes and endoscopic accessories - an international comparison of guidelines]. Z Gastroenterol 2002; 40:531-42. [PMID: 12122603 DOI: 10.1055/s-2002-32807] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Endoscopic examinations and procedures are essential for diagnosis and treatment of gastrointestinal diseases. As a result of poor reprocessing practice microorganisms can be transmitted via endoscope. The majority of infection transmissions is due to insufficient performance of cleaning and disinfection disregarding guidelines of societies of gastrointestinal endoscopy. A review of the literature and a comparison of European and American guidelines for reprocessing flexible endoscopes are given. Differences in the classification of endoscopic devices, on the possibility of prion transmission, recommendations on staff training and protection, quality assurance of reprocessing and evidence-based graduation of guidelines are stressed and discussed. With respect to the procedure of endoscope reprocessing, differences concerning the cleaning solution to choose, necessity of thoroughly manual cleaning and brushing of the accessible endoscope channels (even in the case of subsequent automatic reprocessing endoscopes in washers-disinfectors), disinfection solution, microbiological quality of water for final rinsing and rationale for alcohol flush of endoscope channels for better drying are mentioned. The need for experimental investigations of the cleaning and disinfection process is stressed. In contrast to recent guidelines of European and American societies of gastrointestinal endoscopy, the now updated recommendations of the Robert Koch-Institute for reprocessing flexible endoscopes and endoscopic accessories are evidence-based and graduated.
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Affiliation(s)
- O Leiss
- Fachbereich Gastroenterologie, Deutsche Klinik für Diagnostik, Wiesbaden.
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Axon AT, Beilenhoff U, Bramble MG, Ghosh S, Kruse A, McDonnell GE, Neumann C, Rey JF, Spencer K. Variant Creutzfeldt-Jakob disease (vCJD) and gastrointestinal endoscopy. Endoscopy 2001; 33:1070-80. [PMID: 11740649 DOI: 10.1055/s-2001-18937] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Variant Creutzfeldt-Jakob disease (vCJD) is a transmissible form of spongiform encephalopathy believed to be contracted from the consumption of bovine spongiform encephalopathy (BSE) infected beef products. To date over 100 individuals have developed this incurable disease. There have been no documented cases of iatrogenic infection, but there is a theoretical risk that surgical procedures could transmit the disease. This review describes the background of the disease and assesses the possible risks of transmission through endoscopic procedures. The risk of transmission by endoscopy is small and probably negligible if suitable procedures are followed. The greatest potential danger arises from healthy individuals who are incubating the disease. Pathological prions (PrP(sc)) may be found in lymphatic tissue of these individuals (particularly tonsils), but smaller amounts have been identified in the appendix and Peyer's patches. These prions are resistant to all forms of conventional sterilization. There is a theoretical risk that biopsy forceps and the operating channel of endoscopes could become contaminated. This review gives recommendations as to how these small risks can be minimized. They include the employment of single-use forceps for biopsies taken from the terminal ileum, greater attention to the maintenance of endoscopic equipment and accessories, more rigorous manual cleaning of endoscopic equipment and the use of well designed, disposable cleaning brushes for the operating channel of the endoscope.
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Axon A, Jung M, Kruse A, Ponchon T, Rey JF, Beilenhoff U, Duforest-Rey D, Neumann C, Pietsch M, Roth K, Papoz A, Wilson D, Kircher-Felgenstreff I, Stief M, Blum R, Spencer KB, Mills J, Mart EP, Slowey B, Biering H, Lorenz U. The European Society of Gastrointestinal Endoscopy (ESGE): check list for the purchase of washer-disinfectors for flexible endoscopes. ESGE Guideline Committee. Endoscopy 2000; 32:914-9. [PMID: 11085484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Beilenhoff U. [Endoscopy. A fascination with nursing and technique]. Pflege Z 1995; 48:261-3. [PMID: 7599883] [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: 01/26/2023]
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