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Biomedical subjects

J D Waye

Publications and source records attributed to J D Waye.

At least 163 records · Page 9Linked to original sources
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Complications and hazards of gastrointestinal endoscopy.

The diagnostic and therapeutic contribution of fiberoptic endoscopy to the advancement of the knowledge of gastrointestinal disease and to its proper management is already established. Technical refinements in the new instruments and extensive acceptance of the advantages of the method makes fiberendoscopy a procedure widely used throughout the world. Therefore, the appreciation of its potential risk of complications and hazards is justified. This review summarizes the complications and hazards of fiberoptic gastrointestinal endoscopy gleaned from reports of endoscopic surveys and individual experiences. Causes and means whereby complications related to upper intestinal and colonic endoscopy can be prevented or treated are discussed.

Colonoscopy↗
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Endoscopic treatment of adenomas.

The endoscopic removal of colon polyps can be safely and efficiently accomplished when established principles of colonoscopy and electrosurgery are followed. This technique requires the proper equipment, a skilled endoscopy assistant, and a well-trained, experienced endoscopist. Complete mastery of basic colonoscopy is essential along with an understanding of the concepts of electrocautery and knowledge concerning the structural configurations of polyps.

Colonic Polyps↗
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Pitfalls in polypectomy: from gene to cure.

Unsuspected problems are commonly encountered during colonoscopic polypectomy. This paper identifies the most frequent difficulties and describes solutions to them. One of the most important pitfalls is overlooking a lesion or tumour in the colon; this can only be solved by better training, experience and care, although it may happen in the best of hands with the most knowledgeable colonoscopist. Other pitfalls addressed include the stuck snare, use of a gastroscope for the difficult sigmoid polyp, and methods to aid discovery and retrieval of the polypectomy specimen.

Colonic Polyps↗
PubMedDate not supplied

Hydrogen peroxide enteritis: the "snow white" sign.

Hydrogen peroxide is a useful disinfectant that has achieved widespread utility in varied clinical settings. We report an epidemic of hydrogen peroxide enteritis that developed in seven patients in our gastrointestinal endoscopy unit during a 2-week period in early 1988. During endoscopy, using recently sterilized endoscopes that were flushed with 3% hydrogen peroxide after the glutaraldehyde cycle, instantaneous blanching (the "snow white" sign) and effervescence were noted on the mucosal surfaces when the water button was depressed. No patient subsequently suffered morbidity or mortality associated with this peroxide enteritis, and the biopsy specimens revealed nonspecific inflammation. The toxicity of hydrogen peroxide when used in enema form is reviewed, as well as the pathogenesis of peroxide enteritis.

Aged↗
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The technique of abdominal pressure in total colonoscopy.

Total colonoscopy can be difficult. It is recognized that abdominal pressure can be helpful in the performance of colonoscopy by externally splinting the endoscope to prevent loop formation. Properly applied abdominal pressure can limit patient discomfort and shorten examination time. Various techniques for abdominal pressure were studied in 201 consecutive patients who had total colonoscopy to the cecum. Abdominal pressure or change of body position was used 619 times in 165 patients (82%), with an average of 3.75 pressure applications per colonoscopy, most lasting less than 30 sec. Pressure was most commonly used when the endoscope tip was at the splenic flexure. Non-specific pressure to a region of the abdomen where looping developed, endoscopically observed specific pressure near the tip, and position change were used in a stepwise manner. Non-specific pressure was more successful in the left (78%) than in the right (47%) colon (p less than 0.0005). As intubation progressed left to right, specific pressure became more useful. When abdominal pressure was not useful, a change in patient position from left lateral to supine was successful in advancing the endoscope tip in 68% of patients.

Abdomen↗
PubMedDate not supplied

Total colonoscopy: is it always possible?

One-thousand three hundred fifty-one consecutive colonoscopies were performed in an office setting without fluoroscopy. Three different models of colonoscopies were utilized; all were manufactured by the Olympus Corporation of America, and included a videoendoscope, a CF-20L immersible OES-type instrument, and an older fiberoptic colonoscope, CFLB-3W. In all colonoscopies, the cecum was reached in 95.9%, even when an obstructing lesion or stenosis was present. Total intubation was performed in 97% of cases with the videoendoscope, 95.5% with the CF-20L, and 95.7% with the CFLB-3W. In a subgroup of 865 colonoscopies, total colonoscopy was performed in 98% of cases when obstructing lesions (carcinoma or stricture) were excluded from analysis. In this subgroup, total colonoscopy could not be performed in 16 patients because of colonic fixation, tortuosity, or for unknown anatomical reasons. Forty-five percent of this subgroup was female, but of the 16 patients in whom total colonoscopy was not possible, 15 were women, 5 of whom had a previous hysterectomy. We conclude that in the absence of any obstructing lesion, an expert can perform complete colonoscopy in 98% of examinations, and in 95% of all patients presenting for colonoscopy. Total colonoscopy may be more difficult in women than men, but a previous hysterectomy does not seem to adversely affect the ability to perform colonoscopy. The type of instrument used for colonoscopy does not impact on the ability to visualize the entire colon.

Colonoscopes↗
PubMedDate not supplied

Colonoscopy and endoscopic therapy for delayed post-polypectomy hemorrhage.

Nine consecutive patients in whom endoscopic management of delayed post-polypectomy hemorrhage was attempted are described. Each patient presented with active rectal bleeding 12 hours to 12 days after snare resection of a colon polyp. In each patient, repeat colonoscopy identified the bleeding site and various combinations of injection therapy, electrocautery, or thermal injury led to cessation of hemorrhage. No complications resulted from repeat colonoscopy and endoscopic therapy. Colonoscopy and endoscopic therapy is feasible, effective, and safe in selected patients with active delayed post-polypectomy hemorrhage.

Colonic Polyps↗