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Biomedical subjects

Simon K Lo

Publications and source records attributed to Simon K Lo.

7 recordsLinked to original sources
PubMed2006

Therapeutic uses of double-balloon enteroscopy.

In spite of initial skepticism toward the practicability of double-balloon enteroscopy, this technology will become an integral part of endoscopy and is likely to find expanded applications in the future. One strong reason to support this technique is the capacity to deliver endoscopic therapies, and thereby minimize aggressive surgical options. With increasing acceptance of capsule endoscopy by the medical community, more small-bowel lesions will be found and more directed endoscopic interventions will be needed. Like many new procedures, reimbursement issues will possibly prevent it from gaining well-deserved popularity. Unlike other common endoscopies, double-balloon enteroscopy is an expensive procedure. It requires fluoroscopy, extended anesthesia support, long procedure time, significant capital investment, and a team of threeor four people (endoscopist, anesthesiologist, nurse). Gastroenterologists and their patients will have to work together to convince insurance carriers that this isa valuable and cost-effective technology worthy of appropriate reimbursement.

Catheterization↗
PubMed2005

Capsule endoscopy: practical applications.

Few advances in the history of gastroenterology have made as dramatic an impact on the diagnosis of gastrointestinal disease as the development and rapid clinical implementation of wireless capsule endoscopy. Less than 4 years after the landmark publication, capsule endoscopy is widely considered an essential component of the diagnostic workup of obscure gastrointestinal bleeding, and its role is expanding in the diagnosis of small bowel diseases such as Crohn's disease. This review appraises the available literature and highlights practical aspects of capsule endoscopy of interest to the clinician. We discuss safety concerns, optimal preparation for the procedure, diagnostic utility as compared to conventional methods, indications for capsule endoscopy, and outcomes.

Abdominal Pain↗
PubMed2004

Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease.

BACKGROUND AND AIMS: Wireless capsule enteroscopy (WCE) offers the potential to directly visualize the entire small bowel and identify superficial lesions not detected by traditional endoscopy and radiography. The aim of this study is to assess the clinical utility of WCE in the evaluation of patients with known or suspected inflammatory bowel disease (IBD). METHODS: Fifty patients with ongoing symptoms underwent Given M2A endoscopic capsule examinations. Indications included: (1) evaluation for small-bowel involvement in patients with IBD with isolated colitis (n = 22), (2) determination of the extent of small-bowel disease in patients with Crohn's disease (CD; n = 20), and (3) workup of suspected IBD (n = 8). Outcome measures were classified as diagnostic when multiple ulcerations were present, suspicious when </=3 ulcerations were seen, and nonspecific or normal. RESULTS: WCE findings were diagnostic for CD in 20 patients and suspicious for small-bowel CD in 10 patients. Seventeen of 20 patients with diagnostic WCE findings improved with increased IBD-directed medical therapy, as did 7 of 10 patients with suspicious study results. WCE was normal or showed nonspecific findings in the remaining 20 patients. Notably, identification of small-bowel lesions in 5 patients with a previous history of isolated colitis resulted in a change in diagnosis to CD after confirmatory ileoscopy with biopsy. CONCLUSIONS: Results of this preliminary study suggest that WCE is a novel and potentially clinically useful method of directly visualizing and diagnosing small-bowel lesions in patients with IBD that can be missed by traditional endoscopic and radiological procedures.

Adolescent↗
PubMed2004

The clinical utility of wireless capsule endoscopy.

Capsule endoscopy is a new method of assessing small bowel disease. Current literature has identified a role in obscure gastrointestinal bleeding and evidence for its use in patients with inflammatory bowel disease is increasing. Use in other settings such as surveillance of polyposis syndromes and assessment of patients with abdominal pain has been proposed. The available literature covering the clinical use of capsule endoscopy is reviewed and avenues of further study are suggested.

Capsules↗
PubMed2002

"Tannenbaum" Teflon stents versus traditional polyethylene stents for treatment of malignant biliary stricture.

BACKGROUND: Premature stent clogging is the major limitation with plastic stents used in the treatment of malignant biliary structures. A pilot study suggested improved duration of patency of the Tannenbaum stent compared with polyethylene stents. The aim of this prospective, multicenter randomized trial was to compare the Tannenbaum Teflon stent with a conventional polyethylene endoprosthesis (Cotton-Leung biliary stent set) for the treatment of malignant biliary strictures. METHODS: Patients over age 18 years with symptoms caused by nonhilar malignant biliary strictures were enrolled. Patients were randomized to receive a 10F Tannenbaum or polyethylene stent after a guidewire was passed beyond the stricture. One hundred six patients (mean age 72 years and 71 years, respectively) were enrolled (54 Tannenbaum, mean age 72 years; 52 polyethylene, mean age 71 years). RESULTS: Tannenbaum and polyethylene stent placement was successful in, respectively, 100% and 96% of procedures without complications. The mean (SD) 90-day stent patency of the Tannenbaum stent was 67% (7%) compared with 73% (7%) for the polyethylene stents. CONCLUSIONS: The present study demonstrated no difference in ease of implantation or stent patency between Tannenbaum and polyethylene stents.

Aged↗