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At least 91 records · Page 5Linked to original sources
PubMed1997

Double blind randomized trial on occult blood bead (OBB) and gastroscopy-pathology screening for gastro-oesophageal cancer.

The study consists of two parts. In the first, 4,970 subjects were given the occult blood bead (OBB) test and 817 underwent gastroscopy: 40 of those screened were found to have cancer, 30 of which had early lesions (15 had carcinoma in situ). In the second part, a double blind randomized control study of the mass screening was conducted. All the tests were free of charge. Subjects over 30 years of age were persuaded to participate. Two-hundred and eight people accepted the OBB test, gastroscopy and histopathological assessment. A total of four cancers (two early, one moderate and one advanced) were detected by OBB test. If the OBB is carried out properly, gastro-oesophageal cancer is unlikely to be missed. We believe that OBB gastroscopy screening for oesophageal and gastric cancer is reliable and practical.

Adenocarcinoma↗
PubMed1976

[Examination using the gastro-camera and gastroscopy--confrontation and complementation].

Both the gastro-camera and gastroscopy are methods of examination dating back to the last century. Since 1955 examination with the gastro-camera has gained major importance in Japan. Not until the efficient gastroscopic instruments based on fiber optics and with extremely flexible points as well as advance view optical systems were developed large-scale, introduction esophageal gastro-bulboscopy in hospitals and in offices of specialists became possible. In our view the replacement of the gastro-camera method of diagnosis as a basic examination by gastroscopy is not justified. The gastro-camera is highly efficient and easily applied if centers for early diagnosis of gastric tumor cooperate with the examining physicans; their own experience with the gastro-camera is a premise for this arrangement. The principal task of endoscopic diagnosis is the determination as to therapy, namely whether surgery or a conservative method should be applied: this is particularly true in the case of early carcinoma stages where a 90% 5-year survival chance prevails. For various reasons gastro-camera examination should be assigned a more prominent role. Gastroscopy and histological examination represent further steps in diagnosing malignant processes. It is not possible to preclude the possiblity of a malignant tumor by means of gastroscopic biopsy.

Biopsy↗
PubMed1976

[Gastroscopy in Austria the results of a questionnaire study (author's transl)].

By means of a questionnaire we have gathered information about gastroscopy in Austria. This inquiry has enabled us to compare the techniques used and the results obtained in the diagnosis of gastric cancer. The final aim of the investigation was to obtain guidelines for the wider application of gastroscopy for the early diagnosis of gastric cancer. The level of response by Austrian endoscopists to the inquiry was high at 72.7%. The results demonstrate a considerable increase in the use of gastroscopy in Austria over the past few years. However, some of the provinces hate fallen behind others. The available equipment is not fully used and reasons for this are discussed. A close correlation is shown to exist between the number of gastric biopsies carried out and the incidence of early gastric cancer. It is further shown that the use of cytological brushing improves the results. Only one third of endoscopists, however, use this method.

Austria↗
PubMed2003

Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding.

BACKGROUND: The development of wireless capsule endoscopy allows painless imaging of the small intestine. Its clinical use is not yet defined. The aim of this study was to compare the clinical efficacy and technical performance of capsule endoscopy and push enteroscopy in a series of 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding. METHODS: A wireless capsule endoscope was used containing a CMOS colour video imager, transmitter, and batteries. Approximately 50,000 transmitted images are received by eight abdominal aerials and stored on a portable solid state recorder, which is carried on a belt. Push enteroscopy was performed using a 240 cm Olympus video enteroscope. RESULTS: Studies in 14 healthy volunteers gave information on normal anatomical appearances and preparation. In 50 patients with gastrointestinal bleeding and negative colonoscopy and gastroscopy, push enteroscopy was compared with capsule endoscopy. A bleeding source was discovered in the small intestine in 34 of 50 patients (68%). These included angiodysplasia (16), focal fresh bleeding (eight), apthous ulceration suggestive of Crohn's disease (three), tumour (two), Meckel's diverticulum (two), ileal ulcer (one), jejunitis (one), and ulcer due to intussusception (one). One additional intestinal diagnosis was made by enteroscopy. The yield of push enteroscopy in evaluating obscure bleeding was 32% (16/50). The capsule identified significantly more small intestinal bleeding sources than push enteroscopy (p<0.05). Patients preferred capsule endoscopy to push enteroscopy (p<0.001). CONCLUSIONS: In this study capsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy. It was safe and well tolerated.

Adolescent↗
PubMed1992

[Consequences of routine gastroscopy before cholecystectomy].

In a retrospective study of 610 patients the role of routine gastroscopy prior to cholecystectomy was investigated. The results demonstrated that only in a low incidence (11% of patients gastroscopied) relevant findings are present. However, most of these patients had a typical history. Therefore, despite risks, routine preoperative endoscopy prior to cholecystectomy should be performed only in patients with a history of upper abdominal pain or discomfort.

Adolescent↗
PubMed1977

Continuous electrocardiographic monitoring with Holter electrocardiocorder throughout all stages of gastroscopy.

Continuous electrocardiographic recording on magnetic tape with a Holter electrocardiocorder was performed during gastroscopy on 55 consecutive patients. ECG recording was begun before premedication and was terminated 1 hr after the withdrawal of the gastroscope. The ECG changes during the different stages of the procedure were separately analyzed: 38.18% of patients had E.C.G. changes--sinus tachycardia (20%), ST-T changes (23.6%), ventricular and atrial premature beats (20.0% and 7.27%, respectively). atrial premature beats with aberrant conduction (3.6%), and coronary sinus rhythm (1.8%). All changes disappeared spontaneously after the procedure. Although relatively safe, gastroscopy requires careful consideration of the risks, especially in severe cardiac patients.

Adult↗
PubMed1984

Simple gastroscopy technique in the rat.

We present a simple method for gastroscopy in the anesthetized rat using an implanted gastric cannula, a standard rigid arthroscope, and a newly designed valve system. The method allows high-quality endoscopy and photo documentation, large-size biopsies, electrocoagulation and fluid collection. Repeated gastroscopy in the same animal is easy and well tolerated.

Animals↗
PubMed1995

Conscious sedation for gastroscopy: patient tolerance and cardiorespiratory parameters.

BACKGROUND/AIMS: Most patients receive conscious sedation for gastroscopy. However, the benefit of the most often used combination of low-dose intravenous midazolam and topical lidocaine on patient tolerance remains poorly defined and has not been shown to outweigh cardiorespiratory risks. To respond to these issues, a randomized, double-blind, placebo-controlled prospective study was performed. METHODS: Two hundred outpatients undergoing diagnostic gastroscopy were assigned to receive either (1) midazolam (35 micrograms/kg) and lidocaine spray (100 mg), (2) midazolam and placebo lidocaine, (3) placebo midazolam and lidocaine, or (4) placebo midazolam and placebo lidocaine. RESULTS: Tolerance (visual analogue scale, 0-100 points; 0, excellent; 100, unbearable) improved as compared with placebo midazolam and placebo lidocaine by 23 points (95% confidence interval, 15-32) in group 1, 15 points (95% confidence interval, 7-24) in group 2, and 10 points (95% confidence interval, 2-18) in group 3. Increasing age (P < 0.001), low anxiety (P < 0.001), and male sex (P < 0.03), but not amnesia, were associated with better patient tolerance. Oxygen desaturation (< 1 minute) occurred in 8.2% and was not more frequent after midazolam treatment. Hypotension was rare (2.1%), and no adverse outcome occurred. CONCLUSIONS: Both low-dose midazolam (35 micrograms/kg) and lidocaine spray have an additive beneficial effect on patients tolerance and rarely induce significant alterations in cardiorespiratory monitoring parameters, thus supporting the widespread use of conscious sedation.

Adult↗
PubMed2001

Changing patterns of sedation use for routine out-patient diagnostic gastroscopy between 1989 and 1998.

BACKGROUND: Knowledge of sedation trends for upper gastrointestinal endoscopy is important for health service planning, particularly in view of rapidly increasing demands on endoscopy services. However, no data are available on sedation trends in Britain over the past 10 years. AIM: To determine sedation use for routine gastroscopy in a single endoscopy unit between 1989 and 1998. METHODS: This was a retrospective study of 9795 consecutive adults (mean age 56 years, range 18-100 years; 4512 females) who had undergone a gastroscopy between 1989 and 1998. Clinical, pharmacological and endoscopic data were retrieved from a computerized database. RESULTS: Over the 10-year study period, the sedation rate remained constant for patients undergoing therapeutic endoscopy (P=0.99) and those undergoing in-patient diagnostic examinations (P=0.63). In contrast, the sedation rate for out-patient diagnostic endoscopy decreased by 54%, from a high of 70% in 1990 to 32% in 1998 (P < 0.0001). Logistic regression analysis showed that the decline in sedation use was greater in females (P < 0.0001) than males and in procedures performed by non-consultant compared to consultant staff (P=0.01). CONCLUSIONS: If our results form part of a national trend, they will have important implications for cardiopulmonary monitoring strategies, recovery room practices and for complication rates due to the use of sedation for upper gastrointestinal endoscopy.

Adolescent↗
PubMed2002

Prospective audit of gastroscopy under the 'three-day rule': a regional initiative in Italy to reduce waiting time for suspected malignancy.

BACKGROUND: A regional initiative, called the 'three-day rule', has recently been introduced in Italy to facilitate the earlier diagnosis of malignancy. It requires patients with suspected severe diseases to have a diagnostic procedure performed within three working days of referral by a general practitioner. AIM: To assess prospectively the effectiveness and compliance with the three-day rule for upper digestive malignancies. METHODS: We compared patients referred for gastroscopy under the three-day rule initiative with contemporaneous open access referrals over a 12-month period at a single large teaching hospital in west Milan. We compared the prevalence of malignancies and other serious non-neoplastic diseases as well as the waiting times in the two groups. The appropriateness of the indications for each referral was also reviewed by a gastroenterologist blind to the outcome of the test. RESULTS: One hundred and forty-two patients referred for gastroscopy under the three-day rule scheme and 767 routine referrals were studied. Significantly more oesophageal/gastric cancers (6% vs. 1%) and serious benign gastrointestinal lesions (grade II-III oesophagitis or peptic ulcer) were diagnosed in three-day rule patients in comparison with routine referrals (P < 0.05). The rate of inappropriate referral was significantly lower in the three-day rule group than in the open access group (39% vs. 22%) (P < 0.01). The estimated cost of the three-day rule scheme (in extra list examinations alone) was 10 780 euros, with about 1198 euros per diagnosis of cancer, but only 229.5 euros per 'useful' diagnosis (including peptic ulcer disease and oesophagitis). CONCLUSIONS: Significantly more upper gastrointestinal cancers and serious benign diseases can be found within a short period to comply with the three-day rule scheme. However, some general practitioners appear to over-interpret alarm symptoms, leading to some inappropriate referrals. Better awareness of appropriate urgent referral criteria is needed in order to ensure that the best use is made of the resources available.

Adolescent↗
PubMedDate not supplied

Audit of sedated versus unsedated gastroscopy: do patients notice a difference?

Unsedated diagnostic gastroscopy has become widely accepted as a diagnostic procedure which avoids the risk of an anaesthetic. It also provides advantages for patients and hospitals in converting the procedure to an ambulatory care investigation. Patient perception of the procedure can sometimes differ from that of medical and nursing staff. We have decided to report our usual clinical practice by auditing 100 consecutive patients undergoing this procedure in a large rural private hospital. Patient tolerance was analyzed in various categories including degree of comfort, degree of pain, ease of breathing and willingness to repeat the procedure under the same conditions. The perceived comfort rating was compared between the patient, the endoscopist and the endoscopy nurse. A total of 100 consecutive patients were evaluated; 55 chose to be sedated and 45 were unsedated. Of the 100 patients tested, 88% stated they would have the procedure the same way if a repeat procedure was required. There was no significant difference between male/female or sedated/unsedated patients. The most important consideration for patients who chose to have the procedure unsedated was the ability to speak to the endoscopist immediately post-procedure. Patient rating of pain was not significantly different between the sedated and unsedated groups. There was no significant difference in the independent assessment by the endoscopist and the nurse with respect to patient comfort in both the sedated and the unsedated groups. However, their assessment differed significantly from the patients own rating, as endoscopists and gastrointestinal (GI) nurses rated the patient degree of comfort as higher than the patients themselves (P < 0.01 for doctor/patient and nurse/patient score, Student's t-test). No complications were reported in either group of patients during the audit. Unsedated diagnostic gastroscopy is perceived to be an acceptable alternative to a sedated procedure by the majority of patients. Patients rate the procedure as more uncomfortable than their health care professionals, but the majority of patients would still have the repeat procedure the same way.

Adult↗
PubMed1977

Death following fiberoptic gastroscopy caused by pheochromocytoma.

A 45-year-old woman was admitted to hospital for investigation of weight loss, sciatica and excess sweating. On examination, whe was found to have a tachycardia and the stigmata of von Recklinghausen's disease. Her investigations included a barium meal and gastroscopy. Following the gastroscopy, she developed ventricular tachycardia and died. An autopsy revealed a pheochromocytoma of the left adrenal gland.

Adrenal Gland Neoplasms↗
PubMed2005

A novel technique of concurrent esophagoscopy and transgastrostomy gastroscopy to dilate a completely obstructed distal esophageal stricture in a child following fundoplication.

We report a successful dilation of a completely obstructed distal esophageal stricture in a 4-year-old boy with combined immune deficiency syndrome, at 2 and half years after fundoplication and gastrostomy tube insertion. Barium studies and esophagoscopy had revealed complete obstruction of the lower esophagus. Transgastrostomy gastroscopy demonstrated a pinhole lumen through the fundoplication wrap; a guide wire was passed into the esophagus; and the stricture was dilated with Savary dilators. We presumed that the stricture was secondary to chronic esophagitis. The stricture was identified and successfully dilated using a novel technique of concurrent esophagoscopy and transgastrostomy gastroscopy.

Child, Preschool↗
PubMed1989

Does a detailed explanation prior to gastroscopy reduce the patient's anxiety?

The object of this study was to investigate the assumption that a detailed explanation and description of gastroscopy to a patient reduces his fears of the procedure. In order to check this assumption, 243 consecutive patients who underwent elective gastroscopy were randomly distributed to 4 groups: Group A received a standard brief description of upper G-I endoscopy by the treating physician; Group B patients were given a detailed description by the endoscopist himself; Group C was given a comprehensive explanation and was shown an album of pictures illustrating each stage of the procedure; Group D saw a specially prepared video film of the procedure. A fifth group, E, consisted of patients who had previously undergone upper gastrointestinal endoscopy. Patient anxiety was measured using the "Spielberger State and Trait Anxiety Scales". According to the scoring on these scales there was no significant difference between the groups, thus showing that increasingly detailed description of the procedure did not diminish patients' fear. Neither did ethnic background or age have any significant influence on these results. Higher education had marginal influence on patients' apprehension about the procedure. However, female patients had significantly higher anxiety state and trait anxiety scoring than men. If endoscopy can be taken as typically representative of all invasive procedures, these results may have a much more general application.

Adolescent↗
PubMed1983

Gallstone, causing bleeding and pyloric stenosis syndrome, diagnosed by urgent gastroscopy.

By means of urgent gastroscopy the authors, right before surgery, recognized a pyloric stenosis syndrome and a gallstone that had caused massive melena in a female patient of 73. Cholecystectomy and a Billroth II gastric resection were performed. Following surgery, a transitory duodenal fistula developed. After a month of clinical treatment the patient was sent home cured. This case draws attention to the importance of removing a gallbladder filled with stones as soon as possible in order to prevent complications, as well as to the necessity for gastroscopy in cases of unexplained abdominal complaints.

Aged↗
PubMed1985

[An unusual case of Boerhave syndrome. Esophageal rupture during preparation for gastroscopy].

A 72-year-old woman who had been given heavy premedication nonetheless developed severe retching at the beginning of a gastroscopy (for suspected gastric ulcer) when the instrument had been advanced only as far as the throat. The investigation was at once terminated, but barium swallow immediately afterwards revealed rupture at the middle third of the oesophagus, with contrast medium flowing into the mediastinum. Despite emergency thoracotomy and suturing of a 4 cm long fresh oesophageal tear in the area of a diverticulum, the patient died from a purulent mediastinitis and confluent pneumonia. The cause of this "spontaneous" rupture of the oesophagus without direct transmission of force (Boerhaave syndrome) in this case was a marked pressure increase in the oesophagus from retching and hyperperistalsis preparatory to gastroscopy. There had definitely not been any instrumental perforation. There was thus no medical negligence.

Aged↗
PubMed1989

Comparison of diazepam with midazolam as i.v. sedation for outpatient gastroscopy.

We studied 26 patients in a double-blind investigation to compare psychomotor and cognitive recovery for 30 h after sedation for day-case gastroscopy with i.v. diazepam 0.15 mg kg-1 or midazolam 0.07 mg kg-1. Significantly more patients reported side effects at 7, 10 and 30 h post-gastroscopy after diazepam than after midazolam (P less than 0.05). Compared with baseline, the midazolam group was significantly impaired in critical flicker fusion threshold, reaction time, dexterity and visualization tasks up to 4 h after administration (P less than 0.05). There was a significant association between midazolam and amnesia for the procedure (P less than 0.001).

Adult↗
PubMed1978

Gastroscopy in surgical practice.

We reviewed the records of 100 consecutive patients who had gastroscopy. All endoscopic work was done by our four-man surgical group. Roentgenographic and endoscopic diagnoses are compared with reference to degree of accuracy. The expanded uses of gastroscopy in surgical practice are illustrated and a plea is made for increased involvement of surgeons in the rapidly expanding field of endoscopy.

Adolescent↗