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At least 109 records · Page 6Linked to original sources
PubMed2006

Immediate endoscopic closure of colon perforation by using a prototype endoscopic suturing device: feasibility and outcome in a porcine model (with video).

BACKGROUND: Perforation is an uncommon but potentially devastating complication of colonoscopy. Surgical closure is the standard of care. Immediate endoluminal closure of a perforation would avoid the morbidity and mortality associated with general anesthesia, laparotomy, and surgical repair. OBJECTIVES: To evaluate the feasibility and safety of full-thickness endoscopic closure of colonic perforations with a prototype endoscopic suturing device, the Eagle Claw, in a porcine model. DESIGN: Endoscopic animal experimental study of closure of colon perforation by using a porcine model. SUBJECTS: Ten pigs were included in the study. INTERVENTIONS: The Eagle Claw was used to close small perforations (1.5 to 2 cm) of the colon created by needle-knife with the animal under general anesthesia by using the endoluminal route. All animals received intravenous antibiotics and were allowed to eat after 24 hours. MAIN OUTCOME MEASUREMENTS: The animals were monitored daily for signs of sepsis and peritonitis. On day 7, they were euthanized. The peritoneal cavity was examined for fecal peritonitis, and the colon perforation site was checked for wound dehiscence and pericolic abscess formation. RESULTS: Endoscopic closure of the colon perforation was successful in 7 animals, and they recovered well without any sepsis or peritonitis. Necropsy did not reveal fecal peritonitis or pericolonic abscess formation at the site of perforation, and the perforation healed well. Closure was successful in 1 animal, but necropsy revealed dehiscence of the colon perforation site. Endoscopic closure was unsuccessful in 2 animals, and these were euthanized immediately. CONCLUSIONS: Closure of acute perforation of the colon is feasible with the Eagle Claw endoscopic suturing device in a porcine model.

Animals↗
PubMed2006

Endoscopic holder-assisted percutaneous endoscopic gastrostomy placement: results of a prospective, randomized comparison study.

BACKGROUND: We developed a new method of endoscope holder-assisted percutaneous endoscopic gastrostomy (PEG) placement requiring only a single physician. OBJECTIVE: This study compared the feasibility and safety of the new method with the conventional pull method of PEG performed by 2 physicians. DESIGN: Prospective, randomized comparison study. SETTING: Rural municipal hospital. PATIENTS: Eighty consecutive patients with dysphagia. INTERVENTIONS: Patients were randomized to receive PEG placement by a single physician using the endoscope holder (40 patients) or by 2 physicians using the conventional pull method (40 patients). MAIN OUTCOME MEASUREMENTS: The success rate, duration, and complications of both methods were scored. RESULTS: The success rate of PEG by either method was similar (98%) using the endoscope holder compared with 100% with the conventional method. The duration of both endoscopic procedures was also similar (12.9 +/- 2 and 11.5 +/- 2 minutes) (P = .43). No major complication occurred with either procedure. There was 1 death within 30 days (of aspiration pneumonia) 3 days after conventional PEG placement. LIMITATIONS: The number of patients evaluated is small. CONCLUSIONS: Endoscope holder-assisted PEG placement allows a single physician to perform all the important aspects of pull PEG placement under direct vision without assistance from another specially trained individual. The method appears to be as feasible and safe as the conventional pull method.

Aged↗
PubMed1997

Comparative evaluation of therapeutic approaches in stage III and IV squamous cell carcinoma of the thoracic esophagus with conventional radiotherapy and endoscopic treatment in combination and endoscopic treatment alone: a randomized prospective trial.

PURPOSE: To define the role of endoscopic dilatation/intubation and radiotherapy in squamous cell carcinoma of esophagus patients to improve their quality of life. METHODS AND MATERIALS: One hundred and four patients with squamous cell carcinoma of the thoracic esophagus having Stage III and IV disease were enrolled in the present study, with 90 patients in Group 1 (nonesophagorespiratory fistula group) and 14 patients in Group 2 (esophagorespiratory fistula group). From Group 1 patients, 47 were subjected to radiotherapy (conventional) and had endoscopic dilatation and/or intubation whenever and wherever required (Group 1a), and 43 patients were allowed to follow the natural course of the disease except palliation with endoscopic dilatation and/or intubation whenever and wherever required (Group 1b). From Group 2, 4 patients received radiotherapy in addition to endoscopic intubation, while 10 patients received only endoscopic intubation. RESULTS: The median survival for Group 1a was 7 months, for Group 1b--3 months, for Group 2a--4.25 months, and Group 2b--3.6 months. Only three patients from Group 1a survived more than 18 months, while no patient from Groups 1b, 2a, or 2b survived for more than 1 year. The difference in survival between Group 1a and 1b was statistically significant. CONCLUSION: The addition of radiotherapy to endoscopic treatment definitely prolongs survival as well as improves the quality of life of these patients. We recommend both for the adequate palliation of patients with this disease.

Adult↗
PubMed2001

Hemodynamic analysis of esophageal varices using color Doppler endoscopic ultrasonography to predict recurrence after endoscopic treatment.

BACKGROUND AND STUDY AIMS: The time to recurrence of esophageal varices may vary greatly between patients even after the same endoscopic therapy. To clarify the factors which contribute to recurrence after endoscopic treatment, the hemodynamics and morphology of the left gastric vein (LGV) were investigated using color Doppler endoscopic ultrasonography (EUS). PATIENTS AND METHODS: A total of 31 patients with high-risk esophageal varices underwent color Doppler-EUS before receiving endoscopic variceal ligation and endoscopic injection sclerotherapy combined therapy. Endoscopic examination was performed every 3 months after the treatment to evaluate recurrence of varices. RESULTS: A total of 18 patients responded to the therapy, while 13 patients did not respond, and had recurrence within 12 months. The hepatofugal flow velocity in the LGV trunk was significantly lower in the responders (9.9 vs. 13.9 cm/sec; P = 0.02). The branch pattern of the LGV was categorized into three groups: anterior branch dominant, posterior branch dominant, and no-dominant type. The incidence of the anterior branch dominant type was significantly less in responders (17 vs. 70 %; P = 0.01). There was no significant difference in the LGV trunk diameter and the size of the paraesophageal vein between the two groups. CONCLUSION: Risk factors for recurrence can be analyzed in detail using color Doppler-EUS. Further investigation using color Doppler-EUS may enable us to select the optimal way to treat esophageal varices to prevent recurrence.

Adult↗
PubMed2005

Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts).

Suprasellar arachnoid cysts represent less than 10% of all intracranial arachnoid cysts. Some of them may be quiescent throughout life, some may become symptomatic as they become enlarged and some disappear spontaneously. In this study we discuss the surgical strategies for endoscopic and endoscope-assisted treatment of suprasellar (Mickey Mouse) cysts and analyze the clinical results and experience collected over some years in our department upon doing these operations routinely. Between December 1996 and December 2003, 13 patients (7 female and 6 male patients), mean age 29 years, underwent endoscopic or endoscope-assisted procedures for suprasellar cysts at our department. The indication for surgical treatment was based on the neurological and radiological examination. The goal of surgical treatment was to normalize the cerebrospinal fluid flow and to establish a communication, permanently, between the cyst cavity and the intraventricular or/and subarachnoid space. Intraoperatively we observed in all patients no complications. Seven of 13 patients, who had received shunt systems in other hospitals before admission in our clinic, remained shunt-free postoperatively. Overall clinical improvement was achieved for a long period of between 6 and 74 months in 11 patients, one developed a psychomotor disturbance and another one, who had epilepsy before treatment, was unchanged postoperatively. Our data suggest that suprasellar cysts are well treated by endoscopic or endoscope-assisted procedures with good clinical outcome and low surgical morbidity.

Adolescent↗
PubMed2003

Endoscopic nodular gastritis: an endoscopic indicator of high-grade bacterial colonization and severe gastritis in children with Helicobacter pylori.

OBJECTIVE: To investigate the significance of endoscopic nodular gastritis associated with Helicobacter pylori infection. METHODS: This prospective study included 185 children (50.8% boys) aged 1 to 12 years (mean, 6.9 +/- 3.0 years) who underwent upper intestinal endoscopy during evaluation of chronic abdominal pain. The authors assessed the endoscopic appearance of the stomach, noting those patients with endoscopic nodular gastritis. Urease activity of gastric mucosal biopsies was measured. With histologic examination, the presence and density of H. pylori organisms, the presence of follicular gastritis, the nature of inflammation, and the gastritis activity grade and overall gastritis score were assessed. RESULTS: H. pylori infection was identified in 50 children (27%). Endoscopic nodular gastritis was significantly associated with active chronic gastritis and follicular gastritis. Nodularity in the stomach showed a high specificity (98.5%) and positive predictive value (91.7%) for the diagnosis of H. pylori infection and was observed in 22 of 50 (44%) H. pylori-positive patients and in 2 of 135 (1.5%) H. pylori-negative patients. A significant association was observed between older age and the prevalence of this finding (P< 0.001). There was a significant increase in endoscopic nodular gastritis with increased H. pylori density and a positive correlation (Pearson coefficient = 0.97) with increased gastritis score on histologic examination. Increase in gastritis score was dependent on increased H. pylori density in patients with gastric nodularity; this finding was independent of age. CONCLUSIONS: Endoscopic findings of antral nodularity in children suggest the presence of H. pylori infection and follicular gastritis and may identify cases of severe gastritis and marked bacterial colonization.

Abdominal Pain↗
PubMed1996

The endoscopic picture reflects transmural inflammation better than endoscopic biopsy in Crohn's disease.

OBJECTIVE: To investigate how the histopathological picture of endoscopic biopsy specimens related to that of transmural sections and also how these related to the endoscopic findings. DESIGN: Prospective controlled study. PATIENTS AND METHODS: Intraoperative endoscopy was performed on 19 patients with Crohn's disease and mucosal biopsies were obtained from various bowel segments that were to be resected. The histopathological appearance of mucosal biopsies was compared to that of transmural bowel sections and to endoscopic findings. Ten patients undergoing surgery for colonic cancer were used as controls. RESULTS: Poor agreement was found between the pathologist's assessment of biopsy specimens and transmural bowel sections (kappa < 0.38) for all histological variables. The endoscopic assessment of inflammatory severity had a better correlation with global histological assessment of transmural bowel wall sections (r = 0.75) than with a global histological assessment of endoscopic biopsy specimens (r = 0.65). CONCLUSION: Endoscopic assessment of inflammation in Crohn's disease better reflects transmural histopathology than mucosal biopsy and thus the severity and extent of inflammation. Routine biopsy sampling is of limited value in Crohn's disease.

Adult↗
PubMed2003

Mechanisms of failure of endoscopic treatment of vesicoureteral reflux based on endoscopic anatomy.

PURPOSE: We examined the mechanisms responsible for technical failure of the endoscopic technique for correcting vesicoureteral reflux based on endoscopic anatomy. MATERIALS AND METHODS: The study included 25 patients, 2 to 15 years old (mean age 8) who received 57 ureteral injections on 1 or more occasions which failed to correct reflux. Each endoscopic procedure for every patient was videotaped and endoscopic photographs were taken to document pretreatment and posttreatment anatomy. Based on the comparative endoscopic anatomical findings, failures were categorized as secondary to volume loss, mound displacement, mound extrusion or indeterminate etiology. RESULTS: Of the 57 ureters the cause of failure was believed to be due to mound displacement in 35%, volume loss in 23%, displacement and volume loss in 29%, mound extrusion in 2% and indeterminate in 11%. The direction of mound displacement was toward the bladder neck (medial, distal) in 76% of those cases. CONCLUSIONS: Endoscopic anatomical findings can account for failure of the injection technique to correct reflux in the majority of failed cases (90%). Mound displacement and volume loss account comparably for treatment failure. One incidence of mound extrusion, previously hypothesized as a mechanism for treatment failure, was documented in our study.

Adolescent↗
PubMed1999

The utility of endoscopic ultrasonography and endoscopy in the endoscopic mucosal resection of early gastric cancer.

OBJECTIVE: To clarify the usefulness of endoscopic ultrasonography (EUS) and endoscopy in the endoscopic mucosal resection (EMR) of early gastric cancer. Patients/Methods-EMR was performed in 61 patients with early gastric cancer over the past five years. The accuracy of the assessment of the depth of cancerous invasion was studied in 49 patients who had EUS before EMR. Forty eight patients were treated with endoscopy alone; in these patients, EUS and endoscopic findings correlated with the clinical course. RESULTS: Forty six patients showed no changes in the submucosal layer or deeper structures on EUS. Pathologically these included 37 patients with mucosal cancer and nine with submucosal cancer showing very slight submucosal infiltration. Three patients showed diffuse low echo changes in the submucosal layer on EUS; pathologically, these included two with submucosal cancer and one with mucosal cancer with a peptic ulcer scar within the tumour focus. Of 48 patients receiving endoscopic treatment alone, 45 showed no tumour recurrence or evidence of metastases on EUS and endoscopy. Three cases of recurrence were observed. Two of these patients had a surgical gastrectomy, and one was re-treated endoscopically. In the former cases, the surgical results correlated well with assessment by EUS and endoscopy. In addition, the latter patient who was re-treated endoscopically after evaluation with EUS and endoscopy has so far had no recurrence. CONCLUSION: The combined use of EUS and endoscopy is effective in diagnosing the depth of cancerous invasion in patients undergoing EMR as well as in clarifying changes both within and between anatomic levels during follow up.

Aged↗
PubMedDate not supplied

Endoscopic removal of a pedunculated early duodenal cancer: diagnostic value of endoscopic ultrasound.

A 79-year-old Japanese woman was admitted to our hospital for evaluation of a polypoid lesion in the second portion of the duodenum. Radiographic and endoscopic examinations of the upper gastrointestinal tract indicated that this mass was pedunculated and had a nodular surface. Endoscopic ultrasonography demonstrated a hypoechoic tumor limited to the mucosa without lymph node involvement. Endoscopic polypectomy was performed. Histologic examination showed a tubular adenocarcinoma arising in an adenoma with invasion limited to the mucosa. Findings were consistent with complete endoscopic resection. Follow-up over a 12-month period has disclosed no evidence of tumor recurrence. Endoscopic polypectomy using information from endoscopic ultrasonography would appear to be a safe and effective method for diagnosis and treatment of pedunculated early duodenal cancers.

Adenocarcinoma↗
PubMedDate not supplied

[Education in endoscopic surgery: courses of endoscopic surgery in Split, Croatia].

Education is very important in endoscopic surgery. It can be performed on endoscopic trainers, live animals, and animal organs, using tissue samples or non-natural materials. Practical work and education can also be performed during the assistance or operating under the supervision. Endoscopic training courses have the important rule, too. We organized three endoscopic courses in Split up to date. The last one lasted 5 days, covered six different topics and included operations on pigs. In comparison with the course in the year 2001, the last course had more participants and lecturers. Lectures, practice and operations took longer time. The interest for attendance was high. The participants were very satisfied, and rated the lectures, practice and operations with the average grade between 4.1 and 4.7 on the anonymous questionnaire at the end of the course. It can be concluded that indispensable education in endoscopic surgery can be performed during endoscopic courses, where participants can reach basic theoretical and practical knowledge and skills. The courses should be permanently improved and modernized, providing a good quality, with interest and engagement of the attendees.

Animals↗
PubMedDate not supplied

Laparoscopic gastric wedge resection for Dieulafoy's disease following preoperative endoscopic localization with India ink and endoscopic clips.

BACKGROUND: Dieulafoy's lesion is a vascular malformation, usually of the stomach but occasionally of the small or large bowel. It is an uncommon, but clinically significant, source of upper gastrointestinal hemorrhage. Three cases have been reported in the literature of laparoscopic gastric wedge resection of these lesions by using intraoperative endoscopic localization. We present the only reported case of preoperative endoscopic localization of a Dieulafoy's lesion with India ink and an endoscopic clip before laparoscopic resection. CASE REPORT: We present an 82-year-old female patient who presented to the emergency department with 3 episodes of hematemesis. Esophagogastroduodenoscopy revealed an actively bleeding Dieulafoy's lesion in the fundus of the stomach along the greater curvature, which was controlled endoscopically. However, the patient had a recurrent episode of bleeding. Repeat endoscopy was performed and the lesion was tagged with 2 endoscopic clips and marked with India ink. A laparoscopic wedge resection was performed after the India ink was identified in the fundus. The patient did well postoperatively. CONCLUSION: Preoperative localization of a Dieulafoy's lesion with India ink and endoscopic clips before laparoscopic wedge resection is a feasible procedure. Therefore, no need exists for intraoperative endoscopy to aid in the localization, as previously reported.

Aged, 80 and over↗
PubMed1999

Non-endoscopic and endoscopic adhesiolysis in post-lumbar laminectomy syndrome: a one-year outcome study and cost effectiveness analysis.

Post lumbar laminectomy syndrome with its resultant chronic low back pain is estimated to occur in 20% to 50% of the patients. Among various procedures available, lysis of epidural adhesions is considered as one of the effective therapeutic modalities of management in these patients, and may be performed either non-endoscopically or endoscopically. This retrospective evaluation included 120 post lumbar laminectomy patients who underwent either non-endoscopic adhesiolysis (Group I) or endoscopic adhesiolysis (Group II) with 60 consecutive patients in each group. The quality of pain relief when greater than 50% was considered significant. Results showed all patients experienced significant relief following both procedures even though the number of patients experiencing significant relief decreased with both techniques over a time period. Overall relief with the first procedure (mean + SEM) was 12 + 3.2 weeks for Group I, and it was 20 + 2.9 weeks for Group II with significantly longer improvement in Group II than Group I. At one year follow up, the results showed that with repeat procedures, 72% in Group I and 40% in Group II experienced significant relief at 6 months, whereas at 12 months, it decreased to 52% in Group I and 22% in Group II, with a significantly greater number of patients experiencing relief at 6 months and 12 months in Group I, than Group II, even though Group I patients underwent a greater number of procedures. Cost effectiveness analysis showed Group I patients experiencing significant relief at a cost of $40 per week, with one year quality of life improvement for $2,080, whereas it was $135 per week improvement in Group II with a one year quality of life improvement at a cost of $7,020 with significant difference noted in cost effectiveness. In conclusion, non-endoscopic epidural adhesiolysis and administration of corticosteroids and hypertonic saline is a safe and cost effective procedure for relieving chronic intractable pain in post lumbar laminectomy patients who failed to respond to other modalities of treatment. Similarly, endoscopic adhesiolysis with the administration of corticosteroids is also a safe and possibly cost-effective technique for relief of chronic intractable pain failing to respond to other modalities of treatments.

Journal Article↗
PubMed1995

Endoscopic ultrasonography in the treatment of oesophageal varices by endoscopic sclerotherapy and band ligation: do we need it?

OBJECTIVE: To assess the role of endoscopic ultrasonography (EUS) in monitoring the treatment of oesophageal varices by endoscopic sclerotherapy and band ligation. METHODS: We studied 35 patients with portal hypertension undergoing elective treatment for oesophageal varices by injection sclerotherapy with absolute ethanol (group 1, n = 19) or by endoscopic variceal ligation (EVL; group 2, n = 16). All patients were examined by EUS before treatment to assess the status of their oesophago-gastric varices and the presence of collateral and perforating veins. Evaluation with EUS was repeated to confirm variceal eradication whenever endoscopy suggested successful obliteration, or to determine the reason for failure when treatment did not appear to be successful. Depending on the endosonographic findings, treatment was continued until EUS showed complete variceal eradication. RESULTS: After treatment, EUS showed insufficient variceal thrombosis in six (17%) patients who appeared to have variceal eradication at endoscopy. EUS was also superior to endoscopy for diagnosing gastric varices and showed patent vessels in 26 (74%) out of 35 patients. Gastric varices observed on EUS were detected at endoscopy in only 60% of cases. Endoscopic sclerotherapy and EVL had induced characteristic changes on EUS evaluation, and oesophageal fibrosis was observed more frequently in endoscopic sclerotherapy than in EVL-treated patients. CONCLUSION: EUS provides valuable information on the status of oesophago-gastric varices and can be used to assess the efficiency of endoscopic sclerotherapy and EVL.

Adult↗
PubMed2004

A novel technique for endoscopic sphincterotomy when using a percutaneous transhepatic cholangioscope in patients with an endoscopically inaccessible papilla.

BACKGROUND: Endoscopic sphincterotomy is difficult and sometimes impossible in patients who have undergone gastrectomy or partial gastrectomy with Billroth II reconstruction. For such patients, a novel technique was developed in which endoscopic sphincterotomy is performed via percutaneous transhepatic cholangioscopy. This report describes an initial experience with this technique. METHODS: After dilation of the percutaneous fistula, a cholangioscope with a push-type sphincterotome attached was inserted into the bile duct via the fistula and then through the papilla into the duodenum. The tip of the instrument then was retroverted to obtain a frontal view of the papilla. Then, a sphincterotomy incision was extended to the proximal, orad margin of the papillary eminence. OBSERVATIONS: Percutaneous transhepatic biliary drainage was performed in 3 patients with obstructive jaundice and bile duct stones. In all patients, percutaneous transhepatic cholangioscopic sphincterotomy was performed successfully, without procedure-related complication. Thereafter, all stones and stone fragments cleared from the duct by spontaneous migration. CONCLUSIONS: Endoscopic sphincterotomy via percutaneous transhepatic cholangioscopy potentially is an innovative technique for endoscopic sphincterotomy in patients with an endoscopically inaccessible papilla.

Aged↗
PubMedDate not supplied

Endoscopic plastic surgery: the endoscopic evaluation of implants after breast augmentation.

There is an ongoing discussion about the possible connection of gel-filled silicone implants for breast augmentation and the development of connective tissue disease. In the absence of any proven link and irrespective of the difficulty to prove such a causality, these discussions lead to great concern for the hundreds of thousands of women who underwent breast augmentation with silicone gel implants. As a consequence there are voices that call for regular checks of the implants with regard to their integrity. All the external methods of judging an implant, including MRI, can--if at all--detect only marked lesions or ruptures. Direct visualization of the implant up to now has been the only safe method. Direct visualization can be carried out by reopening the previous incision or by endoscopic inspection. Endoscopic evaluation needs the dexterity of all endoscopic plastic surgery procedures, but with sufficient training and experience it is a very safe, quick, and highly compliant procedure for the patient and can be combined with endoscopic biopsies and other endoscopic operations such as capsulotomies.

Breast Implants↗
PubMed2001

Impact of upper endoscopic survey during percutaneous endoscopic gastrostomy tube placement.

BACKGROUND: No consensus exists concerning the utility of a full diagnostic upper endoscopy during percutaneous endoscopic gastrostomy (PEG) tube placement. We evaluate the effect of a complete survey on identifying and treating unsuspected gastrointestinal pathology. METHODS: During a 10-year period (1990-2000), 1,706 patients underwent attempted PEG tube placement by five different surgical endoscopists at one institution. A complete survey of the esophagus, stomach, and proximal duodenum was attempted in all cases. Endoscopic findings and recommendations were recorded in a computerized log and patient charts. Pathology results were obtained from a computerized pathology database and patient charts. RESULTS: Placement of a PEG tube was successful in 97%, and a full survey was possible in 99% of the cases. Pathologic findings were found in 38% of the surveyed patients (esophagus, 7%; stomach, 24%; duodenum, 7%). One group with gastrointestinal polyps or gastric ulcers (5.7%) was identified as possible candidates for endoscopic intervention. In 30% of this group (1.8% of the total) a biopsy was performed, or bleeding was treated endoscopically. In a second group pathology was identified in the duodenum (6.4%) that would not have been recognized without a full survey. These duodenal findings resulted in a recommendation for treatment change in 38% of this group (2.4% of the total). CONCLUSIONS: Upper endoscopic survey before PEG tube placement showed a significant amount of unsuspected gastrointestinal pathology. Findings requiring biopsy, immediate treatment, or a change in medical treatment occurred in 4.2% of the cases, and these findings did not prevent PEG tube placement in any patient.

Adolescent↗
PubMed2006

German guidelines for reprocessing endoscopes and endoscopic accessories: guideline compliance in Frankfurt/Main, Germany.

Guidelines for reprocessing flexible endoscopes have been published in many countries. The present survey investigated compliance with German guidelines in all hospitals and private practices in Frankfurt/Main, Germany. In 2003, all endoscopic units in Frankfurt/Main [15 hospitals and 23 private practices (10 large practices performing >1,000 endoscopies/year and 13 small practices performing <1,000 endoscopies/year)] were visited by members of the Public Health Service and assessed using a checklist based on the recommendations of the German guidelines. In 2004, a re-evaluation took place, either by analysing the written reports of the institutions or by visiting them again. Meanwhile, one hospital had closed and three small practices had ceased performing endoscopy, so the re-evaluation encompassed 14 hospitals and 20 private practices. In 2003, hospital compliance with the guidelines was satisfactory but many problems were identified in private practices. Between 2003 and 2004, great improvements were made. By the end of 2004, 90% of private practices had adequate storage facilities for reprocessed endoscopes, and were performing reprocessing of bottles and tubes for air-/water-channel flushing correctly (2003: adequate storage 52%; correct reprocessing 74%). Sterilization of endoscopic accessories was satisfactory, and routine testing of endoscopes after reprocessing was performed in all private practices at the end of 2004 (2003: sterilization of accessories 57%; microbiological control tests 56%). In 2003, although hospital compliance with the guidelines was satisfactory, mandatory improvements were required in private practices, notably in smaller units. Infection control advice and the control of public health regulations resulted in the correction of most processing faults between 2003 and 2004.

Endoscopes↗