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PubMed1978

[Gastroenterological endoscopy--fascination and obligation (author's transl)].

The development of fiber endoscopy has made possible routine endoscopic bioptic examination of the upper (including the duodenum) and lower digestive tract (with the terminal ileum). Biopsy material can be obtained in the necessary quantities with forceps or a loop. In many centers endoscopy is already the basic method for the diagnosis of diseases of the upper digestive tract. A similar tendency is also becoming apparent in colo-ileoscopy. The increase in the frequency of endoscopic investigations is accompanied by a decrease in the number of complications. The increasing importance and dissemination of gastrointestinal fiber endoscopy demands greater and better training facilities and adequate control of qualifications together with an integrated cooperation with the pathologists.

Biopsy↗
PubMed1982

Gastrointestinal endoscopy services--a review of the 70s with predictions for the 80s.

Information obtained from 3 questionnaires circulated to British gastrointestinal endoscopists has been used to trace the development of endoscopy services during the 1970s. Oesophagogastro-duodenoscopy became available in most hospitals; colonoscopy services were slower to develop and endoscopic retrograde cholangio-pancreatography was performed in under 50% of hospitals. Various therapeutic techniques followed the diagnostic procedures and by the end of the decade constituted one of the major areas of growth. The impact of gastrointestinal endoscopy on other disciplines, diagnostic radiology, surgery, pathology and general practice is reviewed. Organizational aspects of endoscopy services with emphasis on staff, premises, instrumentation and finance are discussed. Analysis of the trends during the 70s has allowed some predictions of the likely developments in the 1980s.

Data Collection↗
PubMed1999

[Virtual endoscopy].

After a brief definition of Virtual Endoscopy (VE), the authors, by a personal experience and literature analysis, present the results of this new method in several applications: tracheo-bronchial tree, vessels, colon, bladder, central nervous system; patients were referred by standard endoscopy, advantages and limits were studied. We underline the atraumatic feature of VE and superiority of fibroscopy. Terminology is assessed. To compare two methods, one recent, is not actually specially justified. "VE" development is an undeniably interesting challenge for standard endoscopy. Is is absolutely conceivable that in the next future, an important number of purely diagnostic exams will be carried on by virtual technics (J. F Rey).

Endoscopy↗
PubMed1976

An acrylic dental protector in peroral endoscopy.

A simple acrylic dental prosthesis is described which achieves successful dental protection during peroral endoscopy. This prosthesis is not advocated for all cases, but certainly is well warranted for those patients whose upper dentition is at risk during endoscopy because of the prominence of the incisors, the presence of loose teeth, or with extensive restorative work. In present experience, approximately 10 per cent of patients undergoing endoscopy have such an acrylic prosthesis prepared pre-operatively. The commercially available flexible plastic dental guard is used in approximately 25 per cent of cases, and the remaining cases need no specific attention. It is felt that this prosthesis could be constructed by any dentist conversant with the technique.

Acrylic Resins↗
PubMed1999

Sedation for ambulatory endoscopy.

Diagnostic and therapeutic fiberoscopy of gastrointestinal tract is often performed ambulatory and sedation is sometimes also required. Indication for sedation can be the intervention itself or the patient's psychological state. Aim of the study was to compare the effects of midazolam and combination of midazolam and fentanyl during endoscopy. Twenty eight cases were investigated: oesophagogastroduodenoscopy (n = 14) and colonoscopy (n = 14). Anaesthetics were midazolam (M) in 16 cases, midazolam-fentanyl (MF) in 12 cases. Non-invasive mean arterial pressure, pulse rate, acid-base balance and blood gases (by Astrup method) were recorded before endoscopy, at the 5th and 10th minutes of endoscopy, 15 minutes after intervention and also before emission. Pulse rate changed between 78-92/min. Mean arterial pressure appeared between 84-90 mm Hg. In MF group both were lower but there was not significant difference between the groups. The values were in normal range, there were not metabolic acidosis which needed correction. Onset of sedative effect was 2.8 min. in M group, 2.3 min. in MF group. The ability for adequate reaction returned within 11 min. in M group, within 14 min. in MF group. Fentanyl prolongs sedative effect of midazolam and offers sufficient pain relief. After 3 hours, patients could be emitted from the hospital.

Acid-Base Equilibrium↗
PubMed2000

Light-induced fluorescence endoscopy of the gastrointestinal tract.

The early detection of dysplasia and superficial malignant lesions of the gastrointestinal tract is of significant clinical importance. Recent advances in fluorescence-based endoscopic imaging and spectroscopy of the gastrointestinal tract may offer alternative means of detecting and identifying premalignant and malignant lesions that were otherwise occult or nonspecific on conventional white-light endoscopy. The purpose of this article is to present a general overview of the current developments and possible clinical roles of light-induced fluorescence endoscopy as an adjunct to routine diagnostic endoscopy to enhance screening and surveillance for premalignant and malignant gastrointestinal lesions.

Endoscopy, Gastrointestinal↗
PubMed2000

Overview of infection control problems: principles in gastrointestinal endoscopy.

The practice of flexible gastrointestinal endoscopy has matured significantly in recent years. Unfortunately, two long-standing problems still exist: the complex physical nature inherent to the endoscopes and accessories, and user compliance with established reprocessing guidelines. Improvements have been made, but newer instruments remain comparatively fragile, expensive, and physically complex, and validated data on reprocessing specific instruments is generally lacking. The practice of flexible gastrointestinal endoscopy today, however, is demonstrably safe and beneficial, provided established practice procedures for reprocessing, with emphasis on instrument cleaning, are followed meticulously in each endoscopy center.

Endoscopy, Gastrointestinal↗
PubMed2000

Infectious complications associated with gastrointestinal endoscopy.

Infectious complications resulting from endoscopy rarely occur. This is probably due as much to the efficiency of the gastrointestinal immune system as to effective endoscope disinfection practices. The low incidence may also represent the difficulty linking infections to endoscopy. Recent reports of probable interpersonal transmission of hepatitis C infection during colonoscopy has heightened this concern. This article examines the documented cases of endoscopy related infections and reviews the risk factors for these infections and details guidelines which have been designed to keep the incidence of these complications low.

Bacteremia↗
PubMed2000

American Society for Gastrointestinal Endoscopy-Society of Gastroenterology Nurses and Associates Endoscope Reprocessing Guidelines.

Adequate endoscope reprocessing is one of the most essential functions in any endoscopy setting. Standards and guidelines for reprocessing endoscopes have been established by the Society of Gastroenterology Nurses and Associates (SGNA) and the American Society for Gastrointestinal Endoscopy (ASGE). These standards pertain to any setting in which gastrointestinal endoscopy is performed. Endoscope reprocessing that meets the established standard of practice helps to ensure a patient-ready instrument for all patients, reduces the risk of disease transmission to practitioners and staff, and helps to prolong the life of the endoscope.

Endoscopes, Gastrointestinal↗
PubMed1976

Upper gastrointestinal endoscopy in the pediatric patient.

The value of upper gastrointestinal endoscopy in adults is well established. This study of 50 children demonstrates that upper gastrointestinal endoscopy can be performed safely and effectively in this age group without general anesthesia. Endoscopy appears more sensitive than radiology in the detection not only of superficial mucosal lesions, but of gastric and duodenal ulcers as well.

Age Factors↗
PubMed2001

Safety of endoscopy in patients with end-stage liver disease.

Patients with end-stage liver disease routinely undergo an upper endoscopy for the diagnosis and management of complications of portal hypertension. These cirrhotic patients inherently have additional risks and higher rates of complications secondary to their liver disease and the presence of portal hypertension. Additional considerations and precautions must be taken into account to ensure that the endoscopic procedure is performed with the minimal risks possible. This article discusses the management of cirrhotic patients undergoing endoscopy. It addresses clinical clues for identifying the cirrhotic patient, the use of medications and monitoring equipment for vital signs during endoscopy, blood product administration in acute upper gastrointestinal bleeding, and elective and urgent procedures to diagnose and treat cirrhotic patients.

Antibiotic Prophylaxis↗
PubMed2001

[Gastrointestinal endoscopy--review and perspectives].

Gastrointestinal endoscopy comprises gastroscopy, colonoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic ultrasonography and small bowel enteroscopy are also available, although not in all endoscopy units. The diagnostic accuracy of gastrointestinal endoscopy is very high. Scientific activities include evaluation of methods/regimens where diagnostic gastroscopy can be replaced by non-invasive Helicobacter screening for certain patients, the use of non-invasive alternatives to ERCP (e.g. magnetic resonance), small bowel enteroscopy without the use of an endoscope, and virtual colonoscopy with computer tomography or magnetic resonance techniques. The move away from traditional endoscopic procedures towards more non-invasive techniques is taking place along with the development of new endoscopic procedures to replace traditional surgical techniques, e.g. endoscopic placement of colonic metal stents in acute colonic obstruction.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

[Sedation in pediatric digestive endoscopy].

Sedation for children doing diagnostic or operative pediatric gastrointestinal endoscopy (PE) procedures is performed differently over the world and no consensus is yet agreed on the best paediatric endoscopy sedation (PES). Some centres do not use any sedation, especially in infants, most centre use some form of sedation: conscious sedation, deep sedation and general anaesthesia. We review sedation drugs and describe our centre protocol on 188 consecutive PE: oral premedication with flunitrazepam (0.05 mg/kg/dose) at least 30 min before procedure, petidine (1 mg/kg) followed by increasing boluses of midazolam (0.05 mg/kg up to a maximal 0.2 mg/kg or 5 mg) were given i.v. to obtain a conscious sedation. All PE could be performed and ended safely, PES resulted satisfactory in approximately 65% of patient having conscious sedation. SaO2 < 90% was observed in 2% of cases, one child had a respiratory depression after PE that resolved with flumanezil. Endoscopy and sedation was always performed by the PE team in the immediate vicinity of anaesthesiologists at work. PE can be safely performed with conscious sedation. Basic and advanced resuscitation skills are needed for the PE team who wish to perform both endoscopic and sedation procedures.

Child↗
PubMed2001

Role of endoscopy in inflammatory bowel disease.

Since its introduction into clinical use, flexible fiberoptic endoscopy progressively has become an indispensable tool to diagnose and treat gastrointestinal disorders. Few innovations have had a greater impact on the clinical practice of gastroenterology. In effect, diagnostic endoscopy has become an extension of physical diagnosis. This article reviews the expanding use of endoscopy in inflammatory bowel disease in the pediatric age group.

Adolescent↗
PubMed2001

[Residents training in gynecologic operative endoscopy: a review of Israeli and world experience].

Two decades ago, Gynecologic procedures performed by endoscopy were basically limited to diagnostic procedures. Since 1990, operative endoscopy is increasingly used to treat a growing variety of gynecologic conditions, resulting in shorter hospital stay and smaller, less painful incisions. One of the greatest tasks facing today's academic gynecologic surgeons is training residents and attendant physicians to perform endoscopic surgery adequately and safely. Clearly, there is a need to provide basic knowledge of endosurgical principles, and understanding of equipment and technologies used in operative endoscopy. Also, information on minimization, early recognition and treatment of endoscopic complications is of great importance as well as hands-on experience in these new procedures. We have reviewed the world as well as the Israeli experience in the field and out of this growing base of knowledge we have tried to delineate and forge guidelines for adequate teaching, training and accreditation.

Education, Medical, Graduate↗
PubMed1998

Usefulness of endoscopy in craniofacial trauma.

To determine the extent of endoscopy utilized in craniofacial trauma, a questionnaire was mailed to 400 surgeons in the United States. A 40% response was obtained; 21.3% of the surgeons stated that they had used endoscopy to treat facial fractures; 33% of them had been in practice for 6 to 10 years, and 47% of those who had used endoscopy in craniofacial trauma were in full-time private practice. In facial fractures, endoscopes were used primarily to treat Le Fort fractures (55.9%), followed by zygomatic arch fractures (52.9%). Lack of accompanying instrumentation, such as appropriate drills, to use with the endoscope via small openings was cited as a significant problem; 46% of the respondents were unable to resolve it. Most respondents (55.6%) felt that if proper accompanying instrumentation were to be developed, endoscopes would become an integral component in the management of craniofacial trauma.

Attitude of Health Personnel↗
PubMedDate not supplied

Midazolam sedation for upper gastrointestinal endoscopy: comparison between the states of patients in partial and complete amnesia.

BACKGROUND/AIMS: The amnesia produced by anesthesia is advantageous for unpleasant procedures like gastroscopy, and midazolam is one of the most commonly used anesthesias for endoscopy. However the proper use of midazolam from the viewpoint of complete amnesia has been discussed very little. METHODOLOGY: One hundred and thirty-three unselected patients about to undergo upper gastrointestinal endoscopy were premedicated with sufficient intravenous midazolam to cause enough sedation so that no response was evoked when calling their name. Pulse, arterial pressure, arterial oxygen saturation and the physical signs of patients were recorded continuously during the procedures. After the study, patients were given 0.25 mg of flumazenil and asked if they could recall the procedures. Those who could recall even part of the procedure were not regarded as achieving complete amnesia. The efficacy of the sedative was judged by the appearance of complete amnesia. RESULTS: From our regression analysis complete amnesia was achieved in 75.9% of the total patients. The differences of the blood pressure fall, pulse rate increase and arterial oxygen saturation fall between the patients with complete and partial amnesia were minute and did not cause serious complications. Regression analysis revealed the most important factors for the complete amnesia to be midazolam dose per body weight and habitual hypnotic use. CONCLUSIONS: There are no obvious disadvantages to producing complete amnesia with midazolam for upper gastrointestinal endoscopy. Habitual hypnotic use along with midazolam dose per body weight is the most influencing factor for that purpose.

Amnesia↗
PubMed1975

[Radiography and endoscopy in the diagnosis of the gastroduodenal ulcer].

In the clarification of circumscribed processes in stomach and duodenal bulb radiodiagnostics and endoscopy supplement themselves in an ideal way. The endoscopy seems to have advantages in recognition and explanation of findings on the cardial and subcardial parts of the stomach as well as on the operated stomach. Deformation of the duodenal bulb and changes of the post-stenotic parts can be better judged radiologically. The complete healing of an ulcer is exactly recognisable only by means of endoscopy. Linear ulcers are often not to be seen in radiodiagnostics. With the help of the aimed biopsy the decision on benignity or malignity of the ulcerating process has become easier. Every radiologically not certainly explainable findings and every discrepancy between X-ray picture and complaints of the patients should bring about an endoscopic examination.

Biopsy↗