Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colonoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,603 records · Page 89Linked to original sources
PubMed2004

Endoscopic dilation of benign colorectal anastomotic stricture after low anterior resection: A prospective comparison study of two balloon types.

BACKGROUND: Benign strictures arise in 5.8% to 20% of colorectal anastomoses. For such strictures, endoscopic dilation has proven to be a valid and safe treatment. A variety of endoscopic techniques have been proposed, but controlled prospective trials are lacking. This study compared dilation of this colorectal anastomotic stricture with an over-the-wire balloon designed for treatment of achalasia and with a through-the-scope balloon. METHODS: Thirty patients with symptoms caused by benign colorectal anastomotic stricture were randomly allocated to two treatment groups: 15 underwent dilation with a through-the-scope balloon and 15 had dilation with an over-the-wire balloon. Success was defined as an anastomotic lumen wide enough to allow passage of a standard 13-mm-diameter colonoscope, with resolution of symptoms. The success of dilation, the number of sessions required, the complications, and the duration of the dilation were recorded. Patients were followed for 24 months. RESULTS: Dilation was successful in all patients, with no procedure-related complication. The mean number of sessions required was 2.6 (0.98) in the through-the-scope group and 1.6 (0.77) in the over-the-wire group ( p = 0.009). The duration of response in days was greater in the over-the-wire group vs. the through-the-scope group, 560.8 (248.5) days vs. 294.2 (149.3) days, respectively, p = 0.016. CONCLUSIONS: Through-the-scope and over-the-wire dilation techniques are both effective and safe for treatment of benign colorectal anastomotic strictures. Using a greater diameter over-the-wire pneumatic balloon reduces the number of dilation sessions required and provides a longer-lasting response to dilation.

Adenocarcinoma↗
PubMed2005

Colon polyp retrieval after cold snaring.

BACKGROUND: The removal of small colon polyps by cold snare transection without electrocautery effectively eliminates polyps, and anecdotal reports indicate a low risk of bleeding and perforation. Concerns about using cold snaring have centered on the risk of immediate bleeding and the difficulty in retrieving the polyp. The objective was to determine the retrieval rates of polyps after cold snaring after two different methods of resection and retrieval. METHODS: Consecutive polyps were identified by a single colonoscopist who chose the technique of polypectomy (hot snare, cold snare, or cold forceps). If cold snaring was chosen, an independent observer assigned the polyp to method A (cold resection of polyp without tenting and then suction of the transected polyp into a trap) or method B (ensnare the polyp, pull it into the colonoscope channel, and then transect it while suctioning). The size and the approximate location of all polyps were recorded and all collected specimens were sent separately for histologic examination. Results Of 519 consecutively encountered polyps, 400 were removed by cold snare: 197 were assigned to method A and 203 to method B. The mean size of polyps that were cold snared was 3.5 mm. The mean time to remove and to retrieve polyps with method A was 14.5 seconds (n = 58) and with method B was 18.1 seconds (n = 60) ( p = 0.03). There were no complications from cold snaring. The rate of successful retrieval with method A was 100% (197 of 197 polyps) and with method B was 98% (199 of 203 polyps) ( p = 0.04). CONCLUSIONS: Cold snare removal of colon polyps is associated with a high polyp retrieval rate. Each of two methods of polyp retrieval was effective. Snare transection without tenting of the polyp, followed by suctioning of the specimen off the polyp site, was more efficient, though the difference in efficiency was minimal. Difficulty or failure to retrieve polyps should not be a concern with regard to cold snare polypectomy.

Cold Temperature↗
PubMed1995

Small nonpolypoid neoplastic lesions of the colon: endoscopic features with emphasis on their progression.

We investigated the endoscopic and histologic features of 74 nonpolypoid neoplasias of the colorectum measuring 15 mm or less in diameter. Colonoscopically, they were characterized by flat growth, being either slightly elevated with a central depression or else completely flat against the surrounding mucosa. Of the 54 lesions measuring 5 mm or less in diameter, 3 (7%) were diagnosed as cancer, whereas the remaining 51 (93%) were diagnosed as adenomas with moderate epithelial atypia. The lesions measuring more than 5 mm were fewer in number (20), and they were more frequently given the histologic diagnosis of severe epithelial atypia (20%) and cancer (70%). Whereas the endoscopic features of the cases of adenoma with moderate atypia included both complete flatness and flat-topped elevation with a central depression, the lesions diagnosed as adenoma with severe atypia were endoscopically recognized as flat or slightly depressed lesions, and a deep central depression or prominent elevation was noted in the lesions diagnosed as cancer. These findings suggest that some minute nonpolypoid neoplasias may transform to nonpolypoid cancers and invade the submucosa, whereas others do not manifest rapid growth.

Adenoma↗
PubMed1981

Colonoscopy in ischemic colitis.

Fifteen patients with ischemia of the colon are presented. The majority showed a similar clinical presentation with hematochezia, abdominal pain, and diarrhea in an elderly patient population having associated disease. Colonoscopy was abnormal in all patients studied. Three endoscopic stages were recognized; (1) acute stage characterized by petechiae, pallor, and hyperemia; (2) subacute stage consisting of ulceration and exudation; and (3) chronic stage characterized by stricture, decrease in haustrations, and mucosal granularity. Conventional barium enemas were abnormal and suggested ischemic colitis in six of 15 patients. Rigid proctoscopy was normal or demonstrated nonspecific proctitis in 12 of 15 patients studied. Colonoscopic biopsies demonstrated superficial inflammatory changes in all patients. Thirteen patients had complete mucosal healing endoscopically in 2 weeks to 3 months with stricture developing in four patients. Because ischemic colitis is a distinct subtype of ischemic bowel disease most often limited to the superficial mucosa, colonoscopy is an alternative and usually safe modality in the diagnosis of this entity and proved more accurate that conventional x-ray and proctoscopy.

Aged↗
PubMed1982

A randomized double-blind study of nalbuphine as an analgesic for colonoscopy.

Forty-five patients having ambulatory colonoscopic examinations were randomly assigned to receive premedication with meperidine or with nalbuphine. Both treatment groups received equivalent amounts of intravenous diazepam as an additional sedative. Approximately half of the patients tolerated the procedure well in either treatment arm, but a significantly greater number of patients receiving nalbuphine tolerated the procedure poorly, even with large doses of medication. Nalbuphine does not appear to be as effective as meperidine for relieving the discomfort induced by colonoscopy.

Colonoscopy↗
PubMed1982

The causes of hypoxemia in elderly patients during endoscopy.

Changes in arterial gas tensions were determined in 114 patients undergoing elective gastrointestinal endoscopic examinations with standard or pediatric gastroscopes or colonoscopes. All patients were premedicated intravenously with 0.5 mg of atropine and 10 mg of diazepam. In addition, two thirds received a narcotic, either 50 mg of meperidine or 0.05 mg of the short acting drug fentanyl. The choice of instrument or premedication was usually sequential. There was significant depression of the arterial oxygen tension (Pao2), of 17.4%, immediately following premedication that included a narcotic but not with diazepam alone. Significant reduction of the Pao2 persisted during upper endoscopy if a standard gastroscope was used and meperidine or fentanyl was included in the premedication. If a narrow diameter gastroscope was employed, only meperidine was associated with persistent depression of the Pao2. To minimize hypoxia in elderly patients during upper endoscopy, no narcotic or only a short acting one should be included in their premedication, and a narrow diameter instrument should be used for the examination.

Aged↗
PubMed1983

Left-sided stenosing lesions in colonoscopy.

Of 2625 consecutive colonoscopic examinations, 122 stenotic lesions interfered with endoscopy. The sigmoid was the most frequent site of stenosis (64%). Of the two types of endoscopic patterns, type A, in which there is an intraluminal protruding mass, is the most frequent, and type B, in which a segment of colon gradually narrows, has intact mucosa. Adenocarcinoma was the most frequent cause of type A (83%), and complications related to diverticular disease (32%) and adenocarcinoma (27%) were most often associated with type B. Colonoscopy, guided multiple biopsies, and brushing cytology gave high diagnostic accuracy for type A lesions. In type B cases, brushings were usually negative.

Adenocarcinoma↗
PubMed1984

Prospective evaluation of hospitalized patients with nonactive lower intestinal bleeding--timing and role of barium enema and colonoscopy.

A prospective evaluation of 176 hospitalized patients with nonactive lower intestinal bleeding demonstrated that a barium enema is not a necessary prerequisite for a sensitive and safe total colonoscopic examination. Colonoscopy was better in detecting colonic polyps and colon cancers than barium enema. It was concluded that colonoscopy without prior barium enema provides a sensitive diagnostic approach to hospitalized patients with nonactive lower intestinal bleeding. This approach does not interfere with the early use of angiography and may shorten hospitalization.

Adult↗
PubMed1985

Diagnosis of ileocecal and colonic tuberculosis by colonoscopy.

The colonoscopic findings in 11 proven cases of ileocecal tuberculosis consisted of deformed ileocecal valve in all 11 and contracted cecal lumen in 10. This was associated with mucosal nodules predominantly around the ileocecal valve, pseudopolypoid folds, and mucosal protuberance. Two patients had an isolated cecal ulcer. In three of the 11 patients the examination enabled a histologic diagnosis to be made on the basis of typical granuloma. In the other four patients Mycobacterium tuberculosis was isolated from the tissue obtained through biopsies.

Adult↗
PubMed1985

Training for flexible sigmoidoscopy.

Three hundred twenty-six participants of five 1-day continuing medical education courses on flexible sigmoidoscopy were surveyed to determine their use of lower intestinal endoscopes and to identify how well the education trained them to use the flexible sigmoidoscope. The number of participants using a flexible sigmoidoscope and/or colonoscope increased after the course. About one half of the respondents went from no use of the flexible sigmoidoscope to using it. About one fifth of the respondents were not using a flexible sigmoidoscope after the course for various reasons. Most respondents used more than one instrument after the course, with the combination of the 60-cm flexible sigmoidoscope and the rigid sigmoidoscope being most popular. The overwhelming majority found the flexible sigmoidoscope to be either very easy to use or reasonably easy to use. Only one complication was reported. Most of the respondents had attended only this 1-day course, but one third had taken either other courses or had been supervised for several procedures.

Adult↗
PubMed1986

Ventricular ectopy associated with peroral colonic lavage.

Peroral colonic lavage solutions are widely used to prepare patients for colonoscopy. The effects of peroral colonic lavage on cardiac rhythm have not been evaluated previously. Using continuous electrocardiographic monitoring, the authors evaluated cardiac rhythm in 22 patients undergoing 24 colonoscopic examinations. Monitored periods included a control phase, the period of preparation with the lavage solution, and the period of colonoscopy. In 12 of 24 evaluations, patients demonstrated an increase in ventricular ectopy during the preparation phase compared to the control period (p = 0.01). Two patients demonstrated ventricular tachycardia, four patients manifested complex ventricular ectopy without ventricular tachycardia, and six patients demonstrated an increase in simple premature ventricular contractions. The authors conclude that peroral colonic lavage is associated with increased ventricular ectopy.

Adult↗
PubMed1986

Carbon dioxide-insufflated colonoscopy: an ignored superior technique.

Colonoscopy and barium enema are complementary studies in the diagnosis of the cause of lower intestinal bleeding. The air usually insufflated during colonoscopy often makes it impossible to perform a good barium enema on the same day. As a possible solution to this problem, we studied the quality of barium enemas performed immediately following carbon dioxide-insufflated colonoscopy. All 15 patients who underwent unsuccessful total colonoscopies using carbon dioxide insufflation were able to have barium enemas performed the same day in contrast to only one out of 15 patients who had air-insufflated colonoscopy. In a survey of all hospitals in Illinois with 150 beds or more, we found only 15 of 146 hospitals used carbon dioxide for colonoscopy insufflation. We recommend the routine use of carbon dioxide for colonoscopic insufflation not only for greater safety and comfort for the patient, but also for the convenience and cost savings.

Adult↗
PubMedDate not supplied

Complications of the hot biopsy forceps technique.

Hot biopsy forceps technique involves the use of insulated monopolar electrocoagulating forceps to simultaneously biopsy and electrocoagulate tissue. It has been recommended for removal of diminutive polyps and treatment of vascular ectasias of the gastrointestinal tract. The extent of its use and associated complications have not been delineated. This study evaluated the practice of 517 endoscopists. Seventy-one percent (369 endoscopists) used hot biopsy forceps and reported 117 complications, including 85 episodes of bleeding, 19 perforations, and one death. While the overall complication rate was less than that previously reported for colonoscopic polypectomy, 87% of colon perforations occurred on the right side. Factors that may have been important in the development of complications included the degree and length of current application. Adherence to suggested limitations in current application and use of proper technique should result in fewer complications.

Biopsy↗
PubMedDate not supplied

Mucosal pseudolipomatosis: an air pressure-related colonoscopy complication.

Mucosal pseudolipomatosis is a recently described colonoscopic finding, most likely caused by intramucosal air. We describe four asymptomatic patients with this lesion which completely resolved 3 weeks later on repeat colonoscopy. This is a benign, transient lesion with distinct endoscopic and histologic findings. The similarity between mucosal pseudolipomatosis and pneumatosis cystoides intestinalis is supportive of the mechanical theory for pneumatosis cystoides intestinalis.

Air↗
PubMedDate not supplied

Endoscopic tonometric assessment of intestinal perfusion in a canine model.

In an anesthetized canine model tonometric balloons were colonoscopically placed into the right colon, left colon, and rectum. A femoral arterial line was established for the measurement of blood pressure and arterial bicarbonate. Laparotomy was performed and additional balloons were placed, via enterotomies, into the duodenum, jejunum, and ileum. Baseline measurements of intramural pH were obtained, and then the origin of the superior mesenteric artery was occluded. Additional measurements in all areas were made for two 1-hour intervals. Results showed rapid and marked acidosis as demonstrated by significant (p less than 0.001) pH changes in the jejunum, ileum, and right colon. There were no significant changes in the pH in the duodenum, left colon, or rectum. Systemic arterial pH remained normal. These data demonstrate that tonometric balloons endoscopically placed into the right colon will reflect superior mesenteric artery occlusion at an early stage, and that similar information is likely to be gained by endoscopic placement of these balloons into the jejunum.

Animals↗
PubMedDate not supplied

Endoscopic ultrasonography in the evaluation of colon and rectal disease.

Endosonography of the colon has until recently been limited to examination of the rectum. Rigid and flexible instruments are currently available which allow for detailed images of the rectal wall. Comparative studies suggest that endosonography may be more accurate than computed tomography in the preoperative staging of rectal carcinoma. Recently, an ultrasound colonoscope has been developed which allows for visual examination, biopsy, and endosonography throughout the colon. Experience with this technique is limited and its role in the evaluation of colonic disease has not yet been determined. Further comparative trials are needed to more fully define the role of endosonography in the diagnosis of colorectal disease.

Colon↗
PubMedDate not supplied

Status evaluation: enteroscopy.

Enteroscopy is a method to examine the small bowel mucosa beyond the reach of standard upper endoscopes. In practice it has primarily been used to search for a bleeding lesion in patients where one is not detected by conventional means. Such patients constitute only a small percentage of those who bleed (15,20). Experience is greatest with push enteroscopy. Examination of the distal duodenum and proximal jejunum using a standard or pediatric colonoscope is practical, appears to be safe and provides a satisfactory diagnostic and therapeutic yield in experienced hands. Longer designated push enteroscopes are under investigation. Sonde type enteroscopes can be passed to the ileum in most cases. A cause for bleeding can be detected in approximately one-quarter to one-third of individuals with minimal morbidity. Certain technical problems limit their efficacy and their role in the evaluation of patients with bleeding has not yet been clearly defined.

Endoscopes, Gastrointestinal↗
PubMedDate not supplied

Minute non-polypoid adenoma of the colon detected by colonoscopy: correlation between endoscopic and histologic findings.

To characterize the endoscopic features of minute non-polypoid neoplastic lesions of the colon, we investigated the endoscopic, macroscopic, and histologic findings in 34 lesions detected by colonoscopy, which were smaller than 5 mm and were endoscopically recognized as flat or depressed lesions. The lesions were divided into two groups according to their endoscopic features; 8 lesions were completely flat and the remaining 26 lesions were flat-topped elevations with a central depression. Macroscopic examinations revealed that the center of the endoscopically flat lesion was slightly elevated, whereas the center of the flat-topped elevation was characterized by a central depression. All of the lesions were histologically diagnosed as tubular adenomas. The flat lesions were composed of flatly elevated adenomatous glands, while the flat-topped elevations with a depression were characterized by surrounding hyperplasia arising from normal glands. The whole thickness of the mucosa was replaced by adenomatous glands in the lesions with an obvious central depression, while the adenomas tended to spread superficially in the lesions with a shallow depression. These findings suggest that pre-cancerous lesions other than small polyps do exist in the colon and that colonoscopic examination provides some clue toward a prediction of the histologic architecture of the lesions.

Adenoma↗