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At least 19 recordsLinked to original sources
PubMed1999

Disposable-sheath, flexible gastroscope system versus standard gastroscopes: a prospective, randomized trial.

BACKGROUND: Endoscopically transmitted infections due to inadequate disinfection are rare but well-recognized complications. A new prototype of a flexible, fiberoptic endoscope has been developed that uses a disposable sheath to cover and protect all working surfaces of the endoscope from contamination. The present study investigated the function, reprocessing, and hygienic status of this endoscope system in comparison with standard systems. METHODS: In a prospective, randomized trial, 100 upper endoscopic procedures (50 standard, 50 sheathed) were performed. Analog rating scales were used to evaluate endoscopic performance and reprocessing. Reprocessing time, procedure duration, insertion depth, total instrument downtime, and problems occurring during the procedure were recorded. Microbiologic swabs were obtained from each endoscope. RESULTS: Mean procedure duration was slightly longer with the sheathed system than with standard endoscope (9.9 vs. 8.4 min). Set up and reprocessing times, however, were significantly shorter with the Endosheath (8.9 vs. 48.4 min with the standard endoscope). The disposable-sheath endoscope system permits the rate of performance of procedures to be increased by a factor of up to 3.0. Both endoscopists and reprocessing personnel preferred the standard endoscope. No post-procedure sheath leakage or rupture was seen. CONCLUSION: Our results suggest that the "disposable endoscope" may have important advantages in terms of decreased instrument turn-around time and potentially improved safety.

Adolescent↗
PubMed1998

[Disposable protection for flexible gastroenterologic endoscopy: prospective comparative evaluation of a new gastroscopy system (Endosheath) compared to the standard fiberglass gastroscope].

The reprocessing of flexible gastrointestinal endoscopes is time-consuming and expensive. Endoscopically transmitted infections due to insufficient disinfection are already of clinical importance. A new developed prototype of a flexible, fiberoptic gastroscope was tested in a prospective open randomized trial to evaluate the function. reprocessing and hygienical safety of this disposable, sheathed endoscopic system and was compared with a standard gastroscope. This new endoscopical system utilizes a disposable sheath to cover and protect all working surfaces of the endoscope from contamination. A prospective, randomized trial was performed in our unit to compare the disposable gastroscope (G-F100) with a standard-gastroscope of the newest Generation (GIF-Q 30). Visual analog rating scales were used to record evaluations of endoscope performance and reprocessing by endoscopists and reprocessing personnel. We recorded the time of reprocessing, the time to perform the procedures, depth of insertion, total instrument downtime and any problems which occurred during the procedure. Microbiological swabs were taken from each endoscope. 40 procedures (20 standard, 20 sheathed) were performed. The sheathed gastroscope 8.9 min versus 7.1 min. The overall instrument downtime was significantly shortened by the endosheath (9.8 min versus 47.5 min with the standard gastroscope). The disposable gastroscope-system permits an increase of procedure-frequency up to a factor of 2.9. The standard gastroscope was preferred by the endoscopists and the reprocessing personnel. No microbiological contaminations of the sheathed or the standard gastroscopes could be demonstrated, and no leak of the sheaths was recorded after gastroscopy. The disposable gastroscope has important advantages of decreased instrument turn-around time and potentially increased staff and patient safety.

Gastroscopes↗
PubMed1998

A prospective randomized trial comparing the use of the flexible gastroscope versus the bronchoscope in the management of foreign body ingestion.

BACKGROUND: Foreign body ingestion is a common clinical problem in Hong Kong. Some recent reports have proposed the use of flexible nasoendoscopy for foreign body retrieval. The present study is a prospective randomized trial on the use of the flexible gastroscope and bronchoscope in the management of foreign body ingestion. METHODS: Two hundred sixteen patients older than 11 years were prospectively randomized to flexible endoscopic examination using either the gastroscope (108 patients) or the bronchoscope (108 patients). The duration of the procedure was noted. Patients were asked to assess their overall tolerance to the procedure on a scale of 1 (well tolerated) to 10 (unacceptable). RESULTS: A foreign body was retrieved in 68 patients (31.5%). There was no difference between the two groups in the foreign body retrieval rate, type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three patients required the additional use of the gastroscope for foreign body retrieval at (for one patient) or below (for two patients) the cricopharyngeus. The patient's tolerance level was related only to the duration of procedure (rho = 0.386; p < 0.001). CONCLUSION: The use of the flexible gastroscope is recommended because of its efficacy, safety, and tolerability.

Adolescent↗
PubMed2006

Results of gastroscope bacterial decontamination by enzymatic detergent compared to chlorhexidine.

AIM: To compare the efficacy of enzymatic detergent with chlorhexidine for gastroscope bacterial decontamination. METHODS: A prospective randomized controlled study was undertaken to evaluate the ability of these 2 agents to achieve high level disinfection in a gastroscope. A total of 260 samples were collected from 5 different gastroscopes. Manual cleaning was done for 10 min with these 2 agents separately (n = 130 each). Then all specimens underwent 2% glutaraldehyde soaking for 20 min. After 70% alcohol was rinsed, sterile normal saline was flushed into each gastroscope channel and 40 mL of sample was collected. The sample was sent for aerobic bacterial culture after membrane was filtered. A colony count greater than 200 cfu/mL was considered significant. RESULTS: The positive culture rate was 4.6% in the enzymatic detergent arm and 3.1% in the chlorhexidine arm. Pseudomonas species were the main organism detected from both groups (60%). Multiple organisms were found from 4 specimens (enzymatic detergent arm = 1, chlorhexidine arm = 3). CONCLUSION: The contamination rate of both types of cleaning solution is equivalent.

Acinetobacter baumannii↗
PubMed2006

[Study on the relationship between TCM syndrome and gastroscopic feature in children with stomachache].

OBJECTIVE: To explore the characteristic of TCM syndrome in children with stomachache and its relationship with the gastroscopic feature. METHODS: The relationship between macroscopic syndrome differentiation and microscopic syndrome differentiation in 300 children with stomachache was analyzed by means of clinical syndrome differentiation and gastroscopic examination. RESULTS: The total disease detectable rate of gastroscopic examination was 98.3%. Dampness-heat syndrome and deficiency-cold syndrome were the syndromes that most commonly be detected by either macroscopic or microscopic syndrome differentiation. And the two methods of differentiation showed better coherence in superficial gastritis. CONCLUSION: The clinical effect of TCM therapy on children stomachache could be improved through integrative Chinese and Western medical approach, by conducting syndrome differentiation referring to the gastroscopic features, which could conduct microscopic guidance to the clinical macroscopic syndrome differentiation.

Abdominal Pain↗
PubMed1998

[Gastroscopic criteria and most frequent pain in bile reflux gastritis].

The aim of the paper was consolidation a gastroscopic cryterious and oftenest sufferings in case bile reflux gastritis. In this purpose carry over analysis 1000 successive gastroscopic study performed in case discomfort in abdominal. In 38.2% confirmed on basis gastroscopic exploration presence of bile in the stomach. In 19.1% recognised presence of bile as results bile reflux because of insufficiency duodeno-pyloric instalation. In 6.2% confirmed bile reflux gastritis. A gastroscopic features in bile reflux gastritis are: presence of bile and incrustation in the stomach mucosae a crystals bile, and co-existence changes mucosa: a hyperaemia, fragility and errosiones. Characteristics subjective sufferings are: feeling a rancid fat in the throats (100%), intolerance of the milk (92%) and bile vomit.

Adult↗
PubMed2003

Gastroscope processing in washer-disinfectors at three different temperatures.

Endoscopes are processed chemo-thermally at approximately 56 degrees C in washer-disinfectors in Germany. In this study we investigated the processing of gastroscopes by an endoscope washer-disinfector at different temperatures. A total of 87 gastroscopes were tested hygienically and microbiologically before manual cleaning (after patient use), as well as after manual cleaning and after endoscope washer-disinfector processing at running temperatures of 43, 51 and 56 degrees C. In all tests the suction/biopsy channels of the gastroscopes were flushed with 50 mL sterile solution throughout their full length, from the proximal to the distal ends. The rinse solutions were plated on to various culture media. Also, in order to detect low bacterial counts, 3x10 mL rinse solution was membrane filtrated. The German guideline level for total bacterial counts, applicable since 2002, was exceeded at all temperatures tested (159 cfu/mL at 43 degrees C, <60 cfu/mL at 51 degrees C, and 8 cfu/mL at 56 degrees C). A temperature increase from 43 to 51 degrees C resulted in a highly significant reduction of the residual contamination by aerobic bacteria (P<0.001, Mann-Whitney U Test), Gram-negative bacilli (P<0.001), and pseudomonads (P=0.002). A further temperature increase from 51 to 56 degrees C resulted in a further highly significant drop in residual contamination by aerobic bacteria (P=0.021) and pseudomonads (P=0.036). The aim of the user-minimizing material damage to endoscopes or prolonging their product life-cannot be achieved through lowering the processing temperature without putting patients at risk. In order to ensure adequate processing, endoscope washer-disinfectors should meet the requirements of current draft standards.

Decontamination↗
PubMed2005

Using the gastroscope for incomplete colonoscopy.

PURPOSE: Reports of virtual colonoscopy demonstrate sensitivity similar to that of conventional colonoscopy for polyps 5 mm or larger, suggesting the validity of its use for colorectal cancer screening. Critical to the success of either procedure is the ability to evaluate the entire colon. Cecal intubation rates during diagnostic or screening colonoscopies vary from 53 to 99 percent. We describe the added value of using a gastroscope to perform a colonoscopic examination that would otherwise result in an incomplete colonoscopy. METHODS: From January 1, 2002 to December 31, 2002 a total of 1,979 colonoscopies were performed. A gastroscope was used in 1.3 percent (n = 26) of these colonoscopies in an effort to complete the index examination initially started with a standard or pediatric colonoscope. The success rate was defined as intubating proximal to the initial area of impasse and entering the cecum. RESULTS: Cecal intubation was achieved in 62 percent of patients. CONCLUSIONS: In patients with incomplete conventional colonoscopy, the gastroscope can usually advance through the initial area of impasse with a cecal intubation rate of 62 percent.

Aged↗
PubMed1996

Percutaneous endoscopic gastrostomy placement using the pull-through or push-through techniques: is the second pass of the gastroscope necessary?

BACKGROUND AND STUDY AIMS: The pull-through and push-through techniques widely used for placing a percutaneous endoscopic gastrostomy (PEG) require two passes of the gastroscope. The second pass is considered necessary to assess the correct positioning of the internal bumper. The aim of the present study was to verify whether the second pass is in fact necessary, or whether it could be omitted in most cases. PATIENTS AND METHODS: Eighty patients undergoing pull-through or push-through PEG placement were included in this prospective study, and were randomly assigned to two groups. In the first group, two passes of the gastroscope were carried out, while in the second group the second pass was omitted and the position of the internal bumper was manually assessed by finger palpation of the abdominal wall after the feeding tube had been pulled out through the abdomen. If finger palpation was not considered satisfactory, a control gastroscopy was carried out. In the other cases, plain radiographs of the abdomen were carried out within six hours of the procedure. RESULTS: Thirty-nine patients underwent two-pass PEG placement, and 41 received one-pass PEG placement. In one patient who had a one-pass procedure, the finger palpation was not considered satisfactory; however, a control gastroscopy showed that the internal bumper was correctly placed. In all other one-pass PEG patients, plain radiography of the abdomen showed that the internal bumper was at an adequate distance from the abdominal wall. No major or minor complications associated with the procedure were observed in either group. Bowel sounds reappeared within 24 hours of the procedure in all patients except for one in the two-pass group, in whom they reappeared after 36 hours. One wound infection, treated with systemic antibiotics, occurred in each group within 30 days of the PEG placement. The procedure time saved in the one-pass PEG group averaged 1.5 minutes. CONCLUSIONS: One-pass PEG placement appears to be as safe as the classic pull-through and push-through PEG methods, and can be used routinely to make the procedure quicker and reduce the discomfort for the patient, as well as reducing the risks and costs associated with the second pass of the gastroscope. A control gastroscopy can be reserved for patients with morbid obesity, or for cases in which finger palpation is not considered satisfactory.

Adult↗
PubMed2006

Use of an ultrathin gastroscope to allow endoscopic insertion of enteral wallstents without fluoroscopic monitoring.

Self-expanding metallic stents are useful in relieving tumoral obstruction in the gastrointestinal tract. Endoscopic insertion is usually made through the working channel of a therapeutic endoscope. Fluoroscopy during insertion is thought to be mandatory in most cases. Endoscopists sometimes encounter problems in using or accessing fluoroscopy facilities. This study describes a method to insert, under certain circumstances, enteral Wallstents using only endoscopic control. An ultrathin gastroscope is used to pass severe tumoral strictures and place a guide wire beyond the stenosis. The ultrathin gastroscope is removed leaving the guide wire in place, which is then inserted in a retrograde fashion into a therapeutic colonoscope, allowing insertion of through-the-scope stents. Successful insertion was achieved in 5 malignant gastric outlet obstructions and in 6 rectosigmoid tumoral obstructions. In conclusion, in some cases using an ultrathin endoscope to place a guide wire beyond the stricture can be useful for endoscopic placement of Wallstents without fluoroscopy.

Adenocarcinoma↗
PubMed1999

Advantages of a modified gastroscope for video-assisted internal mammary artery harvesting.

Instead of standard rigid thoracoscopes, we used a modified gastroscope for video assistance during 12 minimally invasive left internal mammary harvesting. Flexibility and remote control of its last centimeters give to the gastroscope a total freedom of movements, and perfect positioning in every direction. The scope is equipped with cold light, a suction canal and an irrigation canal, which allow for in situ washing without needing to remove it from the thoracic cavity. Thanks to these advantages, vision and lighting are always perfect.

Endoscopes↗
PubMed2003

Can Whipple's disease be transmitted by gastroscopes?

OBJECTIVE: To determine whether disinfection protocols currently used for gastroscopes are effective against cultures of Tropheryma whipplei. DESIGN: The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain of T. whipplei grown in cell monolayers was determined. PATIENTS: Two patients who were diagnosed as having Whipple's disease 3 years after they had had intestinal biopsies. RESULTS: The disinfectants reduced bacteria by approximately 2 log to 3 log10 after 5 to 60 minutes of contact. CONCLUSION: The bactericidal activity of a disinfectant is usually considered significant if it causes a 5 log10 or greater reduction in viable bacterial titers. Disinfecting gastroscopes with 2% glutaraldehyde or peracetic acids for 20 minutes may be insufficient to prevent transmission of T. whipplei on the instruments or stop false-positive results on polymerase chain reaction.

Actinomycetales↗
PubMed1999

Zapping Zenker's diverticulum: gastroscopic treatment.

Zenker's diverticulum (ZD) is a common cause of dysphagia in the elderly. Many symptomatic elderly are poor candidates for surgery and/or ear, nose and throat treatment. The author's first experiences with gastroscopic treatment by cutting the Zenker bridge to allow an overflow have recently been published. Only patients with contraindications for general anesthesia were accepted to the pilot group. However, the author now treats all ZD patients in this manner. One hundred and twenty-five patients (male to female ratio 1. 6) were referred for treatment from 1993 to 1997. After introduction of the gastroscope into the esophagus, a nasogastric tube was positioned to treat a ZD bridge with a height of less than 1 cm. The ZD bridge was divided by argon plasma coagulation, if necessary, in combination with monopolar forceps, Savary dilator and/or precut needle. All patients received antibiotics, topical anesthesia to the throat, if necessary, and intravenous midazolam, if possible. Radiography was performed after treatment. Normalization of the diet was allowed when the x-ray showed no signs of leakage. All patients referred for treatment were treated successfully. The median age was 77 years (range 41 to 100 years). Symptomatic improvement was seen in all patients after treatment. Complications included subcutaneous emphysema (n=17), mediastinal emphysema (n=5) and bleeding (n=2). One patient (95 years of age) died in her nursing home 27 days after treatment due to massive pulmonary embolism. The thirty-day mortality rate was otherwise zero. Three patients had been previously treated by surgeons and 12 by ear, nose and throat physicians, without sufficient improvement; all were adequately treated by the author. The mean number of treatment sessions was 1.8. This approach seems safe and effective. Treatment of every patient was possible and was carried out, even in patients in very poor condition, without general anesthesia.

Adult↗
PubMed2005

[Microbiological evaluation of gastroscope decontamination by electrolysed acid water (Clentop WM-1)].

BACKGROUND: The manual disinfection of endoscopes with glutharaldeyde is widely employed. The great routine in gastroenteroscopy services, low number of equipment and the lack of technical knowledge about the decontamination processes are factors that stimulate the inadequate endoscope disinfection, intensifying the risk of transmission of microorganisms. The electrolysed acid water has been effective in the inactivation and destruction of microorganisms. AIM: The purpose of this investigation was to verify the microbicidal efficiency of electrolyzed acid water (Cleantop WM-1) to decontaminate gastroscopes after their using in patients. MATERIAL AND METHODS: Samples from biopsy channel of flexible endoscopes collected after patient use (n = 20) and after disinfection (n = 20) were cultivated in tryptic soy agar, MacConkey agar and Sabouraud dextrose agar. RESULTS: Seventeen of the 20 samples collected after patients examination yielded gram-negative bacilli, gram-positive coccus and yeast cells in contamination of 3 to 5 log10 ufc/mL. Microbial growth was not verified in samples collected after the decontamination process. Conclusion - In this preliminary study, the mechanical disinfection carried through the Cleantop device with electrolyzed acid water showed satisfactory results for the elimination of microorganisms and time optimization in the reprocessing of gastroscopes.

Decontamination↗