Home  About us  Contact
 

Endoscopic Classification (endoscopic + classification)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis

DIGESTIVE ENDOSCOPY, Issue 4 2002
Michio Kaminishi
Background:,Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods:,One hundred and fifty-five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results:,Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion:,Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated. [source]

Numerical modification of the Los Angeles classification of gastroesophageal reflux disease fails to decrease observer variation

DIGESTIVE ENDOSCOPY, Issue 1 2004
Motoyasu Kusano
Background:, We previously reported that a new endoscopic classification of gastroesophageal reflux disease, the Los Angeles classification, showed considerable observer variation depending on the experience of the endoscopist. In the present study, we evaluated some modifications of the classification to determine whether we could decrease observer variation. Methods:, Fifty endoscopic photographs, each showing four images of the squamo-columnar junction, were prospectively obtained from 50 consecutive patients with gastroesophageal reflux disease. Two groups of eight endoscopists divided by their endoscopic experience, group 1 (100,500 procedures) and group 2 (more than 500 procedures), assessed the photographs using classifications with the following modifications: (i) addition of grade O to describe healed mucosal breaks and setting grade B as more than 5 mm or 10 mm; or (ii) addition of grade O and setting grade D as 75,99% or 100% circumferential. Results:, Changing the definition of grade B or grade D did not increase the kappa values for either group of observers. Conclusions:, These modifications of the Los Angeles classification were unable to decrease observer variation. [source]

Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis

DIGESTIVE ENDOSCOPY, Issue 4 2002
Michio Kaminishi
Background:,Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods:,One hundred and fifty-five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results:,Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion:,Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated. [source]

Study on minute surface structures of the depressed-type early gastric cancer with magnifying endoscopy

DIGESTIVE ENDOSCOPY, Issue 3 2001
Kouji Tobita
Background: Gastric surface patterns and morphology of minute surface vessels in depressed lesions were analyzed using a magnifying endoscope with high resolving power to contribute to qualitative diagnosis of gastric cancer. Methods: Subjects were diagnosed with depressed-type early gastric cancer (pT1), there were 63 lesions, 38 differentiated-type lesions, and 25 undifferentiated-type lesions. There were also 40 benign depressed lesions found. After routine observations with an endoscope, amplifying observations of lesions were made by EG-410CR (Fuji Photo Optical; Saitama, Japan) (CR). The images were compared with macroscopic patterns and histopathological patterns of the surgical specimens and endoscopic mucosal resection specimens. Results: Surface patterns of gastric depressed lesions were classified as irregular protrusion, normal papilla, pseudopapilla and amorphia. Irregular protrusion was found only in cancerous lesions. Characteristic minute vessels were observed in amorphia. Their patterns were classified into the following six types: sand, fence, round net, flat net, branch and coil. Irregular protrusion and minute vessels in amorphia (round net, flat net, branch and coil) were specific to cancers. There was a tendency for round net and flat net patterns to be found often in differentiated cancers and for branch and coil patterns to be found often in undifferentiated cancers. Conclusion: This magnifying endoscopic classification is considered useful for the qualitative diagnosis of depressed-type early gastric cancer. [source]

GASTROENTEROLOGY: Prospective evaluation of a clinical guideline recommending early patients discharge in bleeding peptic ulcer

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2010
Marķa Chaparro
Abstract Background and Aim:, To validate an early discharge policy in patients admitted with upper gastrointestinal bleeding (UGIB) due to ulcers. Methods:, Patients with gastroduodenal ulcer or erosive gastritis/duodenitis were included in a previous study aiming to develop a practice guideline for early discharge of patients with UGIB. Variables associated with unfavorable evolution were analyzed in order to identify patients with low-risk of re-bleeding. After that, a one-year prospective analysis of all UGIB episodes was carried out. Results:, A total of 341 patients were identified in the retrospective study. Variables associated with unfavorable evolution were: systolic blood pressure , 100 mmHg, heart rate , 100 bpm, and a Forrest endoscopic classification of severe. 10% of patients were immediately discharged; however, if predictive variables obtained in the multivariate analysis had been used, hospitalization could have been prevented in 34% of patients. A total of 77 patients were included in the prospective analysis. Although only 19.5% of patients were immediately discharged without complications, 29 patients (37.7%) were theoretically suitable for early discharge. Conclusions:, Patients with UGIB who have clean-based ulcers and are stable on admission can be safely discharged immediately after endoscopy. Implementation of the clinical practice guideline safely reduced hospital admission for those patients. [source]