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Standard Endoscope (standard + endoscope)
Selected AbstractsDiscrimination of Normal Gastric Mucosa from Helicobacter pylori Gastritis using Standard Endoscopes and a Single Observation Site: Studies in Children and Young AdultsHELICOBACTER, Issue 2 2004Yoshiko Nakayama ABSTRACT Background., In the Helicobacter pylori -negative normal stomach, collecting venules are visible in the gastric corpus as numerous minute points. This finding has been termed ,regular arrangement of collecting venules' (RAC). The aim of the present study was to investigate the reliability of the presence of the RAC pattern for discrimination of normal gastric mucosa from H. pylori gastritis in pediatric patients. Methods., Fifty-two consecutive children, adolescents and young adults (male:female 24 : 28; median age 15 years, range 8,29 years) referred for endoscopy and assessed for H. pylori infection were prospectively studied. The lower lesser curvature of the corpus near the incisura was evaluated for the RAC pattern using a standard endoscope with the tip close to, but not in contact with, the gastric surface. Gastric biopsies were taken after the endoscopic observation. Results., In all the 29 RAC-positive patients, active H. pylori gastritis was absent, whereas H. pylori gastritis was found in 20 of 23 RAC-negative patients (86.9%). Conclusions., Identification of the RAC pattern at the lower lesser curvature of the corpus using close observation with a standard endoscope proved to be an effective and practical marker to discriminate normal histology from H. pylori gastritis among both children and young adults. Absence of the RAC pattern should prompt gastric mucosal biopsies despite otherwise normal-appearing gastric mucosa. [source] COMPARISON OF ENDOSCOPIC DETECTION RATE OF EARLY GASTRIC CANCER AND GASTRIC ADENOMA USING TRANSNASAL EGD WITH THAT OF TRANSORAL EGDDIGESTIVE ENDOSCOPY, Issue 4 2008Yukiya Yoshida Background:, To investigate the influence of the reduced image quality of transnasal esophagogastroduodenoscopy (EGD) with the ultrathin endoscope (transnasal EGD) on endoscopic diagnoses, we compared the detection rate (DR) of early gastric cancer and gastric adenoma by transnasal EGD with that of transoral EGD using a standard endoscope. Methods:, Transnasal EGD was carried out in 2791 examinations for the purposes of screening or other reasons. Controls were examined by transoral EGD and numbered 3591 examinations. The transnasal endoscope used was an EG530N. Lesions graded C-3 or higher by Kimura-Takemoto's classification were regarded as endoscopic atrophy. Results:, (i) DR in all subjects and those with atrophy were not different between transnasal and transoral EGD. (ii) Multivariate analysis of DR in subjects with atrophy was carried out using five variables: gender, age, purposes of endoscopy, endoscopic insertion route and the four endoscopists. DR was significantly higher in males or subjects ,60 years. No difference was noted between the endoscopic insertion routes (transnasal vs transoral). (iii) The subjects analyzed in (ii) were divided into the transnasal and transoral groups, and multivariate analysis of DR was carried out using four variables. DR was not different among the endoscopists in the transoral group. However, in the transnasal group, DR increased as the years of endoscopic experience was prolonged. Conclusions:, Multivariate analysis detected no significant difference in DR between transnasal and transoral EGD. However, a significant difference in DR by transnasal EGD among the endoscopists is detected. Transnasal EGD should be carefully carried out by experienced endoscopists. [source] EXAMINATION OF RESPIRATORY AND CIRCULATORY DYNAMICS DURING EXAMINATION USING A THIN GASTROINTESTINAL ENDOSCOPE IN ADVANCED-AGE SUBJECTSDIGESTIVE ENDOSCOPY, Issue 2 2007Miyako Niki Background:, Endoscopic examination influences cardiovascular hemodynamics. Upper gastrointestinal examinations are currently performed with a thin endoscope. In the present study, respiratory and circulatory dynamics and autonomic nervous activity using a thin endoscope (XP260) or a standard endoscope (XQ240) were investigated. Methods:, The subjects were 25 healthy adults aged less than 60 years (middle-aged group) and 15 healthy adults aged 60 years or older (advanced-age group). Percutaneous oxygen saturation, tonometric blood pressure, heart rate, and autonomic nervous activity were evaluated before the examination. After the endoscopic procedure, a questionnaire survey regarding examination-related stress was conducted. Results:, In the questionnaire survey, the proportion of subjects who answered ,very stress free' in the thin endoscope group was significantly higher than that in the standard endoscope group. The low frequency power of blood pressure variability (LFBP), an indicator of sympathetic nervous activity, was significantly lower during the thin endoscopic procedure than during the standard endoscopic procedure. Moreover, the ratio of low frequency power to high frequency power of heart rate variability (LFRR/HFRR), an indicator of sympathetic nervous activity, was significantly lower during thin endoscopic procedure than during the standard endoscopic procedure. The maximum rates of change in the LFBP and HFRR powers in the advanced-age group using thin and standard endoscopic procedures were significantly lower than in the middle-aged group. Conclusions:, The findings, although not in cross-over study, suggest that a thin endoscope has a less marked influence on circulatory kinetics. Gastrointestinal endoscopic examinations using a thin endoscope might reduce complications related to endoscopic screening examinations in advanced-age subjects. [source] Predictive factors for esophageal stenosis after endoscopic submucosal dissection for superficial esophageal cancerDISEASES OF THE ESOPHAGUS, Issue 7 2009H. Mizuta SUMMARY Endoscopic submucosal dissection (ESD) has been utilized as an alternative treatment to endoscopic mucosal resection for superficial esophageal cancer. We aimed to evaluate the complications associated with esophageal ESD and elucidate predictive factors for post-ESD stenosis. The study enrolled a total of 42 lesions of superficial esophageal cancer in 33 consecutive patients who underwent ESD in our department. We retrospectively reviewed ESD-associated complications and comparatively analyzed regional and technical factors between cases with and without post-ESD stenosis. The regional factors included location, endoscopic appearance, longitudinal and circumferential tumor sizes, depth of invasion, and lymphatic and vessel invasion. The technical factors included longitudinal and circumferential sizes of mucosal defects, muscle disclosure and cleavage, perforation, and en bloc resection. Esophageal stenosis was defined when a standard endoscope (9.8 mm in diameter) failed to pass through the stenosis. The results showed no cases of delayed bleeding, three cases of insidious perforation (7.1%), two cases of endoscopically confirmed perforation followed by mediastinitis (4.8%), and seven cases of esophageal stenosis (16.7%). Monovalent analysis indicated that the longitudinal and circumferential sizes of the tumor and mucosal defect were significant predictive factors for post-ESD stenosis (P < 0.005). Receiver operating characteristic analysis showed the highest sensitivity and specificity for a circumferential mucosal defect size of more than 71% (100 and 97.1%, respectively), followed by a circumferential tumor size of more than 59% (85.7 and 97.1%, respectively). It is of note that the success rate of en bloc resection was 95.2%, and balloon dilatation was effective for clinical symptoms in all seven patients with post-ESD stenosis. In conclusion, the most frequent complication with ESD was esophageal stenosis, for which the sizes of the tumor and mucosal defect were significant predictive factors. Although ESD enables large en bloc resection of esophageal cancer, practically, in cases with a lesion more than half of the circumference, great care must be taken because of the high risk of post-ESD stenosis. [source] Discrimination of Normal Gastric Mucosa from Helicobacter pylori Gastritis using Standard Endoscopes and a Single Observation Site: Studies in Children and Young AdultsHELICOBACTER, Issue 2 2004Yoshiko Nakayama ABSTRACT Background., In the Helicobacter pylori -negative normal stomach, collecting venules are visible in the gastric corpus as numerous minute points. This finding has been termed ,regular arrangement of collecting venules' (RAC). The aim of the present study was to investigate the reliability of the presence of the RAC pattern for discrimination of normal gastric mucosa from H. pylori gastritis in pediatric patients. Methods., Fifty-two consecutive children, adolescents and young adults (male:female 24 : 28; median age 15 years, range 8,29 years) referred for endoscopy and assessed for H. pylori infection were prospectively studied. The lower lesser curvature of the corpus near the incisura was evaluated for the RAC pattern using a standard endoscope with the tip close to, but not in contact with, the gastric surface. Gastric biopsies were taken after the endoscopic observation. Results., In all the 29 RAC-positive patients, active H. pylori gastritis was absent, whereas H. pylori gastritis was found in 20 of 23 RAC-negative patients (86.9%). Conclusions., Identification of the RAC pattern at the lower lesser curvature of the corpus using close observation with a standard endoscope proved to be an effective and practical marker to discriminate normal histology from H. pylori gastritis among both children and young adults. Absence of the RAC pattern should prompt gastric mucosal biopsies despite otherwise normal-appearing gastric mucosa. [source] | ||||||||||