Abstract:
BACKGROUND:Gastric antral vascular ectasia (GAVE) is characterized by mucosal and submucosal vascular ectasia causing recurrent GI hemorrhage. Treatment of GAVE with endoscopic thermal therapy (ETT) requires multiple sessions for destruction of vascular ectasia and control of bleeding. Endoscopic band ligation (EBL) has become the standard treatment of varices because it effectively obliterates the submucosal plexus of esophageal varices with an acceptably low rate of complications. Additionally, EBL has been used for control of bleeding from other GI vascular lesions. In patients with GAVE and recurrent GI hemorrhage, EBL may offer an alternative to ETT for treatment of large areas of diseased mucosa and submucosa. OBJECTIVE:Our purpose was to compare EBL (n = 9) with ETT (n = 13) for the treatment of bleeding from GAVE. DESIGN:Observational comparative study. PATIENTS:Patients with gastric antral vascular ectasia with occult or overt bleeding. SETTING:Mayo Clinic Arizona, a multispecialty academic medical center. INTERVENTION:EBL or ETT with argon plasma coagulation or electrocautery. MAIN OUTCOME AND MEASUREMENTS:Number of treatments to cessation of bleeding and posttreatment hemoglobin, hospitalization, and transfusion requirement. RESULTS:There were no significant differences in the demographics, clinical presentation, associated portal hypertension, or mean hemoglobin values or the mean number of transfusions or hospitalizations between the 2 groups before treatment. Four patients in the EBL group had failed prior ETT. Compared with ETT, in exploratory statistical testing EBL had a significantly higher rate of bleeding cessation (67% vs 23%, P = .04), fewer treatment sessions required for cessation of bleeding (1.9 vs 4.7, P = .05), a greater increase in hemoglobin values (2.8 g/dL vs 0.9 g/dL, P = .05), a greater decrease in transfusion requirements (-12.7 vs -5.2, P = .02), and a greater decrease in hospital admissions (-2.6 vs -0.5, P = .02) during the follow-up period. Analysis of covariance showed significantly superior efficacy of EBL for cessation of bleeding, postprocedure transfusion, and hospitalization. One patient in the EBL group had postprocedure emesis and 1 in the ETT group had immediate post procedure bleeding. All patients in the EBL group had complete mucosal healing with minimal residual GAVE at follow-up endoscopy failed post-EBL. CONCLUSIONS:Our initial experience suggests that EBL is superior to ETT for the management of GAVE. EBL required fewer treatment sessions for control of bleeding, had higher rates for cessation of bleeding, had a reduction in hospitalizations and transfusion requirements, and allowed for a significant increase in hemoglobin values.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Wells CD,Harrison ME,Gurudu SR,Crowell MD,Byrne TJ,Depetris G,Sharma VKdoi
10.1016/j.gie.2008.02.021subject
Has Abstractpub_date
2008-08-01 00:00:00pages
231-6issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(08)00226-5journal_volume
68pub_type
杂志文章abstract:BACKGROUND:Percutaneous endoscopic gastrostomy (PEG) is an accepted method of placing a feeding tube to enable enteral feeding in patients with swallowing difficulties. However, the factors associated with complications and death after PEG have not been studied in detail. We describe the largest audit of deaths after P...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.10.019
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Patients with chronic constipation or motility disorders may be referred for rectal suction biopsy (RSB) to rule out Hirschsprung's disease (HD). RSB may not be successful beyond infancy because of the increased thickness of the rectal mucosa. EMR could improve the diagnostic yield for HD when compa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.08.037
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Confocal laser endomicroscopy (CLE) allows real-time in vivo histologic evaluation of GI lesions. To our knowledge, there is no reported prospective study comparing endoscopic and optical biopsy using CLE before endoscopic submucosal dissection (ESD) with post-ESD histopathology. OBJECTIVE:We compared endos...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.05.005
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Access to fluoroscopic equipment is limited in some regions where esophageal cancer is common. This report describes a simple method for placement of expandable esophageal stents without fluoroscopy. METHODS:Patients with dysphagia due to unresectable esophageal cancer underwent esophageal stent placement u...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(01)70415-4
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:By assessing the intrapapillary capillary loop in esophageal mucosa, magnifying endoscopy can play an important role in the evaluation of superficial esophageal lesions. A newly developed narrow-band imaging system was applied to magnifying endoscopy in a clinical setting; the benefit of the narrow-band imag...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02532-x
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Preoperative diagnosis of solid pancreatic lesions remains challenging despite advancement in imaging technologies. EUS has the benefit of being a minimally invasive, well-tolerated procedure, although results are operator-dependent. The addition of FNA (EUS-guided FNA) provides samples for cytopathologic an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
doi:10.1016/j.gie.2011.08.049
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Detailed imaging of the common bile duct and main pancreatic duct is possible with endosonography. Utilizing a custom manufactured flexible needle, we have developed a technique of performing endosonography-guided cholangiopancreatography (EGCP). METHODS:Of 205 patients undergoing ERCP, complete ductography...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(06)80108-2
更新日期:1996-02-01 00:00:00
abstract::Gastric mucus and air bubbles are frequent sources of artifacts during endoscopic ultrasonography (EUS). To reduce these artifacts, we prepared a mucolytic-antifoam solution consisting of simethicone, acetylcysteine, and sodium bicarbonate and performed a prospective randomized and controlled trial comparing this solu...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(91)70825-0
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:The Rockall scoring system was developed in unselected patients, the majority of whom did not receive endoscopic therapy. The aim of this study was to assess the validity of the Rockall system in high-risk patients who undergo endoscopic therapy for peptic ulcer hemorrhage. METHODS:Rockall scores were calcu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2005.06.042
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Biopsy specimens obtained from esophageal lesions detected in endoscopic screening with iodine staining have often been diagnosed as high-grade intraepithelial squamous neoplasia (WHO 2000). However, a management strategy for such lesions has not been established. The purpose of this study was to perform EMR...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.027
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Colonoscopy insertion is technically challenging, time-consuming, and painful, especially for the sigmoid. Several pilot studies indicated that the (left) tilt-down position could facilitate the insertion procedure, but no formal trials have been published to demonstrate its efficacy. We performed t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2017.11.012
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Colon capsule endoscopy (CCE) represents a noninvasive technology that allows visualization of the colon without requiring sedation and air insufflation. A second-generation colon capsule endoscopy system (PillCam Colon 2) (CCE-2) was developed to increase sensitivity for colorectal polyp detection compared ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2011.03.1125
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The postulated mechanisms of biliary abnormalities in extrahepatic portal venous obstruction (EHPVO) are either extrinsic compression by collaterals or ischemic injury due to venous thrombosis. If the former hypothesis is correct, then biliary changes should revert to normal after portasystemic shunt surgery...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)80013-3
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Patients undergoing EUS usually receive intravenously administered sedative medication. A double-blind, prospective, randomized trial was conducted to compare midazolam with a placebo for EUS of the esophagus and stomach and to assess patient tolerance and endoscopic feasibility. METHODS:A total of 111 pati...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(03)70018-2
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Endoscopic retrograde intracorporeal lithotripsy with a stone recognition laser system seems to be a promising alternative in patients with difficult bile duct stones. METHOD:Sixteen patients with bile duct stones not suitable for endoscopic standard procedures underwent intracorporeal laser lithotripsy dur...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70042-0
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Ex vivo training of ERCP by using simulators is desirable before trainees perform endoscopy in patients. OBJECTIVE:We aimed to construct a simple and inexpensive but realistic simulator for ERCP training. DESIGN:Construction and establishment of an ERCP simulator. SETTING:Endoscopy suite. INTERVENTION:An...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.01.006
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The nonlifting sign is widely used for evaluating the invasion depth of colorectal tumors, and it is commonly accepted that EMR is contraindicated for colorectal tumors with a nonlifting sign because of the probability of massive submucosal invasion. OBJECTIVE:To identify the clinicopathologic factors that ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.05.057
更新日期:2008-01-01 00:00:00
abstract::Endoscopic ultrasonography was pre-operatively performed in 164 patients with colorectal cancer, and the resected specimens confirmed to be cancerous histologically. Normal colorectal wall was visualized by endoscopic ultrasonography as a five-layered structure. The first, third, and fifth layers were hyperechoic, and...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70163-7
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:EUS provides excellent imaging of the gastric wall. The utility of EUS imaging in guiding the placement of a gastric pacemaker was investigated. METHODS:Fourteen patients underwent gastric pacemaker implantation for refractory gastroparesis at laparotomy. Placement of the lead into the muscle layer of the a...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2002.123275
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Because endoscopic ultrasound (EUS) accuracy for staging gastrointestinal tract tumors is limited by many factors, this study was designed to analyze potential sources of error in the EUS staging of colorectal carcinoma. METHODS:All patients referred for EUS evaluation of colorectal carcinoma were staged pr...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2000.106310
更新日期:2000-06-01 00:00:00
abstract::The endoscopic Congo red test allows accurate and rapid evaluation of the completeness of vagotomy and may result in a lower incidence of postoperative incomplete vagotomy. This report describes 44 patients tested during proximal gastric vagotomy. Evidence of incomplete vagotomy was found in over 95% at the conclusion...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(87)71680-0
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Routine endoscopic mucosal biopsies are generally considered safe. However, the outcomes of performing large numbers of biopsies in subjects enrolled in research protocols have not been reported. OBJECTIVE:Our purpose was to assess the safety of taking numerous mucosal biopsy specimens during endoscopic pro...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.05.015
更新日期:2009-04-01 00:00:00
abstract::In a double-blind, randomized, placebo-controlled study of patients undergoing colonoscopy, sedation with an inhaled mixture of nitrous oxide/oxygen was compared with conventional intravenous sedation (pethidine 50 mg, midazolam 2.5 mg). In the patients studied, no significant differences were noted in number of pain ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(94)70203-9
更新日期:1994-07-01 00:00:00
abstract::A technique for expeditious and safe placement of nasoenteric feeding tubes under direct vision is described. Adult patients undergo feeding tube placement with intravenous sedation and topical anesthesia. Endoscopic tube placement requires an average of 10 min and eliminates many risks associated with blind passage. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(86)71882-8
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Administrative claims data are frequently used for quality measurement. OBJECTIVE:To examine the accuracy of administrative claims for potential colonoscopy quality measures, including findings (polyp or tumor detection), procedures (biopsy or polypectomy), and incomplete colonoscopy. DESIGN:Cross-sectiona...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.07.044
更新日期:2011-03-01 00:00:00
abstract::This is one of a series of documents prepared by the ASGE Training Committee. This curriculum document contains recommendations for training, intended for use by endoscopy training directors, endoscopists involved in teaching endoscopy, and trainees in endoscopy. It was developed as an overview of techniques currently...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.09.023
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Needle aspiration of the pancreas is performed to differentiate pancreatic malignancy, focal chronic pancreatitis, and metastasis to the pancreas. Biopsies may be directed by using EUS, CT, US, or surgery. This study retrospectively compared the accuracy of EUS-guided, CT/US-guided, and surgical tissue sampl...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(02)70181-8
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Eosinophilic esophagitis (EoE) is a chronic inflammatory condition that can be complicated by esophageal strictures requiring endoscopic dilation. Whereas recent data have advanced the notion that dilation can be done effectively with minimal morbidity, issues concerning safety and tolerability remain. OBJE...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.09.034
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Ensuring competence remains a seminal objective of endoscopy training programs, professional organizations, and accreditation bodies; however, no widely accepted measure of endoscopic competence currently exists. OBJECTIVE:By using Delphi methodology, we aimed to develop and establish the content validity o...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.10.035
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:EUS determination of lymph nodal spread of intestinal cancer based on imaging alone is problematic. A noninvasive, reliable means of determining tumor spread to lymph nodes is desirable. This study investigated the feasibility of a computer-assisted evaluation of lymph nodes detected by EUS in patients with ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.128920
更新日期:2002-11-01 00:00:00