Abstract:
BACKGROUND:Large flat polyps may be more amenable to endoscopic resection if an endoluminal method for full-thickness closure were available. OBJECTIVE:Assessment of feasibility of endoluminal full-thickness closure. DESIGN:Prospective, open-label, interventional study. SETTING:Tertiary referral center. PATIENTS:Patients referred to surgery for endoscopically unresectable polyps. INTERVENTIONS:Endoscopic resection of colon polyps with full-thickness closure of the resection site under laparoscopic observation by using a novel needle and T-tag tissue apposition system. MAIN OUTCOME MEASUREMENTS:Feasibility and efficacy of tissue apposition with the TAS during procedure and safety at 3-month follow-up. RESULTS:Nineteen patients referred with unresectable polyps at initial colonoscopy were enrolled. Five patients had successful endoscopic polypectomy and did not require closure of the resulting defect. In 6 patients, the polyp could not be resected endoscopically and surgical resection was performed. Use of the TAS was attempted in 8 and successfully deployed in 7 patients; there was 1 device malfunction. Deployment of the tags through the needle could be performed more safely under laparoscopic guidance when the resection site was visible from the peritoneal cavity. The location of the tags could not be safely determined when the needle was directed toward the retroperitoneal or mesenteric site. There were no long-term complications. Colonoscopy at a 3-month follow-up showed normal healed mucosa with the sutures and anchoring devices in place. LIMITATIONS:Small number of patients, single-center feasibility study without control arm. CONCLUSIONS:Full-thickness endoluminal closure of large polypectomy sites in humans is feasible for selected difficult polyps. Closure should be performed with concurrent laparoscopic guidance to maximize safety. ( CLINICAL TRIAL REGISTRATION NUMBER:NCT00553436.).
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Agrawal D,Chak A,Champagne BJ,Marks JM,Delaney CPdoi
10.1016/j.gie.2009.12.036subject
Has Abstractpub_date
2010-05-01 00:00:00pages
1082-8issue
6eissn
0016-5107issn
1097-6779pii
S0016-5107(09)02941-1journal_volume
71pub_type
临床试验,杂志文章abstract:BACKGROUND:Colorectal cancer occurs more frequently in older people. Because the population of aged persons is increasing, a better understanding of the characteristics of colorectal cancer with respect to age would be useful. The purpose of this study was to determine whether there is any relationship between the site...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.122335
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Effective interventions to prevent residual and/or recurrent adenoma (RRA) after EMR of large sessile and laterally spreading colorectal lesions (LSL) are yet to be determined. RRA may occur due to inconspicuous adenoma at the EMR margin. We aimed to determine the efficacy and safety of extended EMR...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2016.05.015
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Endoscopic sphincterotomy is difficult and sometimes impossible in patients who have undergone gastrectomy or partial gastrectomy with Billroth II reconstruction. For such patients, a novel technique was developed in which endoscopic sphincterotomy is performed via percutaneous transhepatic cholangioscopy. T...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00170-1
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Prediction of a technically difficult colonoscopy may influence patient selection and procedure scheduling. Identification of predictive factors may be difficult because a common endpoint used to evaluate the success of colonoscopy is intubation of the cecum, which is usually achieved. The goal of this study...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.118950
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Patients with familial adenomatous polyposis (FAP) are prone to developing duodenal adenoma and cancer. Optimal surveillance and management of these adenomas are not well established. OBJECTIVE:We assessed the outcome of FAP patients undergoing intense multimodal surveillance and subsequent endoscopic resec...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.08.029
更新日期:2015-04-01 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::Biliary stent blockage by adherence of bacteria and formation of biofilm is a major problem in endoscopic stenting procedures. We have investigated bacterial adherence to hydrophilic polymer (Hydromer)-coated polyurethane stents in stationary and perfusion experiments. Adherence of gram negative and gram positive orga...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70220-5
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:When choosing submucosal injection solutions for EMR, tissue damage should be considered, as well as the lesion-lifting ability. The objective of the study was to find out the potential tissue damage of submucosal injection solutions. METHODS:The submucosal injection solutions examined were the following: n...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.07.052
更新日期:2005-12-01 00:00:00
abstract::Fiberoptic upper gastrointestinal endoscopy has become an accepted procedure with recognized and acceptable complication rates. Recently, significant hypoxemia during upper gastrointestinal endoscopy has been identified. This report evaluates changes in arterial blood gases and investigates the effects of drugs, smoki...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(84)72419-9
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare use and tolerance of transnasal and transoral diagnostic endoscopy with small-diameter endoscopes in unsedated patients. METHODS:Patients being seen for diagnostic endoscopy were randomly assigned to have an unsedated transnasal or transoral procedure. Two prototype narr...
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(99)70003-9
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Although early diagnosis of esophageal carcinoma is an important determinant of outcome, early stage carcinomas are rarely detected on routine endoscopic examination. Iodine staining may be useful in the detection of early stage esophageal carcinoma, especially in high-risk populations. In a prior study, 29....
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2001.111387
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Hospitals increasingly need, besides effectiveness data, accurate and reliable cost data to allocate their resources as efficiently as possible. In this article, a framework to calculate the hospital costs of setting up a new activity is presented and applied to pediatric endoscopy. METHODS:The cost calcula...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70007-x
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Splenic complications of pancreatitis are exceedingly rare, occurring in only 2.2% of cases. Patients typically present in a dramatic fashion and often need an urgent procedure to prevent overwhelming infection or hemorrhage. Historically, the procedures involve surgery (distal pancreatectomy and splenectomy...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.04.031
更新日期:2006-10-01 00:00:00
abstract::Absolute alcohol is a potentially optimal agent for sclerotherapy of esophageal varices. It is cheap and readily available. We compared the efficacy and safety of alcohol with those of a commonly used sclerosing agent, polidocanol. The study was planned to include patients with previous bleeding from esophageal varice...
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(88)71404-2
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Photodynamic therapy (PDT) may be used to ablate high-grade dysplasia/early stage cancer (HGD/T1) in patients with Barrett's esophagus. PDT may result in esophageal stricture. This nonrandomized, unblinded, dose de-escalation study in consecutive patients was designed to determine the lowest light dose effec...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(04)02394-6
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Ileoscopy is the criterion standard for mucosal lesions of terminal ileum but is performed in 5% of colonoscopy activity, and the need for training is undefined. OBJECTIVE:To assess the learning curve and skill-keeping line of ileoscopy. DESIGN:Prospective randomized study. SETTING:Single GI endoscopy uni...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2005.09.029
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Endoscopic submucosal dissection (ESD) is the standard of care for treating gastric intramucosal neoplasias in Japan. However, it is seldom performed in Western countries, mainly because it is technically very challenging. Several traction methods have been proposed to facilitate submucosal dissection, but t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.07.037
更新日期:2011-11-01 00:00:00
abstract::The use of endoscopic ultrasonography (EUS) in the diagnosis of submucosal upper gastrointestinal tract lesions was examined in 308 patients. Two-hundred ten submucosal tumors, 89 cases of esophagogastric varices, and 9 cases of non-Hodgkin's lymphoma were found. EUS images were interpreted based upon a five-layer EUS...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71010-3
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Wireless capsule endoscopy (CE) is the investigation of choice in obscure GI bleeding (OGIB), with a high diagnostic yield when compared with other modalities. It enables specific treatment to be instigated in a significant proportion of cases, with the aim of reducing rebleeding rates. Little evidence is cu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.06.054
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND AND AIMS:There is a growing need for valid, efficient, and easy scoring scales to rate the quality of cohort studies. We aimed to develop and validate a quality assessment score to be used for cohort studies. METHODS:We followed a rigorous process to establish content, face, and construct validity. Most que...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.10.007
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:The endoscopic landmark used to diagnose Barrett's esophagus differs between Japanese and Western endoscopists. OBJECTIVE:To compare the degree of diagnostic variation in results achieved by Japanese endoscopists when using the palisade vessels as a landmark of the distal esophagus and when using the gastri...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.04.029
更新日期:2006-08-01 00:00:00
abstract::Endoscopic ultrasonography was performed in 25 patients with suspected pancreatic disease. Cancer of the pancreas was recognized in 9 of 10 cases with 1 false negative and 2 false positive diagnoses. Chronic pancreatitis was recognized in 89% of cases. Technical difficulties limited the success of the examination in 2...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72761-9
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Glucagon is effective when used as an antimotility agent during ERCP, but at high doses it may cause nausea and vomiting. Octreotide acetate, a long-acting synthetic analog of somatostatin, inhibits contractility of the small intestine and is generally well tolerated. The purpose of this study was to determi...
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(95)70130-3
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Wire-guided cannulation (WGC) was reported to decrease post-ERCP pancreatitis (PEP), but risk factors for PEP in WGC are not fully elucidated. OBJECTIVE:To evaluate the incidence and risk factors of PEP in WGC. DESIGN:Single-center retrospective study. SETTING:Academic center. PATIENTS:A total of 800 con...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.06.005
更新日期:2015-01-01 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:BACKGROUND AND AIMS:Optical diagnosis allows for real-time endoscopic assessment of colorectal polyp histology and consists of the resect and discard and diagnose and leave paradigms. This survey assessed patient acceptance of optical diagnosis and their responses to a hypothetical doomsday scenario. METHODS:We conduc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.11.031
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:EUS-guided FNA is a well-recognized technique for sampling the pancreas, peri-intestinal lymph nodes, and mass lesions. The role of EUS-guided FNA in the diagnosis of peritoneal carcinomatosis has not been well studied. OBJECTIVE:We aimed to determine the feasibility and success in sampling lesions in the p...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.05.031
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Complications after endoscopic biliary sphincterotomy occur in 8% to 10% of patients when studied prospectively. It is not known whether the type of electrocautery current affects this rate. Theoretically, less edema of the ampulla after a pure cutting current sphincterotomy could decrease the risk of pancre...
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(98)70348-7
更新日期:1998-02-01 00:00:00
abstract::Although upper gastrointestinal endoscopy is generally a safe procedure, it is known to be associated with arterial oxygen desaturation. We studied 82 patients undergoing diagnostic upper gastrointestinal endoscopy following a standard premedication consisting of xylocaine throat spray and intravenous midazolam. The m...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70564-1
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Although total obstruction or secondary atresia of the esophagus is extremely rare, high-grade strictures are not uncommon. The retrograde approach was previously described to achieve dilation when the conventional antegrade method fails. SETTING:Gastroenterology laboratory in a tertiary referral center. P...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.08.008
更新日期:2007-02-01 00:00:00