Abstract:
:In vivo real-time assessment of the histology of diminutive (≤5 mm) colorectal polyps detected at colonoscopy can be achieved by means of an "optical biopsy" by using currently available endoscopic technologies. This systematic review and meta-analysis was performed by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee to specifically assess whether acceptable performance thresholds outlined by an ASGE Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) document for clinical adoption of these technologies have been met. We conducted direct meta-analyses calculating the pooled negative predictive value (NPV) for narrow-band imaging (NBI), i-SCAN, and Fujinon Intelligent Color Enhancement (FICE)-assisted optical biopsy for predicting adenomatous polyp histology of small/diminutive colorectal polyps. We also calculated the pooled percentage agreement with histopathology when assigning postpolypectomy surveillance intervals based on combining real-time optical biopsy of colorectal polyps 5 mm or smaller with histopathologic assessment of polyps larger than 5 mm. Random-effects meta-analysis models were used. Statistical heterogeneity was evaluated by means of I(2) statistics. Our meta-analyses indicate that optical biopsy with NBI, exceeds the NPV threshold for adenomatous polyp histology, supporting a "diagnose-and-leave" strategy for diminutive predicted nonneoplastic polyps in the rectosigmoid colon. The pooled NPV of NBI for adenomatous polyp histology by using the random-effects model was 91% (95% confidence interval [CI], 88-94). This finding was associated with a high degree of heterogeneity (I(2) = 89%). Subgroup analysis indicated that the pooled NPV was greater than 90% for academic medical centers (91.8%; 95% CI, 89-94), for experts (93%; 95% CI, 91-96), and when the optical biopsy assessment was made with high confidence (93%; 95% CI, 90-96). Our meta-analyses also indicate that the agreement in assignment of postpolypectomy surveillance intervals based on optical biopsy with NBI of diminutive colorectal polyps is 90% or greater in academic settings (91%; 95% CI, 86-95), with experienced endoscopists (92%; 95% CI, 88-96) and when optical biopsy assessments are made with high confidence (91%; 95% CI, 88-95). Our systematic review and meta-analysis confirms that the thresholds established by the ASGE PIVI for real-time endoscopic assessment of the histology of diminutive polyps have been met, at least with NBI optical biopsy, with endoscopists who are expert in using this advanced imaging technology and when assessments are made with high confidence.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
ASGE Technology Committee.,Abu Dayyeh BK,Thosani N,Konda V,Wallace MB,Rex DK,Chauhan SS,Hwang JH,Komanduri S,Manfredi M,Maple JT,Murad FM,Siddiqui UD,Banerjee Sdoi
10.1016/j.gie.2014.12.022subject
Has Abstractpub_date
2015-03-01 00:00:00pages
502.e1-502.e16issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(14)02592-9journal_volume
81pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Transgastric flexible endoscopic anastomosis might offer advantages over open and laparoscopic surgery, especially for bariatrics or patients with obstructive malignancy. OBJECTIVE:To develop methods for performing transgastric anastomosis. DESIGN/RESULTS:Twelve gastrojejunal anastomoses were formed in pig...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.035
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Over the past decade, ERCP has become the preferred method of treatment for biliary strictures in patients after orthotopic liver transplantation (OLT). Although data strongly support ERCP for treating anastomotic strictures, the little information available for the role of ERCP in the treatment of nonanasto...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.09.057
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Although there is a large body of data on the accuracy of endoscopic ultrasonography (EUS) in the diagnosis and staging of various gastroenterological disorders, little has been published on the influence of EUS in the management of patients. Data on the performance of EUS and patient acceptance are also spa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70152-5
更新日期:1999-12-01 00:00:00
abstract::Twenty patients undergoing clinically indicated elective colonoscopy were prospectively monitored noninvasively for alterations in cardiorespiratory function. Most of the patients were elderly and many had either cardiac or pulmonary disease. All subjects were premedicated with intramuscular meperidine and continuousl...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72764-4
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Remote control of capsule endoscopes might allow reliable inspection of the human stomach. OBJECTIVE:To assess the safety and efficacy of manipulation of a modified capsule endoscope with magnetic material (magnetic maneuverable capsule [MMC]) in the human stomach by using a handheld external magnet. DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2010.08.053
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Use of colonoscopy is thought to reduce colorectal cancer (CRC) mortality, but its impact at the population level is unclear. OBJECTIVE:To estimate the effect of current colonoscopy use on CRC mortality and its further potential in reducing CRC mortality. DESIGN:Population-level analysis was performed by u...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.12.005
更新日期:2011-03-01 00:00:00
abstract::Guide wires have become an essential part of therapeutic biliary and pancreatic endoscopy. The Teflon-painted stainless steel wire still remains the standard guide wire. However, special situations call for the use of some of the more specialized guide wires mentioned in this article. The endoscopist needs to be famil...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/s0016-5107(96)70262-6
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Obesity is becoming epidemic in proportion and is leading to considerable morbidity and mortality in the community. Bariatric surgery offers one tested solution to sustained weight loss and comorbidity reduction. However, it is associated with a significant number of complications. OBJECTIVE:The objective o...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2009.06.025
更新日期:2009-12-01 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:The main objective of this prospective study was to evaluate the independent diagnostic accuracy of gastroesophageal endoscopic signs for cirrhosis. METHODS:Endoscopic signs were evaluated in vivo by one observer and on standardized videotape recordings by a consensus opinion of two endoscopists, with the s...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(98)70156-7
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Per current guidelines, patients with a first-degree relative (FDR) with adenomas should get screened at age 40. Data on the prevalence of adenomas and advanced adenomas (AAs) in these patients are lacking. OBJECTIVE:To examine the prevalence of adenomas and AAs in 40- to 49-year-old individuals undergoing ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.01.046
更新日期:2012-04-01 00:00:00
abstract:PURPOSE:The safety and efficacy of esophageal dilation is enhanced when direct visualization is possible, tactile sensation and feedback from resistance is maintained, and multiple dilations with a single passage of the dilating device is an option. The InScope Optical Dilator (InScope, a Division of Ethicon Endo-Surge...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.08.042
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:It has been reported that the occurrence of acute cholangitis is common, especially when the self-expanding metal stent (SEMS) is placed across the main duodenal papilla. OBJECTIVE:To determine the incidence of duodenobiliary reflux and acute cholangitis after placement of SEMSs across the main duodenal pap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.12.054
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Double-balloon endoscopy (DBE) is a new method that allows visualization, tissue sampling, and therapeutic intervention of a variety of pathologies throughout the small-intestinal tract. OBJECTIVE:In the present study, we evaluated the diagnostic yield of DBE and its impact on the final diagnosis, treatment...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.03.1062
更新日期:2008-10-01 00:00:00
abstract::Chronic radiation proctopathy is a common sequela of radiation therapy for malignancies in the pelvic region. A variety of medical and endoscopic therapies have been used for the management of bleeding from chronic radiation proctopathy. In this guideline, we reviewed the results of a systematic search of the literatu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,实务指引
doi:10.1016/j.gie.2019.04.234
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND AIMS:The greatest known risk factor for duodenal cancer in familial adenomatous polyposis (FAP) is Spigelman stage (SS) IV duodenal polyposis. Endoscopic surveillance is recommended in FAP patients with SS 0 to IV, and prophylactic duodenectomy should be considered in SS IV. Cancer occurs in patients wit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.07.033
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Endocuff (Arc Medical Design, Leeds, UK) and Endocuff Vision (Arc Medical Design, Leeds, UK) are effective mucosal exposure devices for improving polyp detection during colonoscopy. AmplifEYE (Medivators Inc, Minneapolis, Minn, USA) is a device that appears similar to the Endocuff devices but has re...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.06.046
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Existing EUS catheter probes have limited depth of penetration and lack color flow and Doppler capabilities. This study prospectively assessed the feasibility and safety of using a phased vector array US catheter in the human GI tract. METHODS:Eleven patients underwent EUS with a steerable 9F phased vector ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(02)70056-4
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:The role of EUS in the locoregional staging of gastric carcinoma is undefined. OBJECTIVE:We aimed to comprehensively review and quantitatively summarize the available evidence on the staging performance of EUS. DESIGN:We systematically searched the MEDLINE, Cochrane, CANCERLIT, and EMBASE databases for rel...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
doi:10.1016/j.gie.2011.01.030
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:En bloc EMR is performed in Japan as a curative treatment for early stage gastric cancer. However, current methods of EMR are technically difficult and require proficiency in determining the extent of the cancer. This study assessed the feasibility of a new method to obviate these problems and to facilitate ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01285-4
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Because sphincterotomy accounts for a major portion of the morbidity and mortality associated with ERCP, we have proposed endoscopic balloon papillary dilation or sphincteroplasty as an alternative. METHODS:We report the outcome in a series of 100 patients in whom balloon sphincteroplasty was attempted for ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70052-8
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Little is known about gastric neoplasms arising from hyperplastic polyps (HPs). OBJECTIVE:To investigate the risk factors associated with neoplasms within HPs and to evaluate the role of alterations of the p16-cyclin D1-pRb pathway in the malignant transformation of HPs. DESIGN:Retrospective, case-control ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.04.020
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Celiac disease may be complicated by symptoms that raise the suspicion of small-intestinal malignancy. The objective is to evaluate wireless capsule endoscopy (WCE) in complicated celiac disease. METHODS:This is a prospective study at a university referral center. There were 47 patients. The indications for...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)01566-x
更新日期:2005-07-01 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 AND AIMS:Cold snare polypectomy (CSP) and jumbo forceps polypectomy (JFP) have been shown to be effective for removing diminutive colorectal polyps (DCPs) (≤5 mm). However, no study has compared complete resection rates between CSP and JFP for DCPs. The aim of this study was to compare the efficacy and safet...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2019.01.016
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Acute GI bleeding is a life-threatening complication of warfarin therapy. Acute GI bleeding in patients with an international normalized ratio of 4.0 or greater (supratherapeutic) is often attributed to trivial mucosal lesions. The aim of the study was to determine the frequency of potentially significant le...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:EUS has less than optimal interobserver agreement for the diagnosis of chronic pancreatitis. The newly developed Rosemont consensus scoring system includes weighted criteria and stricter definitions for individual features. OBJECTIVE:The primary aim was to compare the interobserver agreement of standard and...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2009.10.043
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Despite advances in endoscopic treatment methods for upper GI hemorrhage, hemostasis is often difficult to achieve, particularly when the endoscopic view at the site of hemorrhage is poor because of the presence of mucus and blood. The investigators developed an end hood that facilitates endoscopic hemostati...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2003.206
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Choledochocele is a rare abnormality involving the intramural segment of the common bile duct. ERCP is essential to demonstrate a choledochocele. The aim of this study was to investigate the duodenoscopic and cholangiographic findings during ERCP. METHODS:Over a 4-year period, 17 symptomatic patients (8 men...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(98)70187-7
更新日期:1998-09-01 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