Abstract:
BACKGROUND AND AIMS:Endoscopic resection (ER) is a safe and effective treatment for nonmalignant complex colorectal polyps (complex polyps). Surgical resection (SR) remains prevalent despite limited outcomes data. We aimed to evaluate SR outcomes for complex polyps and compare SR outcomes to those of ER. METHODS:We performed a single-center, retrospective, cohort study of all patients undergoing SR (2003-2013) and ER (2011-2013) for complex polyps. We excluded patients with invasive carcinoma from the SR cohort. Primary outcomes were 12-month adverse event (AE) rate, length of stay (LOS), and costs. SR outcomes over a 3-year period (2011-2013) were compared with the overlapping ER cohort. RESULTS:Over the 11-year period, 359 patients (mean [± SD] age 64 ± 11 years) underwent SR (58% laparoscopic) for complex polyps. In total, 17% experienced an AE, and 3% required additional surgery; 12-month mortality was 1%. Including readmissions, median LOS was 5 days (IQR 4-7 days), and costs were $14,528. When an AE occurred, costs ($25,557 vs $14,029; P < .0001) and LOS (11 vs 5 days; P < .0001) significantly increased. From 2011 to 2013, 198 patients were referred for ER, and 73 underwent primary SR (70% laparoscopic). There was a lower AE rate for ER versus primary SR (10% vs 18%; P = .09). ER costs (including rescue SR, when required) were lower than those of primary SR ($2152 vs $15,264; P < .0001). CONCLUSIONS:AEs occur in approximately one-sixth of patients after SR for complex polyps. ER-accounting for rescue SR caused by malignancy, AEs, or incomplete resection-is associated with markedly lower costs than SR. These data should be used when counseling patients about treatment options for complex polyps.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Keswani RN,Law R,Ciolino JD,Lo AA,Gluskin AB,Bentrem DJ,Komanduri S,Pacheco JA,Grande D,Thompson WKdoi
10.1016/j.gie.2016.01.048subject
Has Abstractpub_date
2016-08-01 00:00:00pages
296-303.e1issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(16)00108-5journal_volume
84pub_type
杂志文章abstract:BACKGROUND AND AIMS:Chromoendoscopy (CE) has been shown to generate both a superior diagnostic yield and dysplasia detection rate than conventional white-light endoscopy and requires a high-quality bowel preparation. The aim of this study was to identify predictors of the ability to perform CE in patients with inflamma...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.09.039
更新日期:2019-02-01 00:00:00
abstract::From June 1991 to September 1992, 16 patients (mean age, 72 +/- 5 years) were treated with intra-corporeal laser lithotripsy (ICL). Thirteen patients had choledocholithiasis with at least one stone larger than 20 mm; 3 patients had intra-hepatic lithiasis. All other methods, including mechanical lithotripsy, extra-cor...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(94)70058-3
更新日期:1994-05-01 00:00:00
abstract::Epinephrine injection is an effective, simple, and economical method of endoscopic hemostasis for bleeding peptic ulcers. We measured catecholamine levels in 18 patients with actively bleeding ulcers (8 gastric ulcers and 10 duodenal ulcers) treated by endoscopic injection. Injection of epinephrine (1:10,000 IU) was g...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70004-8
更新日期:1993-01-01 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:BACKGROUND:The aim of this study was to evaluate the effectiveness of endoscopic sphincterotomy for preoperative and postoperative complications of hepatic hydatid disease. METHODS:Nineteen patients underwent endoscopic treatment for complications of hepatic hydatid disease. Indications for ERCP in 5 patients treated ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.118256
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND AND AIMS:Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or with...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2015.07.016
更新日期:2015-11-01 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:Access to the papilla of Vater or enteral anastomoses to the biliary tract or pancreatic duct is difficult in patients with altered anatomy. The usual approach to the papilla of Vater with a side-viewing duodenoscope, designed for passage through the stomach, pyloric channel, and proximal duodenum, is not su...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.06.017
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:The newly developed i-SCAN application can theoretically maximize the effectiveness of colonoscopy. However, the practical usefulness of the i-SCAN application during screening colonoscopy has not been assessed. OBJECTIVE:To assess the efficacy of the i-SCAN application during screening colonoscopy. DESIGN...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2011.11.040
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:There are limited data regarding work-related injury among endoscopists. OBJECTIVE:To define the prevalence of endoscopy-related musculoskeletal injuries and their impact on clinical practice and to identify physician and practice characteristics associated with their development. DESIGN:Survey. SETTING:E...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.06.036
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Flumazenil is a competitive benzodiazepine antagonist that acts to reverse their sedative and hypnotic effects. It is indicated in the management of benzodiazepine overdose, but its role in the routine reversal of endoscopic conscious sedation has not been defined. METHODS:Patients undergoing diagnostic upp...
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(96)70091-3
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND AND AIMS:Early neoplasia in Barrett's esophagus (BE) can be effectively and safely removed by endoscopic resection (ER) using multiband mucosectomy (MBM). This study aimed to document performance of a novel MBM device designed for improved visualization, easier passage of accessories, and better suction powe...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2018.06.030
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent inserti...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.12.050
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:To assess the efficacy of adjuvant sclerotherapy after banding for the treatment of esophageal varices, a randomized trial was carried out of endoscopic variceal ligation (EVL) alone with sequential sclerotherapy versus sequential ligation-sclerotherapy (SLS) after banding with respect to variceal eradicatio...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mge.2001.114061
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Endoscopic therapies for early neoplasia in Barrett's esophagus may be a viable alternative to esophagectomy. OBJECTIVE:Our purpose was to compare endoscopic therapy and esophagectomy. DESIGN:Retrospective review from a single institution. SETTING:A medium-sized tertiary referral center. PATIENTS AND INT...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.08.042
更新日期:2008-04-01 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:The thoracic duct plays an important role in fluid balance, lipid absorption, and transport of immunologically active cells. The thoracic duct is difficult to access but is readily identified by EUS. The present study assessed the feasibility of EUS identification and EUS-guided puncture of the thoracic duct...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02880-3
更新日期:2004-04-01 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 AND AIMS:Elective endoscopy resumed in our outpatient ambulatory center after instituting the preprocedure policy of a confirmed negative coronavirus disease 2019 (COVID-19) reverse transcriptase polymerase chain reaction (RT-PCR) status performed 72 hours before a scheduled procedure as mandated by the stat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.10.001
更新日期:2020-10-08 00:00:00
abstract:BACKGROUND AND AIMS:This study aims to assess current practices and perspectives of gastroenterologists on approaches to code status before inpatient endoscopy. METHODS:Self-reported data were obtained through a voluntary, anonymous survey of gastroenterologists and gastroenterology trainees in the United States (U.S....
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2021.01.005
更新日期:2021-01-18 00:00:00
abstract:BACKGROUND:Studies suggest that endoscopist-related factors such as colonoscopy withdrawal time are important in determining the adenoma detection rate (ADR). OBJECTIVE:To determine the importance of withdrawal technique in differentiating among endoscopists with varying ADRs. DESIGN:Prospective, multicenter study. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2011.03.003
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Split-dose bowel preparation for colonoscopy results in superior preparation quality. However, some endoscopy units remain hesitant to prescribe split-dose preparation given theoretical concerns about possible aspiration caused by gastric residual fluid when a second dose is given close to the time ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.08.081
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:No objective measure of the level of sedation is universally accepted. However, bispectral index monitoring is currently used to objectively measure sedation levels in several clinical settings. This study compares the temporal relationship of bispectral index levels versus the Observer's Assessment of Alert...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2000.107284
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Surveillance of intestinal metaplasia (IM) of the gastric mucosa should be limited to patients at high risk of gastric cancer. Patients with extensive IM are at increased cancer risk; however, the intragastric extent of IM is usually unknown at the time of the initial diagnosis. OBJECTIVE:To assess the pred...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2008.08.041
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:The chemical composition and clinical significance of white bile in patients with malignant biliary obstruction were evaluated in a prospective study. METHODS:Consecutive patients (January 1996 through December 1997) with inoperable malignant biliary obstruction underwent endoscopic placement of 10F straight...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.121336
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Endoscopic ultrasound (EUS)--guided fine-needle aspiration (FNA) is frequently performed for diagnostic evaluation of lesions in or near the gastrointestinal (GI) tract. Little data exist concerning possible infectious complications associated with EUS-guided FNA. This prospective evaluation was undertaken t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.108966
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND AND AIMS:The cecal intubation rate (CIR) is a widely accepted key performance indicator (KPI) in colonoscopy but lacks a universal calculation method. We aimed to assess whether differences in CIR calculation methods could have an impact on perceived trainee outcomes. METHODS:A systematic review of CIR calc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
doi:10.1016/j.gie.2018.12.026
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The long-term efficacy of sequential insertion of multiple plastic stents for benign biliary strictures is poorly defined. The aims of this study were to evaluate the long-term outcome (bile duct patency, complications) of this therapy and to identify predictors of a good outcome. METHODS:Retrospective revi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.122955
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:An accurate determination of the extent of Barrett's metaplasia is critical to the study of its natural history and response to therapy. Our hypothesis is that area calculations offer advantages over length estimates of Barrett's. METHODS:Changes in both measures and estimates of progression or regression b...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70173-1
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:18-Fluorodeoxyglucose positron emission tomography (PET) is used clinically to detect recurrent colon cancer after surgical resection, but the sensitivity of PET for premalignant colon lesions and early stage colon cancer is not well defined. METHODS:In a prospective study, 45 patients with a total of 58 co...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02775-0
更新日期:2005-03-01 00:00:00