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rate of adverse events of gastroduodenal snare polypectomy for non-flat polyp is low: A prospective and multicenter study

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World Journal of Gastroenterology 2017年第47期23卷 8405-8414页

作者： Henry Córdova Lidia Argüello Carme Loras Antonio Naranjo Rodríguez faust riu pons Joan B Gornals David Nicolás-Pérez Xavier Andújar Murcia Luis Hernández Santos Santolaria Carles Leal Carles pons Enrique Pérez-Cuadrado-Robles Orlando García-Bosch Michel Papo Berger José Luis Ulla Rocha Cristina Sánchez-Montes Gloria Fernández-Esparrach Endoscopy Unit.Institut de Malalties Digestives Hospital ClínicIDIBAPSCIBERehdUniversitat de Barcelona Digestive Endoscopy Unit Digestive Diseases DepartmentGastrointestinal Endoscopy Research GroupIISLa Fe Polytechnic University Hospital Hospital Universitari Mútua de Terrassa CIBERehd Hospital Reina Sofía Hospital Del Mar Hospital Universitari de Bellvitge IDIBELLUniversitat de BarcelonaHospitalet de Llobregat Hospital Universitario de Canarias Hospital Santos Reyes Aranda de Duero Hospital San Jorge Consorci Hospitalari de Vic Universitat de Vic Hospital de Viladecans Hospital Morales Meseguer Hospital Moisès Broggi Sant Joan Despí Hospital Joan XXIII Complejo Hospitalario de Pontevedra

AIM To evaluate the rate of adverse events(AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers. METHODS Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after theprocedure. RESULTS308 patients were included and a single polypectomy was performed in 205. Only 36(11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm(5-60) and in 294 cases(95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219(71.1%) patients. Nine patients presented AEs(2.9%), and 6 of them were bleeding(n = 6, 1.9%)(in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of *** Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.

关键词： Polypectomy Bleeding Adverse events Protruded polyps Gastroduodenal Foregut

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Narrow band imaging and white light endoscopy in the characterization of a polypectomy scar:A single-blind observational study

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World Journal of Gastroenterology 2018年第45期24卷 5179-5188页

作者： fausto riu pons Montserrat Andreu Javier Gimeno Beltran Marco Antonioálvarez-Gonzalez Agustín Seoane Urgorri Josep Maria Dedeu Luis Barranco Priego Xavier Bessa Gastroenterology Department Hospital del MarBarcelona 08003Spain IMIM(Hospital del Mar Medical Research Institute) Barcelona 08003Spain Department of Medicine Autonomous University of BarcelonaBarcelona 08003Spain Pompeu Fabra University Barcelona 08003Spain Pathology Department Hospital del MarBarcelona 08003Spain.

AIM To assess the incremental benefit of narrow band imaging(NBI) and white light endoscopy(WLE), randomizing the initial technique for the detection of residual neoplasia at the polypectomy scar after an endoscopic piecemeal mucosal resection(EPMR).METHODS We conducted an observational study in an academic center to assess the incremental benefit of NBI and WLE randomly applied 1:1(NBI-WLE or WLE-NBI) in the follow-up of a post-EPMR scar by the same *** A total of 112 EPMR scars were included. The median baseline polyp size was 20 mm(interquartile range: 14-30). At first review, NBI and WLE showed good sensitivity(85.0% vs 78.9%), specificity(77.1% vs 84.2%) and overall accuracy(80.0% vs 82.5%). NBI after WLE(WLE-NBI group) improved accuracy, but this difference was not statistically significant [area under the curve(AUC): 86.8% vs 81.6%, P = 0.15]. WLE after NBI(NBI-WLE group) did not improve accuracy(AUC: 81.4% vs 81.1%, P = 0.9). Overall, recurrence was found in 39/112(34.8%) *** Although no statistically significant differences were found between the two techniques at the first postEPMR assessment, the use of NBI after WLE may improve residual neoplasia detection. Nevertheless, biopsy is still required in the first scar review.

关键词： Colonoscopy Narrow band imaging Endoscopic mucosal resection

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Evaluation of an educational telephone intervention strategy to improve non-screening colonoscopy attendance:A randomized controlled trial

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World Journal of Gastroenterology 2020年第47期26卷 7568-7583页

作者： Agustin Seoane Xenia Font Juan C Perez Rocio Perez Carlos F Enriquez Miriam Parrilla faust riu Josep M Dedeu Luis E Barranco Xavier Duran Ines A Ibanez Marco A Alvarez Digestive Department Endoscopy UnitHospital del MarParc de Salut MarBarcelona 08003Spain Colorectal Cancer Research Group IMIM(Hospital del Mar Medical Research Institute)Barcelona 08003Spain Department of Medicine Autonomous University of BarcelonaBarcelona 08003Spain Consulting Service on Methodology for Biomedical Research IMIM(Hospital del Mar Medical Research Institute)Barcelona 08003Spain

BACKGROUND Colonoscopy attendance is a key quality parameter in colorectal cancer population screening *** these programmes,educative interventions with bidirectional contact carried out by trained personnel have been proved to be an important tool for colonoscopy attendance improvement,and because of its huge clinical and economic impact,they have been widely ***,outside of this population programmes,educative measures to improve colonoscopy attendance have been poorly studied and no navigation interventions are usually *** To investigate the clinical and economic impacts of an educational telephone intervention on colonoscopy attendance outside colorectal cancer screening *** This randomized controlled trial included consecutive patients referred to colonoscopy from primary care centres from November 2017 to May *** intervention group(IG)received a telephone intervention,while the control group(CG)did *** assigned to the IG received an educational telephone call 7 d before the colonoscopy *** intervention was carried out by two nurses with deep endoscopic knowledge who were previously trained for a telephone educational intervention for *** impact on patient compliance with preparedness protocols related to bowel cleansing,antithrombotic management,and sedation scheduling was also evaluated.A second call was conducted to assess patient ***-to-treat(ITT)and perprotocol(PP)analyses were *** A total of 738 and 746 patients were finally included in the IG and CG *** hundred thirteen(83%)patients were contacted in the *** non-attendance rate was lower in the IG,both in the ITT analysis(IG 8.4%vs CG 14.3%,P<0.001)and in the PP analysis(4.4%vs 14.3%,P<0.001).In a multivariable analysis,belonging to the control group increased the risk of nonattendance in both,the ITT analysis(OR 1.81,95%CI:1.27 to 2.58,P=0.001)and the PP analysis(O

关键词： Colonoscopy Quality improvement No-show patients Nursing education Patient compliance Telephone intervention

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