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Non-physician endoscopists: A systematic review

World Journal of Gastroenterology 2015年第16期21卷 5056-5071页

作者： Maximilian Stephens Luke F Hourigan Mark Appleyard George Ostapowicz Mark Schoeman Paul V Desmond Jane M Andrews Michael Bourke David Hewitt David A Margolin Gerald J Holtmann Department of Gastroenterology and Hepatology Princess Alexandra Hospital Faculty of Medicine and Biomedical Sciences University of Queensland Department of Gastroenterology and Hepatology RBWH Department of Gastroenterology and Hepatology Gold Coast Hospital QLD 4215 Department of Gastro-enterology and Hepatology Royal Adelaide Hospital and University of Adelaide St Vincent’s Hospital University of MelbourneMelbourne VIC 3010Australia Department of Gastroenterology and Hepatology Westmead HospitalUniversity of Sydney School of Medicine University of Queensland Department of Gastroenterology Queensland Elizabeth II Jubilee HospitalCoopers PlainsBrisbane QLD 4108Australia Department of Colon and Rectal Surgery Ochsner Clinic Foundation Ochsner Clinical SchoolUniversity of Queensland

AIM:To examine the available evidence on safety, competency and cost-effectiveness of nursing staff providing gastrointestinal(GI) endoscopy ***:The literature was searched for publications reporting nurse endoscopy using several databases and specific search *** were screened against eligibility criteria and for *** searches yielded 74 eligible and relevant articles; 26 of these studies were primary research articles using original datasets relating to the ability of nonphysician *** publications included a total of 28883 procedures performed by non-physician ***:The number of publications in the field of non-specialist gastrointestinal endoscopy reached a peak between 1999 and 2001 and has decreased thereafter.17/26 studies related to flexible sigmoidoscopies,5 to upper GI endoscopy and 6 to *** studies were from metropolitan centres with nurses working under strict supervision and guidance by specialist *** distribution of publications showed the majority of research was conducted in the United States(43%),the United Kingdom(39%)and the Netherlands(7%).Most studies conclude that after appropriate training nurseendoscopists safely perform ***,in relation to endoscopic competency,safety or patient satisfaction,all studies had major methodological *** were often not randomized(21/26studies)and not appropriately *** relation to cost-efficiency,nurse endoscopists were less costeffective per procedure at year 1 when compared to services provided by physicians,due largely to the increased need for subsequent endoscopies,specialist follow-up and primary care ***:Contrary to general beliefs,endoscopic services provided by nurse endoscopists are not more cost effective compared to standard service models and evidence suggests the *** significant shortcomings and biases limit the validity and

关键词： Nurse endoscopist Cost-benefit Servicemodel Patient satisfaction Outcome parameter

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Endoscopic Methods in the Diagnosis and Treatment of Pancreatic Cancer

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Journal of Cancer Therapy 2013年第10期4卷 1-6页

作者： Zoltán Berger Maria Ester Bufadel Godoy Alex Navarro Reveco University of Chile Clinical Hospital Department of Medicine Gastroenterology Section Santiago Chile

Endoscopic methods are widely used in the diagnosis and palliative treatment of pancreatic cancer. The most sensitive method in early diagnosis is endosonography (EUS) which can also provide histological diagnosis. Diagnostic ERCP became a rather rare procedure as a consequence of wide availability of Magnetic Resonance Cholangiopancreatography (MRCP) but ERCP assisted intraductal methods have gained importance (brush-cytology, intraductal ultrasound, optical coherence tomography) and finally, peroral pancreatoscopy has become technically feasible but available only in some specialized centers. Minimally invasive endoscopic methods play an important role in the palliative treatment of unresectable pancreatic cancer which represents the majority of cases. EUS-guided histological confirmation of adenocarcinoma is crucial in the election of chemotherapy. Celiac plexus blockade and endoscopic biliary and pancreatic stent placement contribute to pain reduction, drainage of obstructed bile duct and assure a better quality of life.

关键词： endoscopist Early Diagnosis Palliative Treatment

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Diagnostic pitfall of sebaceous gland metaplasia of the esophagus

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World Journal of Clinical Cases 2014年第7期2卷 311-315页

作者： King-Wah Chiu Cheng-Kun Wu Long-Sheng Lu Hock-Liew Eng Shue-Shian Chiou Department of Internal Medicine Division of Gastroenterology and HepatologyKaohsiung Chang Gung Memorial Hospitaland Chang Gung UniversityCollege of MedicineKaohsiung 83305Taiwan Department of Pathology Kaohsiung Chang Gung Memorial Hospitaland Chang Gung UniversityCollege of MedicineKaohsiung 83305Taiwan

We investigated the sebaceous gland metaplasia(SGM) of the esophagus and clarified the evidence of misdiagnosis and its diagnosis pitfall. Cases of pathologically proven SGM were enrolled in the clinical analysis and reviewed description of endoscope. In the current study, we demonstrated that SGM is very rare esophageal condition with an incidence around 0.00465% and an occurrence rate of 0.41 per year. There were 57.1% of senior endoscopists identified 8 episodes of SGM. In contrast, 7.7% of junior endoscopists identified SGM in only 2 episodes. Moreover, we investigated the difference in endoscopic biopsy attempt rate between the senior and junior endoscopist(P = 0.0001). The senior endoscopists had more motivation to look for SGM than did junior endoscopists(P = 0.01). We concluded that SGM of the esophagus is rare condition that is easily and not recognized in endoscopy studies omitting pathological review.

关键词： Esophagus Sebaceous gland Metaplasia Endoscopy endoscopist

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在煽动性的肠疾病的内视镜检查法什么时候并且为什么

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World Journal of Gastrointestinal Endoscopy 2012年第6期4卷 201-211页

作者： Rajaratnam Rameshshanker Naila Arebi Department of Gastroenterology St Mark’s HospitalWatford RoadLondonHA1 3UJUnited Kingdom

Endoscopy plays an important role in the diagnosis and management of inflammatory bowel disease(IBD).It is useful to exclude other aetiologies,differentiate between ulcerative colitis(UC) and Crohn’s disease(CD),and define the extent and activity of *** is used for monitoring of the disease,which in turn helps to optimize the *** plays a key role in the surveillance of UC for dysplasia or neoplasia and assessment of post operative *** endoscopy and double balloon enteroscopy are increasingly used in patients with *** applications relate to stricture dilatation and dysplasia *** endoscopist’s role is vital in the overall management of IBD.

关键词： Colonoscopy Oesophagogastroduodenoscopy Capsule endoscopy Enteroscopy Ulcerative colitis Crohn’s disease Dysplasia endoscopist

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