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esophagogastroduodenoscopy with conscious sedation does not interfere with catheter-based 24-h pH monitoring

World Journal of Gastroenterology 2013年第11期19卷 1805-1810页

作者： Yung-Kuan Tsou Jau-Min Lien Chin-Kuo Chen Cheng-Hui Lin Hsing-Yu Chen Mu-Shien Lee Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalChang Gung University College of MedicineTaoyuan 333Taiwan Department of Otolaryngology Chang Gung Memorial HospitalChang Gung University College of MedicineTaoyuan 333Taiwan Center for Traditional Chinese Medicine Chang Gung Memorial HospitalChang Gung University College of MedicineTaoyuan 333Taiwan

AIM:To investigate the impact of esophagogastroduodenoscopy with conscious sedation on the subsequent 24-h catheter-based pH ***:Fifty patients with extra-esophageal symptoms of gastroesophageal reflux disease undergoing ambulatory dual-probe 24-h pH monitoring were enrolled from March 2010 to August *** of the data were collected prospectively and analyzed ***-six patients(72%,group A) underwent pH monitoring shortly after esophagogastroduodenoscopy(EGD) with conscious sedation,and 14 patients(28%,group B) underwent pH monitoring without conscious *** 24-h pH data from two time periods were analyzed:the first 4 h(Period Ⅰ) and the remaining time of the study(Period Ⅱ).RESULTS:The mean age of the patients was 49.6 ± 12.5 years;20 patients(40%) were *** baseline data,including age,sex,body mass index,reflux esophagitis,the Reflux Symptom Index,and the Reflux Findings Score,were comparable between the two *** percentage of total time with a pH < 4 and the frequency of acid reflux during Period Ⅰ were not significantly different between the two groups,as measured using both pharyngeal(0.03% ± 0.10% vs 0.07% ± 0.16%,P = 0.32;and 0.07 ± 0.23 episodes/h vs 0.18 ± 0.47 episodes/h,P = 0.33,respectively) and esophageal probes(0.96% ± 1.89% vs 0.42% ± 0.81%,P = 0.59;and 0.74 ± 1.51 episodes/h vs 0.63 ± 0.97 episodes/h,P = 0.49,respectively).The percentage of total time with a pH < 4 and the frequency of acid reflux were also not significantly different between Periods I and Ⅱ in group A patients,as measured using both pharyngeal(0.03% ± 0.10% vs 0.23% ± 0.85%,P = 0.21;and 0.07 ± 0.23 episodes/h vs 0.29 ± 0.98 episodes/h,P = 0.22,respectively) and esophageal probes(0.96% ± 1.89% vs 1.11% ± 2.57%,P = 0.55;and 0.74 ± 1.51 episodes/h vs 0.81 ± 1.76 episodes/h,P = 0.55,respectively).CONCLUSION:EGD with conscious sedation does not interfere with the results of subsequent 24-h pH monitoring in patients with extra-esophageal

关键词： esophagogastroduodenoscopy Conscious sedation pH monitoring Gastroesophageal reflux disease Extraesophageal symptoms

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Drug-induced mucosal alterations observed during esophagogastroduodenoscopy

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World Journal of Gastroenterology 2024年第16期30卷 2220-2232页

作者： Masaya Iwamuro Seiji Kawano Motoyuki Otsuka Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan

Several features of drug-induced mucosal alterations have been observed in the upper gastrointestinal tract,i.e.,the esophagus,stomach,and *** include pill-induced esophagitis,desquamative esophagitis,worsening of gastroesophageal reflux,chemotherapy-induced esophagitis,proton pump inhibitor-induced gastric mucosal changes,medication-induced gastric erosions and ulcers,pseudomelanosis of the stomach,olmesartan-related gastric mucosal inflammation,lanthanum deposition in the stomach,zinc acetate hydrate tabletinduced gastric ulcer,immune-related adverse event gastritis,olmesartan-associated sprue-like enteropathy,pseudomelanosis of the duodenum,and lanthanum deposition in the *** endoscopists,acquiring accurate knowledge regarding these diverse drug-induced mucosal alterations is crucial not only for the correct diagnosis of these lesions but also for differential diag-nosis of other *** minireview aims to provide essential information on druginduced mucosal alterations observed on esophagogastroduodenoscopy,along with representative endoscopic images.

关键词： Diagnosis esophagogastroduodenoscopy Non-neoplastic lesions Esophageal lesions Gastric lesions Duodenal lesions

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Clinical features of gastroesophageal reflux disease and erosive esophagitis:Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia

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World Journal of Gastroenterology 2024年第34期30卷 3883-3893页

作者： Firehiwot A Mengistie Abate B Shewaye Abel T Tasamma Zekarias S Ayalew Department of Internal Medicine Addis Ababa UniversityAddis Ababa 1176Addis AbabaEthiopia Department of Internal Medicine Rheum Rheumatology and Internal Medicine Specialty ClinicAddis Ababa 1000Addis AbabaEthiopia Division of Gastroenterology and Hepatology Department of Internal MedicineAdera Medical and Surgical CenterAddis Ababa 1000Addis AbabaEthiopia

BACKGROUND Gastroesophageal reflux disease(GERD)is a common disease worldwide with varying clinical presentations and risk *** data for Africa is lacking,but an increasing trend is expected due to demographic and epidemiological *** endoscopic studies for general gastrointestinal disorders have shown some patients with erosive esophagitis(EE),no studies in Ethiopia have investigated the clinical characteristics,risk factors,and severity of GERD using esophagogastroduodenoscopy(EGD).AIM To assess the clinical features of GERD in Ethiopian patients who underwent EGD and determine the severity and risk factors of *** We conducted a multicenter,retrospective cross-sectional study of 221 patients diagnosed with GERD and endoscopic findings of EE at Trauma Associated Severe Hemorrhage and Amniotic Membrane Stem Cell between January 2019 and August *** were collected from electronic medical records and phone call *** used descriptive statistics and binary logistic regression analysis with SPSS version 26 to identify the association between variables with a statistical significance set at P value<*** The mean±SD age of the patients was 44.8(±15.9)years,with a male-to-female ratio of 1.6:*** most commonly reported symptom was epigastric pain(80.5%),followed by heartburn(43%).Los Angeles(LA)-A EE was diagnosed in 71.1%of patients,followed by LA-B(14.9%),LA-C(7.7%),and LA-D(5.9%).Multivariate analysis showed that age 50 or above,presence of bleeding,and endoscopic findings of duodenitis/duodenopathy were significantly associated with severe EE(P<0.05).Stricture and Barrett’s esophagus were observed in 4.5%and 1.36%of patients with EE,*** Most of the patients had milder EE with fewer ***,severe EE was more prevalent in older patients and those with duodenitis/duodenopathy.

关键词： Gastroesophageal reflux disease Erosive esophagitis Hiatal hernia esophagogastroduodenoscopy Heart burn

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Evaluation of preferable insertion routes for esophagogastroduodenoscopy using ultrathin endoscopes

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World Journal of Gastroenterology 2014年第17期20卷 5045-5050页

作者： Satoshi Ono Keiko Niimi Mitsuhiro Fujishiro Yu Takahashi Yoshiki Sakaguchi Chiemi Nakayama Chihiro Minatsuki Rie Matsuda Itsuko Hirayama-Asada Yosuke Tsuji Satoshi Mochizuki Shinya Kodashima Nobutake Yamamichi Atsuko Ozeki Lumine Matsumoto Yumiko Ohike Tsutomu Yamazaki Kazuhiko Koike Center for Epidemiology and Preventive Medicine Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan Department of Gastroenterology Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan Department of Endoscopy and Endoscopic Surgery Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

AIM: To evaluate the discomfort associated with esophagogastroduodenoscopy (EGD) using an ultrathin endoscope through different insertion routes.

关键词： esophagogastroduodenoscopy Ultrathin endoscope Visual analog scale

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Review of oral and pharyngolaryngeal benign lesions detected during esophagogastroduodenoscopy

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World Journal of Gastrointestinal Endoscopy 2023年第7期15卷 496-509页

作者： Masaya Iwamuro Kenta Hamada Seiji Kawano Yoshiro Kawahara Motoyuki Otsuka Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Practical Gastrointestinal Endoscopy Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan

Recent advancements in endoscopy equipment have facilitated endoscopists’detection of neoplasms in the oral cavity and pharyngolaryngeal *** particular,image-enhanced endoscopy using narrow band imaging or blue laser imaging play an integral role in the endoscopic diagnosis of oral and pharyngolaryngeal *** these advancements,limited studies have focused on benign lesions that can be observed during esophagogastroduodenoscopy in the oral and pharyngolaryngeal ***,this mini-review aimed to provide essential information on such benign lesions,along with representative endoscopic images of dental caries,cleft palate,palatal torus,bifid uvula,compression by cervical osteophytes,tonsil hyperplasia,black hairy tongue,oral candidiasis,oral and pharyngolaryngeal ulcers,pharyngeal melanosis,oral tattoos associated with dental alloys,retention cysts,papilloma,radiation-induced changes,skin flaps,vocal cord paresis,and vocal fold *** it is imperative to seek consultation from otolaryngologists or dentists in instances where the diagnosis cannot be definitively ascertained by endoscopists,the merits of attaining foundational expertise pertaining to oral and pharyngolaryngeal lesions are *** article will be a valuable resource for endoscopists seeking to enhance their understanding of oral and pharyngolaryngeal lesions.

关键词： Benign diseases Diagnosis esophagogastroduodenoscopy Non-neoplastic lesions Oral lesions Pharyngolaryngeal lesions

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Ultrathin endoscope flexibility can predict discomfort associated with unsedated transnasal esophagogastroduodenoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第7期5卷 346-351页

作者： Satoshi Ono Keiko Niimi Mitsuhiro Fujishiro Tomoko Nakao Kazushi Suzuki Yumiko Ohike Shinya Kodashima Nobutake Yamamichi Tsutomu Yamazaki Kazuhiko Koike Center for Epidemiology and Preventive Medicine Graduate School of Medicine the University of TokyoTokyo 113-8655 Japan Department of Gastroenterology Graduate School of Medicine the University of TokyoTokyo 113-8655 Japan Department of Endoscopy and Endoscopic Surgery Graduate School of Medicine the University of TokyoTokyo 113-8655 Japan

AIM: To evaluate the effects of choice of insertion route and ultrathin endoscope types. METHODS: This prospective study (January-June 2012) included 882 consecutive patients who underwent annual health checkups. Transnasal esophagogastroduodenoscopy (EGD) was performed in 503 patients and transoral EGD in 235 patients using six types of ultrathin endoscopes. Patients were given a choice of insertion route, either transoral or transnasal, prior to EGD examination. For transoral insertion, the endo-scope was equipped with a thin-type mouthpiece and tongue depressor. Conscious sedation was not used for any patient. EGD-associated discomfort was assessed using a visual analog scale (VAS; no discomfort 0maximum discomfort 10). RESULTS: Rates of preference for transnasal insertion were significantly higher in male (male/female 299/204 vs 118/117) and younger patients (56.8 ± 11.2 years vs 61.3 ± 13.0 years), although no significant difference was found in VAS scores between transoral and transnasal insertion (3.9 ± 2.3 vs 4.1 ± 2.5). Multivariate analysis revealed that gender, age, operator, and endoscope were independent significant predictors of VAS for transnasal insertion, although gender, age, and endoscope were those for transoral insertion. Further analysis revealed only the endoscopic flexibility index (EFI) as an independent significant predictor of VAS for transnasal insertion. Both EFI and tip diameter were independent significant predictors of VAS for transoral insertion. CONCLUSION: Flexibility of ultrathin endoscopes can be a predictor of EGD-associated discomfort, especially in transnasal insertion.

关键词： esophagogastroduodenoscopy Ultrathin endoscope Visual analog scale Discomfort Surveillance

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Two case reports of acute upper gastrointestinal bleeding from duodenal ulcers after Roux-en-Y gastric bypass surgery: Endoscopic diagnosis and therapy by single balloon or push enteroscopy after missed diagnosis by standard esophagogastroduodenoscopy

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World Journal of Gastrointestinal Endoscopy 2017年第10期9卷 521-528页

作者： Seifeldin Hakim Srinivas R Rami Reddy Mihaela Batke Gregg Polidori Mitchell S Cappell Division of Gastroenterology and Hepatology Department of MedicineWilliam Beaumont Hospital Oakland University William Beaumont School of Medicine

The diagnosis and opportunity for endoscopic therapy of gastric or duodenal lesions may be missed at esophagogastroduodenoscopy(EGD) because of technical difficulty in intubating at EGD the postoperatively excluded stomach and proximal duodenum in patients status post Roux-en-Y gastric bypass(RYGB). Two cases are reported of acute upper gastrointestinal bleeding 10 or 11 years status postRYGB, performed for morbid obesity, in which the EGD was non-diagnostic due to failure to intubate the excluded stomach and proximal duodenum, whereas subsequent push enteroscopy or single balloon enteroscopy were diagnostic and revealed 4-cm-wide or 5-mm-wide bulbar ulcers and even permitted application of endoscopic therapy. These case reports suggest consideration of push enteroscopy, or single balloon enteroscopy, where available, in the endoscopic evaluation of acute UGI bleeding in patients status post RYGB surgery when the EGD was non-diagnostic because of failure to intubate these excluded segments.

关键词： Morbid obesity Bariatric surgery Roux-en-Y gastric bypass surgery Upper gastrointestinal bleeding esophagogastroduodenoscopy Push enteroscopy Single balloon enteroscopy Therapeutic endoscopy Double balloon enteroscopy

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Usefulness of applying lidocaine in esophagogastroduodenoscopy performed under sedation with propofol

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World Journal of Gastrointestinal Endoscopy 2013年第5期5卷 231-239页

作者： Felipe de la Morena Cecilio Santander Carlos Esteban Beatriz de Cuenca Juan Antonio García Javier Sánchez Ricardo Moreno Endoscopy Unit Department of GastroenterologyHospital Universitario Infanta CristinaCP 28981 ParlaMadridSpain Department of Gastroenterology Hospital Universitario de la PrincesaCP 28006 MadridSpain Department of Anaesthesiology Hospital Universitario Infanta CristinaCP 28981 ParlaMadridSpain Department of Pharmacology Hospital Universitario Infanta CristinaCP 28981 ParlaMadridSpain

AIM:To determine whether topical lidocaine benefits esophagogastroduoduenoscopy(EGD) by decreasing propofol dose necessary for sedation or procedurerelated ***:The study was designed as a prospective,single centre,double blind,randomised clinical trial and was conducted in 2012 between January and May(NCT01489891).Consecutive patients undergoing EGD were randomly assigned to receive supplemental topical lidocaine(L;50 mg in an excipient solution which was applied as a spray to the oropharynx) or placebo(P;taste excipients solution without active substance,similarly delivered) prior to the standard propofol sedation *** propofol was administered as a bolus intravenous(iv) dose,with patients in the L and P groups receiving initial doses based on the patient’s American Society of Anaesthesiologists(ASA) classification(ASAⅠ-Ⅱ:0.50-0.60 mg/kg;ASA Ⅲ-Ⅳ:0.25-0.35 mg/kg),followed by 10-20 mg iv dose every 30-60 s at the anaesthetist’s *** signs,anthropometric measurements,amount of propofol administered,sedation level reached,examination time,and the subjective assessments of the endoscopist’s and anaesthetist’s satisfaction(based upon a four point Likert scale) were *** statistical tests were performed by the Stata statistical software suite(Release 11,2009;StataCorp,LP,College Station,TX,United States).RESULTS:No significant differences were found between the groups treated with lidocaine or placebo in terms of total propofol dose(310.7 ± 139.2 mg/kg per minute vs 280.1 ± 87.7 mg/kg per minute,P = 0.15) or intraprocedural propofol dose(135.3 ± 151.7 mg/kg per minute vs 122.7 ± 96.5 mg/kg per minute,P = 0.58).Only when the L and P groups were analysed with the particular subgroups of female,< 65-year-old,and lower anaesthetic risk level(ASA Ⅰ-Ⅱ) was a statistically significant difference found(L:336.5 ± 141.2 mg/kg per minute vs P:284.6 ± 91.2 mg/kg per minute,P = 0.03) for greater total propofol requirements).The total i

关键词： Lidocaine Propofol esophagogastroduodenoscopy Sedation Adverse effects

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Usefulness of continuous suction mouthpiece during esophagogastroduodenoscopy: A single-center, prospective,randomized study

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World Journal of Gastrointestinal Endoscopy 2013年第10期5卷 508-513页

作者： Takao Maekita Jun Kato Yukihiko Nakatani Shotaro Enomoto Ema Takano Masahiro Tsuji Tsuyoshi Nakaya Kosaku Moribata Yosuke Muraki Naoki Shingaki Toru Niwa Hisanobu Deguchi Kazuki Ueda Izumi Inoue Mikitaka Iguchi Hideyuki Tamai Masao Ichinose Department of Gastroen-terology School of Medicine Wakayama Medical UniversityWakayama Department of Internal Medicine Nakaya HospitalWakayama

AIM: To develop a new continuous suction mouthpiece(CSM) and evaluate its usefulness for screening esophagogastroduodenoscopy(EGD).METHODS: A total of 196 patients who were scheduled to undergo screening EGD were assigned to one of two groups: a group using the CSM and a group using a conventional mouthpiece. Extent of salivary flow,frequency of saliva suction, number of choking episodesduring the examination, and incidence of aspiration pneumonia after the examination were evaluated and compared between the two groups. Adverse events during and after EGD were also examined. In addition, the oral cavity was meticulously examined after the ***: The same number of patients was randomly allocated to each group. There were no significant differences between the two groups in sex, age,biopsy procedure, duration of procedure and depth of sedation. Aspiration pneumonia and other significant adverse events were not observed in either group. The grade of extent of salivary flow was significantly lower in patients with the CSM than in patients with the conventional mouthpiece(P < 0.001). Although there was no significant difference, less frequent suctioning and fewer choking episodes were observed in patients with the CSM than in patients with the conventional mouthpiece(P = 0.082 and P = 0.084, respectively). In addition, there were no patients in the CSM group who required saliva suctioning during the ***: Use of the CSM during screening EGD can reduce the extent of salivary flow. The device is expected to reduce complications and contamination with saliva.

关键词： Mouthpiece esophagogastroduodenoscopy Aspiration Saliva Suction

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Causative factors of discomfort in esophagogastroduodenoscopy: A large-scale cross-sectional study

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World Journal of Gastrointestinal Endoscopy 2020年第4期12卷 128-137页

作者： Kenichiro Majima Takeshi Shimamoto Yosuke Muraki The Department of Health Management Kameda Medical CenterKamogawa City 296-8602Chiba PrefectureJapan The Department of Gastroenterology Graduate School of MedicineThe University of TokyoChiba City 261-7114Chiba PrefectureJapan

BACKGROUND It is important to reduce patient discomfort in *** measures can be taken to alleviate discomfort if the causative factors are determined;however,all the factors have not been elucidated *** To clearly determine the factors influencing discomfort in transoral esophagogastroduodenoscopy using a large-size cross-sectional study with readily available *** Consecutive patients who underwent screening transoral esophagogastroduodenoscopy consecutively between August 2017 and October 2017 at a health check-up center were *** was evaluated using a face scale between 0 and 10 with a 6-level *** and multiple regression analyses were performed to investigate the factors related to the discomfort in *** analysis was performed in both the unsedated and sedated study ***,sex,height,body mass index,smoking status,alcohol intake,hiatal hernia,history of gastrectomy,biopsy during examination,Lugol’s solution usage,administration of butylscopolamine with/without a sedative(pethidine,midazolam,or both),endoscope model,history of endoscopy,and endoscopists were considered as possible factors of *** Finally,1715 patients were enrolled in this ***,the median discomfort score was 2 and the interquartile range was *** discomfort(score≥6)was recorded in 18%of the *** to univariate analysis,in the unsedated group,young age(P<0.001),female sex(P<0.001),and no history of endoscopy(P<0.001)were factors associated with increased *** differences were also noted for height(P=0.007),smoking status(P=0.003),and endoscopists(P<0.001).In the sedation group,young age(P<0.001),female sex(P<0.001),and no history of endoscopy(P=0.004)were associated with increased discomfort;additionally,significant differences were found in smoking status(P<0.001),type of sedation(P<0.001),and endoscopists(P=0.027).There

关键词： esophagogastroduodenoscopy Discomfort Smoking Alcohol Pethidine Endoscopy

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