Diagnostic value of double-balloon enteroscopy for small bowel Crohn disease / 中华消化内镜杂志

ObjectiveTo investigate the value of double-balloon endoscopy for the diagnosis of small bowel Crohn disease(CD).MethodsData of 141 patients with suspected CD undergoing double-balloon endoscopy were reviewed.Diagnosis was made based on pathological,endoscopic findings and clinic follow-up results.Detection rates and diagnosis rates of small bowel CD were compared by double-balloon enteroscopy,CT enterography and capsule endoscopy.ResultsThe detection and diagnosis rates of small bowel CD by double-balloon endoscopy were 90.8％ ( 128/141 ) and 98.4％ ( 126/128),respectively.These two variables by CT enterography were 76.0％ (19/25) and 89.5％ (17/19),and those by capsule endoscopy were 60.0％ (15/25) and 93.3％ (14/15).ConclusionDouble balloon enteroscopy has high application value for the diagnosis of small bowel CD.For those contraindicated with endoscopy,CT enterography can be considered as a preferred auxiliary diagnostic modality.

Endoscopic removal of an extensive sinonasal schwannoma

Schwannoma is a rare, benign and slow-growing tumour which arises exclusively from Schwann cells. Essentially this tumour can be found in any part of the body. In the paranasal sinuses and nasal cavity, this tumour originates mostly from the ophthalmic and maxillary branches of the trigeminal nerve. The most common clinical presentation is unilateral nasal obstruction. Histological examination is crucial for diagnosis. The main modality of treatment is surgical excision. The type of surgery will depend on the location and extent of the tumour. Even though it is generally considered a benign tumour, there have been reports of potential malignant transformation. We report a case of a 52-year-old man with an extensive nasal mass which was removed endoscopically and histologically confirmed as schwannoma.

Ruhof Cleansing Detergent Applied to Clean Endoscopies / 中华医院感染学杂志

OBJECTIVE To analyze the cleaning efficiency of using Ruhof multi-enzyme detergent to clean endoscopies. METHODS Take 80 sets of used endoscopies as samples and clean them with multi-enzyme detergent in "four-trough" way as instructed by the Ministry of Health.After cleaning,the changes in bio-burden residual on the endoscope′s surface and jet obstruction were observed. RESULTS After cleaning the endoscopes with Ruhof multi-enzyme detergent,the bio-burden residual on the endoscope′s surface as well as jet obstruction,and the surface cleanness evaluation value had decreased enormously.The difference value before and after cleaning was significant(P

Sedación rutinaria en gastroenterología: experiencia de 15 meses en el Hospital Central de la Policía. Bogotá / Routine sedation in gastroenterology: 15-month experience in the Central Police Hospital. Bogota

Objetivo: La sedación en procedimientos endoscópicos es aún muy poco utilizada en nuestro país. El objetivo del estudio es describir la experiencia del Hospital Central de la Policía con el uso rutinario de sedación para los procedimientos endoscópicos. Métodos: Durante un período de 15 meses se administró sedación rutinaria para todo tipo de procedimientos endoscópicos, por un gastroenterólogo apoyado en una Enfermera Jefe entrenada para tal fin, utilizando monitoreo clínico, de Pulso-Oximetría y de Tensión arterial automatizada. Los medicamentos principalmente utilizados fueron Propofol, Midazolam y Fentanyl. Resultados: De un total de 1414 procedimientos endoscópicos el 81.1% (1147) se realizaron bajo sedación leve a moderada. No se presentaron complicaciones con consecuencias clínicas, ni hubo mortalidad en esta serie. La satisfacción de los pacientes fue unánime. La sedación facilitó la realización de los procedimientos al gastroenterólogo. Conclusión: La sedación rutinaria para procedimientos endoscópicos por personal entrenado y con monitoreo adecuado, es una práctica segura, que facilita la realización de los mismos y genera gran satisfacción y aceptación por parte de los pacientes.

Objective: The sedation for endoscopies procedures is not frequently used in our country. This study goal is to describe the experience the Hospital Central de la Policia has in routine use of sedation for the endoscopies procedures. Methods: During a period of 15 months it was administrated routine sedation for all type of endoscopies procedures by a gastroenterologist assisted by a Chief Nurse trained with that purpose, using clinic monitoring, Oximetry -Pulse and automated arterial tension methods. The mainly used medicines were Propofol, Midazolam and Fentanyl. Results: From a total of 1414 endoscopies procedures, the 81.1% (1147) were made under light or moderate sedation. There was no evidence (presence) of any complications of clinic consequences, neither any mortality on this sample. The patients satisfaction was unanimous. The sedation made easier the procedures execution by the specialist (gastroenterologist). Conclusion: The routinely sedation for endoscopies procedures made by trained personnel with the appropriate monitoring, is a safe practice which makes easier the procedure itself and generates enormous satisfaction and acceptance by the patients.

Comparation between traditional thyroid surgery and endoscopic thyroidectomy / 中国普通外科杂志

Objective To explore the safety,minimal invasion and cosmetic effect of endoscopic thyroidectomy.Methods From May 2007 to April 2008,among 413 cases of thyroid operations,238 cases were operated by endoscopic techniguc and 175 cases were operated by traditional methods.the operation time,intra operative blood loss,incision cosmetic score,postoperative hospitalization time,cost of hospitalization,and surgical complications between the two mehods were compared.Results Both groups of patients were operated successfully without postoperative bleeding,hoarseness,or hypocalcemia.Compared with traditional thyroid surgery,endoscopic thyroidectomy had less blood loss,shorter operation time,and higher-satisfaction cosmetic effect without significant scars or skin color changes.Conclusions Compared with traditional thyroid surgery,endoscopic thyroidectomy has the desired advantages of excelent cosmetic result,safety,and quick recovery.It is an ideal operation method for treatment of benign thyroid diseases.

Evaluation of intestinal diseases diagnosed by capsule endoscopies / 中华消化内镜杂志

Objective To assess the detection of intestinal lesions by capsule endoscopies in Chinese patients. Methods To review the history and outcomes of 53 patients underwent 55 times ol capsule endoscopies from April 2002 to January 2003. Results Fifty-three patients received 55 times of capsule endoscopies , only one patient failed due to weak gastric peristalsis. Complication never happened. The capsule remained in the stomach and small intestine for an average of 44 minutes (range 6 - 135 minutes) and 334 minutes (range 90 -433 minutes) respectively. Three patients did not discard the capsule properly due to the stricture of small intestine. The diseases detected were small intestinal cancer, lymphoma, polyps, leio-myoma, xanthoma, Crohns disease, intestinal erosion and congestion, ascariasis, triehuriasis, foreign body and angiodysplasia. Conclusion This study demonstrates that the manipulation of capsule endoscopy is simple and safe, and provides excellent visualization of small intestine. Capsule endoscopy is superior to radiography or angiography in detecting lesions of small intestine, but it cannot afford enough information on orien-tation and histology.

Study of digestive diseases diagnosed by M2A capsule endoscopy / 中华消化内镜杂志

Objective To evaluate the application of M2A capsule endoscopies ( CE) in the diagnosis of digestive tract diseases. Methods Forty - five patients (26 males, 19 females) , suffered from gastrointestinal bleeding, abdominal pain or chronic diarrhea were referred to this study and underwent capsule endoscopies. Their average age was 47. 8 years old (a range of 15 - 78). Capsule endoscopies were performed with the Given M2A video capsule system. The conventional diagnostic procedures (including small bowel radiograph, gastroenteroscopy, colonoscopy, etc. ) were done in 31 patients before or after the CE, thus the results of both procedures were compared. Results Among 45 patients, 44 have completed CE successfully. Any complication never experienced. The quality of photos was excellent. The significant pathological findings were revealed in 37 patients, diagnostic yield was therefore 84. 1% . Patients with esophagogastric diseases, small bowel diseases and colon diseases were found in 5,29 and 3 cases respectively. Thirty -one patients received a conventional diagnostic procedure before or after CE. Twenty one of them suffered from GI bleeding, pathological changes were found in 17 patients by capsule endoscopies, only 4 patients by conventional procedure; five of them suffered from abdominal pain, pathological changes were found in 5 patients by CE, only 2 patients by conventional procedure; 4 of them suffered from chronic diarrhea, pathological changes were found in 4 patients by CE, only 1 patient by conventional procedure. The pathological sites located by CE were quite similar to those by conventional diagnostic work-up. Conclusion CE has the advantages of high safety, excellent visualization and precise localization. Its efficiency in diagnosis is much better than that of conventional procedure, and is indispensable in the diagnosis of digestive tract diseases.

Grading of mucosal histological biopsies, clinical appearances and endoscopies in patients with active ulcerative colitis / 中华消化内镜杂志

Objective To investigate the correlations between histological grading of the mucosal biopsies, clinical appearances and endoscopies of patients with active ulcerative colitis ( AUC) , and their roles in the therapeutic outcomes. Methods To analyze the grading in pathological, endoscopic and clinical manifestations of 133 patients, and use the scores to estimate each clinical appearance. A prospective study and Spearman correlation coefficients analysis were taken in this study. Results Among 133 patients, the grading of histological, clinical and endoscopic results in grades Ⅰ ,Ⅱ , Ⅲ , andⅣwere 29,45 ,37 and 22; 85 , 39,9 and 0; 8,30,16 and 79 cases respectively. There were significant positive correlations between histological grading and the following parameters; melena ( r =0. 49, P= 0. 000) , bowel movement ( r =0. 30, P = 0.001) , ESR (r=0. 42, P =0.000) , AI(r=0.56, P=0.000) , clinical grade (r=0.52, P=0.000) endoscopic grade (r = 0. 35 , P =0. 000). And no significant negative correlation with Hb (r = -0. 13, P = 0. 125). In 68 mild and moderate cases after administered SASP for 6 weeks with clinical remission there were 16 and 19 cases with 0 grade in endoscopies and histology respectively, and in the former group 7 cases fall in histological grade I . Conclusion There was no agreement in the clinical, endoscopic and histological grades of the AUC patients. For the evaluation of therapy, the sequence of priority is histological grade, endoscopic grade, and then clinical grade.