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Objective To compare the operation effect of esophageal foreign body removal with transparent cap-assisted endoscopic technique and traditional method. Methods Ninety-six patients with foreign body incarcerated in esophageal were randomly divided into two groups, and they were underwent transparent cap-assisted endoscopic esophageal foreign body removal or traditional endoscopic esophageal foreign body removal respectively. The clinical data of the two groups were collected, and the success rate, the operation time, the endoscopic vision clarity and the complication rate of the two groups were all recorded and analyzed. Results The success rate in transparent cap-assisted endoscopic technique group was 100% compared with 95.83% in traditional method group, and two cases of failure were transferred to transparent cap-assisted endoscopic technique and finally succeed. The mean operation time were (8.58±3.21) min in transparent cap-assisted endoscopic technique group, and (10.64 ± 5.45) min in traditional method group, and there was no significant difference in two groups (P > 0.05). Forty-five cases got A level and three got B in transparent cap-assisted endoscopic technique group in endoscopic vision clarity, in contrast to 35 A, 11 B and two C in traditional method group. The difference between the two groups was statistically significant (P = 0.020). There was no case with serious complications such as bleeding, perforation or death in two groups. Conclusions Transparent cap-assisted endoscopic technique for body removal is safety and efficacy, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal.
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Objective To observe and explore the effects of transparent cap-fitted colonoscope combined with carbon dioxide injection on the cecal intubation time and detection of colonic polyps during enteroscopy. Methods 216 patients underwent colonoscopy from January 2014 to June 2016 were selected and randomly divided into A, B, C groups according to random number table, 72 cases in each. Group A with transparent cap-fitted colonoscopy, group B with CO2 injection before colonoscopy, and group C combined with the above two methods and then underwent colonoscopy, cecal intubation time and colonic polyp detection rate were compared among the three groups during the inspection. Results A, B, C groups with cecal intubation ratio showed no significant differences (95.8% vs 90.3% vs 98.6%) (χ2 = 5.34, P = 0.069); the sequence of mean cecal intubation time was group Cgroup A>group B (38.9% vs 34.7% vs 23.6%) (χ2 = 4.10, P = 0.129). The sequences of visual analogue scale score after 10 min [(4.35 ± 0.62) vs (4.88 ± 0.85) vs (5.57 ± 1.05)] and 30 min [(3.04 ± 0.37) vs (3.30 ± 0.56) vs (4.41 ± 0.84)] of coloscope withdraw were both group C
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Objective To evaluate the efficacy and safety of combined use of insulated-tip knife, titanium clips and transparent caps in the resection of large pedunculated colorectal polyps. Methods Therapeutic method: with the assistance of transparent cap, 1~3 titanium clip(s) were applied to the base of the stalk to block blood supply of large polyps and then insulated-tip knife was utilized to resect polyps by cutting the stalk. Research method: retrospectively analyze the clinical data of 45 large pedunculated colorectal polyps (head ≥ 2.0 cm) which were treated by the method mentioned above from January 2014 to December 2015. Statistics of procedure time, clip numbers, complication rates were used to assess the effect of the treatment. Results 45 large polyps were successfully removed one time without any severe complications of bleeding or perforation during procedure except a very small amount of blood were oozing from the cutting edge in 3 cases. There were also no delayed complications of bleeding or perforation after procedure. The average number of titanium clip was 2.7 and the average operating time was (5.7 ± 1.2) min (range 3 ~ 12 min). Conclusion Combined application of insulated-tip knife, titanium clips and transparent cap inthe resection of large pedunculated colorectal polyps is safe, effective and convenient to conduct.
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Objective To evaluate the efficacy and safety of combined use of insulated-tip knife, titanium clips and transparent caps in the resection of large pedunculated colorectal polyps. Methods Therapeutic method: with the assistance of transparent cap, 1~3 titanium clip(s) were applied to the base of the stalk to block blood supply of large polyps and then insulated-tip knife was utilized to resect polyps by cutting the stalk. Research method: retrospectively analyze the clinical data of 45 large pedunculated colorectal polyps (head ≥ 2.0 cm) which were treated by the method mentioned above from January 2014 to December 2015. Statistics of procedure time, clip numbers, complication rates were used to assess the effect of the treatment. Results 45 large polyps were successfully removed one time without any severe complications of bleeding or perforation during procedure except a very small amount of blood were oozing from the cutting edge in 3 cases. There were also no delayed complications of bleeding or perforation after procedure. The average number of titanium clip was 2.7 and the average operating time was (5.7 ± 1.2) min (range 3 ~ 12 min). Conclusion Combined application of insulated-tip knife, titanium clips and transparent cap inthe resection of large pedunculated colorectal polyps is safe, effective and convenient to conduct.
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Proximal transparent cap of endoscope has an important effect in endoscopic diagnosis and treatment, including endoscopic submucosal tumor ligation, endoscopic mucosal resection, endoscopic removal of foreign body, endoscopic variceal ligation and sclerotherapy, endoscopic submucosal dissection, peroral endoscopic myotomy, endoscopic submucosal dissection through tunnel.This article reviewed the effect of different transparent caps in endoscopic diagnosis and treatment.
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[Objective]To analyze the advantages of transparent cap assisted endoscopy in the diagnosis and treatment of duode-nal diseases.[Methods]From September 2014 to December 2015,62 cases with suspicious duodenal diseases in the endoscopy cen-ter of our hospital randomly divided into transparent cap group(n=31)and routine group(n=31)according to the time sequence. The visual field resolution,success rate of image capture and operating time were compared in 2 groups.[Results]Thirty cases in transparent cap group had clear visual field definition ,which was obviously higher than 9 cases in conventional group (96.8% vs 29%,P < 0.001). Twenty-three cases in transparent cap group and 8 cases in routine group were successfully captured(90.3% vs 25.8%,P < 0.001). The average operating time of the transparent cap group was significantly shorter than that of the conventional group(150+58 vs 95+36 seconds,P=0.004).[Conclusion]Transparent cap endoscope examination is more effective in the treat-ment of duodenal diseases,and the image capture is higher and the operation time is shorter.
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Objective To investigate the application value of transparent cap assisted colonoscopy one-man operation in a routine examination.Methods 400 outpatient or inpatient patients required colonoscopy were randomly divided into a transparent and non-transparent cap set group,groups were single-person operation method colonoscopy examination,enrolled 200 patients in each group,two cases of abdominal surgery colonoscopy inserted mirror average time detection of polyps,the number of cases of abdominal auxiliary pressing needs and changing position,as well as analysis.Results A transparent and non-transparent cap set cap group,the average time was inserted mirror 263.0s and 345.0s,polyps were detected in 53 and 50,the number of patients required abdominal compressions and assisted changing position were 30 cases and 67 patients with abdominal surgery cases mirror the average time was inserted 202.3s and 434.6s.Conclusion The transparent cap assisted colonoscopy single operation is a practical,safe,effective and efficient way to check the mirror insert.
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A sharp, impacted fish bone in the esophagus is an indication for urgent endoscopy. Endoscopic removal of such an object is a challenging task. An endoscopic protector hood is then used to remove the object. However, an endoscopic hood protector is not always available. In a patient with a large hiatal hernia, the protector hood may not return to the original shape when it passes through the gastroesophageal junction and therefore may not properly protect the esophageal mucosa from the sharp foreign body. In our case, it was impossible to deploy the endoscopic hood protector through the gastroesophageal junction despite multiple attempts. We propose an alternative solution for such cases. We safely removed a large sharp-edged flat fish bone that was folded and compressed using a detachable snare after releasing and pushing the fish bone into the stomach using an endoscope equipped with a transparent cap used for dilating the esophageal wall. This method of using an endoscopic cap and detachable snare is a safe, useful alternative for endoscopically removing a large sharp-edged flat foreign body from the upper gastrointestinal tract. This alternative technique has not been reported in the English medical literature.
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Aged, 80 and over , Humans , Male , Esophagoscopy/instrumentation , Esophagus , Foreign Bodies/diagnostic imagingABSTRACT
PURPOSE: Recently, the use of a transparent cap attached to the tip of the colonoscope has been revealed to be helpful in both detecting colorectal polyps and shortening the intubation time to the cecum. The aim of this study was to examine the usefulness of transparent cap-attached colonoscopy (CAC) as compared with conventional colonoscopy (CC) in terms of the technical ease and efficiency. METHODS: Colonoscopies from a total of 228 patients between May and October 2008 were prospectively collected. All colonoscopies were performed by single colorectal surgeon whose experience exceeded 3,000 colonoscopies. Patients were assigned to the CAC group (n=114) or to the CC group (n=114). The cecal intubation rate and time, the polyp detection rate, the adenoma detection rate, the withdrawal time, and the visual analogue scale (VAS) of the patient's pain were compared. RESULTS: There were no significant differences in the age, sex, body mass index, previous history of abdominal operation, diverticulosis, and the degree of bowel preparation between the two groups. The cecal intubation rate was 100% in both groups. The cecal intubation time was significantly shorter in the CAC group than in the CC group overall (5.3+/-4.0 min vs. 7.6+/-4.3 min, P<0.001), as well as for female (6.1+/-2.8 min vs. 9.1+/-4.7 min, P<0.001) patients. There were no statistically significant differences in the total colonoscopy time (13.1+/-6.3 min vs. 14.5+/-5.2 min, P=0.066), the polyp detection rate (38.6% vs. 33.3%, P=0.408), the adenoma detection rate (28.1% vs. 25.4%, P=0.654), and the VAS scale of pain (2.48 vs. 2.74, P=0.353) between the CAC and the CC groups. CONCLUSION: The transparent cap is effective in shortening the cecal intubation time, especially in female patients.
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Female , Humans , Adenoma , Body Mass Index , Cecum , Colonoscopes , Colonoscopy , Diverticulum , Intubation , Polyps , Prospective StudiesABSTRACT
Objective To evaluate the feasibility of transparent cap-fitted endoscopy in improving diagnostic yield of Barrett's esophagus(BE).Methods A total of 168 patients with endoscopieally suspected BE were randomly divided into cap group(n=60)and control group(n=108).A transparent cap-fitted endoscopy Was applied in cap group to take biopsy,while a routine one was used in control group,and 2 biopsies from suspected lesions were collected in each patient.BE was diagnosed in the presence of columnar epithelium and the diagnostic rate was compared between 2 groups.Results The diagnostic rates of BE were 83.3%(50/60)and 69.4%(75/108)in cap and control group,respectively(P＜0.05).Conclusion The lesions at cardia Call be exposed clearly with capped endoscopy,which facilitates localized biopsy and BE diagnosis.
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Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal (GI) tract, but the lesion occurs rarely in the esophagus. Although only 10~30% of GISTs are malignant at the time of diagnosis, many reports show that it is difficult to predict the prognosis and underlying potential of non-malignant ones. Thus, the surgical removal of GISTs is even being proposed as a standard treatment. Recently the endoscopic removal of submucosal tumors of the GI tract is being done in popular, but it has been still considered as both difficult and risky to resect a tumor originating from the muscularis propria layer using the endoscopic methods. Herein, we report a case of an incidentally found submucosal tumor originating from the muscularis propria treated with an endoscopic submucosal dissection method which was performed after a preceding mucosectomy using a transparent cap. The mass turned out to be an esophageal GIST.
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Esophagus , Gastrointestinal Stromal Tumors , Gastrointestinal Tract , PrognosisABSTRACT
BACKGROUND/AIMS: Well differentiated rectal carcinoid tumors which are less than 1cm in diameter can be treated by endoscopic resection. We aimed to evaluate the efficacy of endoscopic resection in treating small sized rectal carcinoids. METHODS: Medical records of 30 rectal carcinoid cases treated by endoscopic resection in Yonsei University College of Medicine, Severance Hospital between January 1995 and March 2007 were reviewed retrospectively. RESULTS: Mean age was 49.7 years and male to female ratio was 1:0.88. Mean size of tumor was 6.29+/-3.06 mm and 25 out of 30 patients (83.3%) had tumors of diameter less than 10 mm. Twenty-two out of 30 patients treated by conventional polypectomy, 6 by endoscopic mucosal resection using a transparent cap (EMR-C) and 2 by endoscopic submucosal dissection (ESD). Histological examination revealed that 9 patients had resection margin positive for tumor; 7 (31.8%) were in polypectomy group, 1 (16.7%) in EMR-C group, and 1 (50%) in ESD group (p=0.868). Five patients underwent transanal excision to remove residual tumor. No residual tumor was found in additionally resected tissue. Mean follow-up duration was 19. 3 months (range 0-122), and there were no recurrence. CONCLUSIONS: Endoscopic resection is an effective method in the treatment of small rectal carcinoids. However, long-term outcome remains to be elucidated by a large scaled prospective study.
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Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoid Tumor/pathology , Demography , Endoscopy, Gastrointestinal , Follow-Up Studies , Microsurgery , Rectal Neoplasms/pathology , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND/AIMS: There were two blind spots during colonoscopy, one was on angulated portion of colon, other was on non-fixated portion of colon. In spite of careful inspection during routine colonoscopy, small lesions behind the semilunar folds can be situated in blind spots, where they are easily overlooked. The aim of this study was to evaluate the efficacy of total colonoscopy with transparent cap in identifying such lesions, in comparison with colonoscopy without the cap. METHODS: We performed colonoscopy with or without transparent cap in 30 patients and 30 controls. During colonoscopy, frequencies of ileal intubation, time required for intubation as far as the terminal ileum and degrees of patients discomfort were checked. RESULTS: Colonoscopy with a transparent cap ensured good visual fields during insertion and withdrawal of the colonoscopy. There were no significant differences in the intubation times to the terminal ileum or in the frequencies of terminal ileal intubation, degree of patients discomfort between the two procedures. CONCLUSIONS: Total Colonoscopy with a transparent cap allows inspection of the blind area of the colonic mucosa behind the semilunar folds, with good visual fields. But the statistical significance was not found in this study. This method may be potentially useful for both screening and diagnostic purposes. Further study in more cases would be needed.