Gastrointestinal endoscopy
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Gastrointest. Endosc. · Jul 2018
Randomized Controlled Trial Comparative StudyEfficacy of anterior versus posterior per-oral endoscopic myotomy for treating achalasia: a randomized, prospective study.
Per-oral endoscopic myotomy (POEM) has been demonstrated to be safe and effective for treating achalasia. Two approaches-anterior myotomy and posterior myotomy-are used during POEM. However, little is known about the comparison between the 2 different approaches. The objective of the study is to compare the safety and short-term efficacy of the 2 approaches for treating achalasia. ⋯ The short-term treatment efficacy, manometry outcomes, and adverse events were comparable between the anterior and posterior myotomy groups. Large-scale studies with long-term follow-up are warranted for a more definitive conclusion. (Clinical trial registration number: ChiCTR-ICR-15007211.).
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Gastrointest. Endosc. · May 2018
Review Meta Analysis Comparative StudyComparison of EUS with MRCP in idiopathic acute pancreatitis: a systematic review and meta-analysis.
Idiopathic acute pancreatitis (IAP) poses a diagnostic challenge for gastroenterologists, because confirmation of the disease etiology has important implications for the selection of the best possible treatment and the prevention of possible recurrence or the development of chronic pancreatitis (CP). ERCP, EUS, and MRCP typically are used to diagnose IAP when conventional radiologic methods fail. However, their exact role in the diagnosis of IAP has not yet been determined. ⋯ EUS and MRCP should both be used in the diagnostic work-up of IAP as complementary techniques. EUS had a higher diagnostic accuracy than MRCP (64% vs 34%) in the etiologic diagnosis of IAP and should be preferred for establishing a possible biliary disease and CP diagnosis, whereas S-MRCP was superior to EUS and MRCP in diagnosing a possible anatomic alteration in the biliopancreatic duct system, such as pancreatic divisum.
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Gastrointest. Endosc. · May 2018
Randomized Controlled Trial Comparative StudyContinued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.
Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients. ⋯ Endoscopists performing moderate sedation should continue midazolam rather than switching to diphenhydramine in patients who do not achieve adequate sedation with usual doses of midazolam and an opioid. (Clinical trial registration number: NCT01769586.).
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Gastrointest. Endosc. · May 2018
Effectiveness of a cap-assisted device in the endoscopic removal of food bolus obstruction from the esophagus.
The use of a transparent cap has been found to be effective for retrieval of an esophageal foreign body. However, data on the use of a cap in food bolus obstruction (FBO) are limited. This study aims to assess the effectiveness of a cap-assisted technique compared with conventional techniques in removal of FBO. ⋯ The cap-assisted technique has been found to be effective and safe in removal of esophageal FBO. This technique was associated with a shorter procedural time and a reduced LOS compared with conventional techniques. However, these findings require further validation in a randomized control study.
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Gastrointest. Endosc. · Mar 2018
Multicenter Study Comparative Study Observational StudyA prospective comparison of live and video-based assessments of colonoscopy performance.
Colonoscopy performance is typically assessed by a supervisor in the clinical setting. There are limitations of this approach, however, because it allows for rater bias and increases supervisor workload demand during the procedure. Video-based assessment of recorded procedures has been proposed as a complementary means by which to assess colonoscopy performance. This study sought to investigate the reliability, validity, and feasibility of video-based assessments of competence in performing colonoscopy compared with live assessment. ⋯ Video-based assessments of colonoscopy procedures using the GiECAT have strong evidence of reliability and validity. In addition, assessments using videos were feasible, although live assessments were easier.