Endoscopy
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Randomized Controlled Trial Comparative Study
High definition colonoscopy combined with i-Scan is superior in the detection of colorectal neoplasias compared with standard video colonoscopy: a prospective randomized controlled trial.
Colonoscopy is the accepted gold standard for the detection of colorectal cancer. The aim of the current study was to prospectively compare high definition plus (HD+) colonoscopy with I-Scan functionality (electronic staining) vs. standard video colonoscopy. The primary endpoint was the detection of patients having colon cancer or at least one adenoma. ⋯ HD+ colonoscopy with I-Scan is superior to standard video colonoscopy in detecting patients with colorectal neoplasia based on this prospective, randomized, controlled trial.
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Randomized Controlled Trial
Impact of fluoroscopy on oral double-balloon enteroscopy: results of a randomized trial in 156 patients.
The routine utility of fluoroscopy during double-balloon enteroscopy (DBE) via the oral route has been not prospectively evaluated. Up to now, there have been no prospective randomized trials to assess whether fluoroscopy improves outcomes. The aim of this study was to assess the value of fluoroscopy during oral DBE. ⋯ Fluoroscopy during DBE via the oral route does not provide a significant gain in insertion depth, advancement time, or diagnostic yield in comparison with nonfluoroscopically guided procedures. In experienced hands, fluoroscopy does not have to be used routinely during oral DBE.
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Comparative Study
Transcylindrical cholecystectomy under local anesthesia plus sedation. A pilot study.
The practice of laparoscopic cholecystectomy under local anesthesia is almost anecdotal. For 15 years we have been using a "transcylindrical cholecystectomy" technique for the treatment of cholelithiasis, cholecystitis, and choledocholithiasis. The present study was undertaken to assess the feasibility of transcylindrical cholecystectomy under local anesthesia through a prospective and longitudinal efficacy study. ⋯ Transcylindrical cholecystectomy under local anesthesia is a feasible technique that builds on the benefits of laparoscopic cholecystectomy, and confers an economic advantage and improved safety for patients.
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Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of mediastinal lymph nodes is increasingly used to detect noncaseating granulomas in patients with suspected sarcoidosis. The optimal needle size and tissue processing method for detecting noncaseating granulomas are debated. We assessed the value of cell-block analysis when added to conventional cytological evaluation of EUS aspirates obtained by 22-gauge needles in patients with stage I and II sarcoidosis. ⋯ Cell-block analysis added to conventional cytological evaluation of 22-gauge EUS aspirates, results in a high yield in detecting granulomas in patients with suspected sarcoidosis and reduces the false-negative rate substantially. EUS has a considerably higher yield in stage I compared with stage II sarcoidosis. For an optimal yield, four needle passes are required.