Endoscopy
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Randomized Controlled Trial Multicenter Study
Carbon dioxide insufflation improves intubation depth in double-balloon enteroscopy: a randomized, controlled, double-blind trial.
Double-balloon enteroscopy (DBE) has been proven effective for deep intubation of the small bowel. However, intubation depth is limited by distention of the small bowel due to air insufflation during the procedure. The present trial investigated whether carbon dioxide (CO (2)) instead of standard air insufflation would improve intubation depth during DBE, as well as reduce postprocedure pain. ⋯ CO (2) insufflation significantly extended intubation depth in DBE. CO (2) insufflation also reduces patient discomfort. CO (2) insufflation may lead to a higher diagnostic and therapeutic yield of DBE, with reduced patient discomfort.
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Comparative Study
Autofluorescence endoscopy versus conventional white light endoscopy for the detection of superficial gastric neoplasia: a prospective comparative study.
Preliminary studies have suggested autofluorescence endoscopy (AFE) to be accurate in the diagnosis of gastric tumors. Our prospective blinded study systematically compared AFE with white light endoscopy (WLE) for the detection of superficial gastric neoplasia. ⋯ Although one quarter of elevated gastric neoplasias were detected only by AFE, its specificity is poor; therefore its clinical value is limited.
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Ultrasonographic elastography is a new technique for describing the mechanical properties of tissue during real-time ultrasonography. The aim of this study was to test the feasibility of this method in endosonography (EUS) of the dorsal mediastinum, and to compare the elastographic patterns of lymph nodes with results from EUS-guided fine-needle aspiration biopsy (FNAB). ⋯ EUS elastography of mediastinal lymph nodes can be performed reliably. The results are good for a noninvasive technique, but they remain inferior to the success rate of EUS-guided FNAB. The method might occasionally be useful for targeting the most suitable lymph nodes for FNAB.
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Physiologic reactions during natural orifice transluminal endoscopic surgery (NOTES) may differ from those at laparoscopy. This experimental study assessed the effect of pneumoperitoneum induced by endoscope air pump on hemodynamics and inspiratory pressures during transgastric peritoneoscopy. ⋯ On-demand insufflation with a standard endoscopic light source/insufflator resulted in a marked median increase and wide variation in IAP throughout transgastric peritoneoscopy. Hemodynamic changes were moderate. However, major increases in PIP suggest a need for stricter control of intra-abdominal hypertension during NOTES.