Gastrointestinal endoscopy clinics of North America
-
Gastrointest. Endosc. Clin. N. Am. · Oct 2010
ReviewMaximizing the value of the endoscopist-pathologist partnership in the management of colorectal polyps and carcinoma.
Good communication between clinician and pathologist is essential for optimal patient care and management of colorectal polyps and carcinoma. General principles of communication include making sure that the pathologist and endoscopist have all the information needed to make an accurate diagnosis and that the pathologist communicates the diagnosis back to the endoscopist in a clear and timely fashion. The increasing complexity of classification of colorectal polyps and carcinomas has added to the need for clear communication pathways. The first part of this article is devoted to an outline of general communication issues; the second is a discussion of current concepts in colorectal polyps and carcinomas.
-
Gastrointest. Endosc. Clin. N. Am. · Jan 2010
ReviewEndoscopic mucosal resection and endoscopic submucosal dissection for esophageal dysplasia and carcinoma.
Advanced cancer in the esophagus is a serious and fatal disease that invades locally to deeper layers of the esophageal wall with significant risk of nodal metastasis and invasion of adjacent organs. One reliable method of avoiding this is to detect lesions at an early stage of esophageal cancer and then to resect them locally. ⋯ EMR includes strip-off biopsy, double-channel techniques, cap technique, EMR using a ligating device, and so on. ESD is a newly developed technique in which submucosal dissection is carried out using an electrocautery knife to acquire a single-piece specimen.
-
Endocytoscopy is a new imaging and magnification technology. It has been developed for observation of cellular structure and applied in the esophageal cancer. In this article we summarize the important aspects of this new modality.
-
Best sedation practices for pediatric endoscopy involve the consideration of many patient factors, including age, medical history, clinical status, and anxiety level, as well as physician access to anesthesia support. A recent survey of pediatric gastroenterologists suggests that endoscopist-administered intravenous (iv) sedation and anesthesiologist-administered propofol represent common sedation regimens in children. Technical advances in ventilatory monitoring are contributing to increased patient safety for all children undergoing gastrointestinal procedures, regardless of sedation type.
-
Gastrointest. Endosc. Clin. N. Am. · Oct 2008
ReviewGastroenterologist-directed propofol: an update.
Gastroenterologist directed propofol has been proven safe in more than 220,000 published cases. Administration of low doses of opioid and/or benzodiazepine ("balanced propofol sedation") is the safest format for gastroenterologist directed propofol. Specific training is needed to undertake gastroenterologist directed propofol administration.