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대한소화기내시경학회> Clinical Endoscopy

Clinical Endoscopy update

  • : 대한소화기내시경학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 격월
  • : 2234-2400
  • : 2234-2443
  • : 대한소화기내시경학회지(~2011)→Clinical Endoscopy(2012~)

수록정보
55권1호(2022) |수록논문 수 : 26
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55권5호(2022년 09월) 수록논문
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KCI등재 SCOPUS

저자 : Jae Min Lee , Yehyun Park , Jin Myung Park , Hong Jun Park , Jun Yong Bae , Seung Young Seo , Jee Hyun Lee , Hyung Ku Chon , Jun-won Chung , Hyun Ho Choi , Jun Kyu Lee , Byung-wook Kim

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 581-587 (7 pages)

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Procedural sedation has become increasingly common in endoscopy. Sedatives and analgesics induce anxiolysis and amnesia. In addition, an appropriate level of sedation is necessary for safe procedures including therapeutic endoscopy. Midazolam and propofol are the most commonly used drugs in sedative endoscopy. In recent years, the need to ascertain the safety and effectiveness of sedation has increased in practice. Therefore, new sedatives and analgesic drugs for optimal sedative endoscopy, have recently emerged. This article reviews the characteristics of sedatives and analgesics, and describes their clinical use in gastrointestinal endoscopy.

KCI등재 SCOPUS

저자 : Chawisa Nampoolsuksan , Vitoon Chinswangwatanakul , Asada Methasate , Jirawat Swangsri , Atthaphorn Trakarnsanga , Chainarong Phalanusitthepha , Thammawat Parakonthun , Voraboot Taweerutchana , Nicha Srisuworanan , Tha

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 588-593 (6 pages)

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In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

KCI등재 SCOPUS

저자 : Chang Bong Yang , Sang Hoon Kim , Yun Jeong Lim

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 594-604 (11 pages)

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Over the past decade, technological advances in deep learning have led to the introduction of artificial intelligence (AI) in medical imaging. The most commonly used structure in image recognition is the convolutional neural network, which mimics the action of the human visual cortex. The applications of AI in gastrointestinal endoscopy are diverse. Computer-aided diagnosis has achieved remarkable outcomes with recent improvements in machine-learning techniques and advances in computer performance. Despite some hurdles, the implementation of AI-assisted clinical practice is expected to aid endoscopists in real-time decision-making. In this summary, we reviewed state-of-the-art AI in the field of gastrointestinal endoscopy and offered a practical guide for building a learning image dataset for algorithm development.

KCI등재 SCOPUS

저자 : Mamoru Takenaka , Masatoshi Kudo

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 605-614 (10 pages)

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The double-guidewire method has been increasingly used in endoscopic procedures for biliary and pancreatic diseases in recent years, including endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography-related procedures. In addition, double-lumen catheters with uneven distal and proximal lumen openings have been introduced, making it possible to easily create a double-guidewire situation, and the usefulness of the double-guidewire technique using uneven double-lumen cannulas has been widely reported. Although the advantages of using two guidewires depend on the particular situation and the appropriate use of the two guidewires, deepening the knowledge of the double-guidewire method will contribute greatly to troubleshooting in daily practice. In this review, the usefulness of the double-guidewire technique is discussed with respect to two main areas: selective insertion of guidewires and devices and biliary cannulation.

KCI등재 SCOPUS

저자 : Suprabhat Giri , Shivaraj Afzalpurkar , Sumaswi Angadi , Sridhar Sundaram

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 615-625 (11 pages)

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Background/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis.
Methods: A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs.
Results: Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89-1.04) and procedural time (mean difference=-4.53 seconds; 95% CI, -22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71-0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83-1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63-0.89). Six studies reported no adverse events.
Conclusions: MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.

KCI등재 SCOPUS

저자 : Dong-hoon Yang

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 626-627 (2 pages)

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KCI등재 SCOPUS

저자 : Seok Jeong

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 628-629 (2 pages)

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KCI등재 SCOPUS

저자 : Shivanand Bomman , Sofya Malashanka , Adil Ghafoor , David J. Sanders , Shayan Irani , Richard A. Kozarek , Andrew Ross , Michal Hubka , Rajesh Krishnamoorthi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 630-636 (7 pages)

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Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution's programmatic allocation of resources during the safe implementation of TIF as a new procedure.
Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was performed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and outcomes were evaluated during transition.
Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure duration was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02).
Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effective transition to a fully outpatient procedure.

KCI등재 SCOPUS

저자 : Joon Seop Lee , Chang Min Cho , Yong Hwan Kwon , An Na Seo , Han Ik Bae , Man-hoon Han

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 637-644 (8 pages)

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Background/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs.
Methods: In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques.
Results: The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis.
Conclusions: SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.

KCI등재 SCOPUS

저자 : Nisa Netinatsunton , Natcha Cheewasereechon , Tanawat Pattarapuntakul , Jaksin Sottisuporn , Kanet Kanjanapradit , Bancha Ovartlarnporn

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 5호 발행 연도 : 2022 페이지 : pp. 645-654 (10 pages)

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Background/Aims: Narrow Band Imaging (NBI) International Colorectal Endoscopic (NICE) and Workgroup Serrated Polyps and Polyposis (WASP) classifications were developed for optical diagnosis of neoplastic and sessile serrated polyps, respectively. Near-focus NBI with NICE combined with WASP criteria for optical diagnosis of colonic polyps has not yet been evaluated. We aimed to compare the accuracy of near-focus NBI (group A) with normal-focus NBI (group B) in real-time optical diagnosis of colorectal polyps using combined NICE and WASP criteria.
Methods: Among 362 patients, 118 with 227 polyps were recruited. Groups A and B included 62 patients with 130 polyps (three lost polyps) and 56 patients with 106 polyps (six lost polyps), respectively. Optical diagnoses were compared with pathological reports.
Results: The accuracy of optical diagnosis of neoplastic polyps in groups A and B was not significantly different (76% vs. 71%, p=0.52). WASP criteria provided all false positive diagnoses of sessile polyps as serrated polyps in 31 (16.2%) patients.
Conclusions: Near-focus NBI was not superior to normal-focus NBI in optical diagnostics of neoplastic polyps using NICE criteria. In our study, WASP classification yielded all false positives in the diagnosis of sessile serrated adenomas/polyps. Routine real-life optical diagnosis of polyps is still unadvisable.

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KCI등재SCOUPUS

저자 : Basavana Goudra , Monica Saumoy

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 1-7 (7 pages)

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The gastrointestinal endoscopy paradigm is rapidly changing, and technological advancements are largely responsible. In tandem, anesthesia providers are adapting to the changing needs and demands. The challenges are unique. Complications arising from the procedures are both routine, such as aspiration and hypoxia, and procedure specific, such as bleeding, pneumothorax, pneumopericardium, and pneumoperitoneum. It is crucial for the anesthesia provider to have a good understanding of the techniques employed by the endoscopist. A higher index of suspicion is also essential to diagnose and appropriately manage many of the complications. In this review, an effort is made to discuss both procedural aspects and anesthesia challenges. We hope that both endoscopists and anesthesia providers will benefit from this review. Clin Endosc 2022;55:1-7

KCI등재SCOUPUS

저자 : Swapnil Sahebrao Walke , Shamshersingh Chauhan , Vikas Pandey , Rahul Jadhav , Vipul Chaudhari , Deepti Vishwanathan , Kailash Kolhe , Meghraj Ingle

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 8-14 (7 pages)

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Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia. Clin Endosc 2022;55:8-14

KCI등재SCOUPUS

저자 : Tetsuya Suwa , Kohei Takizawa , Noboru Kawata , Masao Yoshida , Yohei Yabuuchi , Yoichi Yamamoto , Hiroyuki Ono

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 15-21 (7 pages)

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Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist's skill. Clin Endosc 2022;55:15-21

KCI등재SCOUPUS

저자 : Dushyant Singh Dahiya , Asim Kichloo , Faiz Tuma , Michael Albosta , Farah Wani

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 22-32 (11 pages)

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Radiotherapy (RT) is a treatment modality that uses high-energy rays or radioactive agents to generate ionizing radiation against rapidly dividing cells. The main objective of using radiation in cancer therapy is to impair or halt the division of the tumor cells. Over the past few decades, advancements in technology, the introduction of newer methods of RT, and a better understanding of the pathophysiology of cancers have enabled physicians to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues. However, RT has numerous complications, the most common being radiation proctitis (RP). It is characterized by damage to the rectal epithelium by secondary ionizing radiation. Based on the onset of signs and symptoms, post-radiotherapy RP can be classified as acute or chronic, each with varying levels of severity and complication rates. The treatment options available for RP are limited, with most of the data on treatment available from case reports or small studies. Here, we describe the types of RT used in modern-day medicine and radiation-mediated tissue injury. We have primarily focused on the classification, epidemiology, pathogenesis, clinical features, treatment strategies, complications, and prognosis of RP. Clin Endosc 2022;55:22-32

KCI등재SCOUPUS

저자 : Shivanand Bomman , Munish Ashat , Navroop Nagra , Mahendran Jayaraj , Shruti Chandra , Richard A Kozarek , Andrew Ross , Rajesh Krishnamoorthi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 33-40 (8 pages)

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Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates.
Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model.
Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I2=94.96).
Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted. Clin Endosc 2022;55:33-40

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KCI등재SCOUPUS

저자 : Prasit Mahawongkajit , Jirawat Swangsri

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 43-44 (2 pages)

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KCI등재SCOUPUS

저자 : Naoki Muguruma , Tetsuji Takayama

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 45-46 (2 pages)

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KCI등재SCOUPUS

저자 : Seifeldin Hakim , Amrita Sethi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 47-48 (2 pages)

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KCI등재SCOUPUS

저자 : Calcedonio Calcara , Camilla Ciscato , Arnaldo Amato , Emanuele Sinagra , Costanza Alvisi , Sandro Ardizzone , Andrea Anderloni , Pietro Gambitta

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 1호 발행 연도 : 2022 페이지 : pp. 49-57 (9 pages)

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Background/Aims: The coronavirus disease 2019 (COVID-19) outbreak has modified the activities of endoscopy units worldwide. Herein, we investigated the impact of the COVID-19 outbreak on anesthesiologist assistance for endoscopic procedures in Lombardy, Italy.
Methods: A questionnaire concerning anesthesiologist assistance provided from October 26 to December 6, 2020, in comparison with the same period in 2019, was sent to endoscopic units in Lombardy.
Results: Approximately 54% (34/63) of the units responded. A reduction in the number of all endoscopies (-33.5%; 18792 in 2020 vs. 28264 in 2019) and anesthesiologist-assisted endoscopies (-15.3%; 2652 in 2020 vs. 3132 in 2019) was reported. A greater reduction in anesthesiologist assistance was observed in government community units (-29.5%) than in academic (-14%) and private community units (-4.6%). Among all units, 85% reported a reduction in anesthesiologist assistance; 65% observed a delay/ cancellation of procedures; 59%, a restricted patient selection; 17%, the need to transfer some patients to other hospitals; and 32%, a related worsening of procedure quality.
Conclusion: The COVID-19 pandemic compromised the anesthesiologist assistance for endoscopic procedures in Lombardy, which worsened the procedure quality mainly in government community units. The COVID-19 “stress test” suggests a more balanced allocation of anesthesiologic resources in the future. Clin Endosc 2022;55:49-57

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