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Clinical Endoscopy update

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

수록정보
55권1호(2022) |수록논문 수 : 26
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55권2호(2022년 03월) 수록논문
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KCI등재 SCOPUS

12021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

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

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 167-182 (16 pages)

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Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk. Clin Endosc 2022;55:167-182

KCI등재 SCOPUS

2Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art

저자 : Alessia Chini , Michele Manigrasso , Grazia Cantore , Rosa Maione , Marco Milone , Francesco Maione , Giovanni Domenico De Palma

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 183-190 (8 pages)

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Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential. Clin Endosc 2022;55:183-190

KCI등재 SCOPUS

3Single Use (Disposable) Duodenoscope: Recent Development and Future

저자 : Kihyun Ryu , Sunguk Jang

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 191-196 (6 pages)

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Unlike simple forward-viewing endoscopes such as gastroscope or colonoscope, duodenoscope houses much more complex design to fulfil its function. This design differences leave duodenoscopes more prone to contamination from inadequate disinfection process and potential dissemination of pathogens. Recent reports on dissemination of infection through the duodenoscope mandated an overhaul of duodenoscope utilization including development of a disposable duodenoscope. This article reviews the current state of disposable duodenoscope development, including reported early efficacy as well as its future direction and utilization. Clin Endosc 2022;55:191-196

KCI등재 SCOPUS

4Confocal Laser Endomicroscopy in the Diagnosis of Biliary and Pancreatic Disorders: A Systematic Analysis

저자 : Do Han Kim , Somashekar G. Krishna , Emmanuel Coronel , Paul T. Kröner , Herbert C. Wolfsen , Michael B. Wallace , Juan E. Corral

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 197-207 (11 pages)

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Background/Aims: Endoscopic visualization of the microscopic anatomy can facilitate the real-time diagnosis of pancreatobiliary disorders and provide guidance for treatment. This study aimed to review the technique, image classification, and diagnostic performance of confocal laser endomicroscopy (CLE).
Methods: We conducted a systematic review of CLE in pancreatic and biliary ducts of humans, and have provided a narrative of the technique, image classification, diagnostic performance, ongoing research, and limitations.
Results: Probe-based CLE differentiates malignant from benign biliary strictures (sensitivity, ≥89%; specificity, ≥61%). Needle-based CLE differentiates mucinous from non-mucinous pancreatic cysts (sensitivity, 59%; specificity, ≥94%) and identifies dysplasia. Pancreatitis may develop in 2-7% of pancreatic cyst cases. Needle-based CLE has potential applications in adenocarcinoma, neuroendocrine tumors, and pancreatitis (chronic or autoimmune). Costs, catheter lifespan, endoscopist training, and interobserver variability are challenges for routine utilization.
Conclusions: CLE reveals microscopic pancreatobiliary system anatomy with adequate specificity and sensitivity. Reducing costs and simplifying image interpretation will promote utilization by advanced endoscopists. Clin Endosc 2022;55:197-207

KCI등재 SCOPUS

5A Novel Aerosol-Exposure Protection Mask for Patients During Upper Endoscopy

저자 : Soo-jeong Cho

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 208-209 (2 pages)

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6Fecal Calprotectin as a Surrogate Marker for Mucosal Healing After Initiating the Therapeutic Anti-Tubercular Trial

저자 : Satimai Aniwan

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 210-212 (3 pages)

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7Predicting Malignancy by Peroral Pancreatoscopy of an Intraductal Papillary Mucinous Neoplasm with a Dilated Main Pancreatic Duct: Is Seeing Enough?

저자 : Yun Nah Lee , Jong Ho Moon

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 213-214 (2 pages)

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8Perception of Gastrointestinal Endoscopy Personnel on Society Recommendations on Personal Protective Equipment, Case Selection, and Scope Cleaning During Covid-19 Pandemic: An International Survey Study

저자 : Parit Mekaroonkamol , Kasenee Tiankanon , Rapat Pittayanon , Wiriyaporn Ridtitid , Fariha Shams , Ghias Un Nabi Tayyab , Julia Massaad , Saurabh Chawla , Stanley Khoo , Siriboon Attasaranya , Nonthalee Pausawasdi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 215-225 (11 pages)

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Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them.
Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables.
Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039).
Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines. Clin Endosc 2022;55:215-225

KCI등재 SCOPUS

9Preclinical Efficacy and Clinical Feasibility of a Novel Aerosol-Exposure Protection Mask for Esophagogastroduodenoscopy

저자 : Mai Ego Makiguchi , Seiichiro Abe , Yutaka Okagawa , Satoru Nonaka , Haruhisa Suzuki , Shigetaka Yoshinaga , Ichiro Oda , Okamoto Ryuta , Yutaka Saito

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 226-233 (8 pages)

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Background/Aims: This study aimed to assess the efficacy of a novel aerosol-exposure protection (AP) mask in preventing coronavirus disease in healthcare professionals during upper gastrointestinal endoscopy and to evaluate its clinical feasibility.
Methods: In Study 1, three healthy volunteers volitionally coughed with and without the AP mask in a cleanroom. Microparticles were visualized and counted with a specific measurement system and compared with and without the AP mask. In Study 2, 30 patients underwent endoscopic resection with the AP mask covering the face, and the SpO2 was measured throughout the procedure.
Results: In Study 1, the median number of microparticles in volunteers 1, 2, and 3 with and without the AP mask was 8.5 and 110.0, 7.0 and 51.5, and 8.0 and 95.0, respectively (p<0.01). Using the AP mask, microparticles were reduced by approximately 92%. The median distances of microparticle scattering without the AP mask were 60, 0, and 68 in volunteers 1, 2, and 3, respectively. In Study 2, the mean SpO2 was 96.3%, and desaturation occurred in three patients.
Conclusion: The AP mask could provide protection from aerosol exposure and can be safely used for endoscopy in clinical practice. Clin Endosc 2022;55:226-233

KCI등재 SCOPUS

10Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam

저자 : Ji Hyung Nam , Dong Kee Jang , Jun Kyu Lee , Hyoun Woo Kang , Byung-wook Kim , Byung Ik Jang

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 55권 2호 발행 연도 : 2022 페이지 : pp. 234-239 (6 pages)

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Background/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxical reactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients who previously experienced paradoxical reactions.
Methods: This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions to midazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation) or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction.
Results: A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II (n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did not differ between groups.
Conclusions: Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam was readministered. Clin Endosc 2022;55:234-239

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KCI등재SCOUPUS

1Anesthesia for Advanced Endoscopic Procedures

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

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2When to Discharge a Patient After Endoscopy: A Narrative Review

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

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3Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors

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

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4Radiation Proctitis and Management Strategies

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

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5Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

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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7Is General Anesthesia Needed in Endoscopic Submucosal Dissection for Lesions Located in the Mid to Upper Stomach?

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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8Artificial Intelligence-Based Colorectal Polyp Histology Prediction: High Accuracy in Larger Polyps

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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9Value of Endoscopic Ultrasonography in Evaluating Unexplained Isolated Common Bile Duct Dilation on Imaging

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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10Impact of the COVID-19 Outbreak on Anesthesiologist Assistance for Endoscopic Procedures

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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