• Title/Summary/Keyword: Endoscopy, gastrointestinal

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New sedatives and analgesic drugs for gastrointestinal endoscopic procedures

  • 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;Endoscopic Sedation Committee of the Korean Society of Gastrointestinal Endoscopy
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.581-587
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    • 2022

  • 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.

  • https://doi.org/10.5946/ce.2021.283 인용 PDF

Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett's esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis

  • Igor Logetto Caetite Gomes;Diogo Turiani Hourneaux de Moura;Igor Braga Ribeiro;Sergio Barbosa Marques;Alexandre de Sousa Carlos;Beanie Conceicao Medeiros Nunes;Bruno Salomao Hirsch;Guilherme Henrique Peixoto de Oliveira;Roberto Paolo Trasolini;Wanderley Marques Bernardo;Eduardo Guimaraes Hourneaux de Moura
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.181-190
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    • 2024

  • Background/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett's esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported. Methods: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

  • https://doi.org/10.5946/ce.2023.065 인용 PDF

Submucosal endoscopy: the present and future

  • Zaheer Nabi;Duvvur Nageshwar Reddy
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.23-37
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    • 2023

  • Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

  • https://doi.org/10.5946/ce.2022.139 인용 PDF

Preparation of image databases for artificial intelligence algorithm development in gastrointestinal endoscopy

  • Chang Bong Yang;Sang Hoon Kim;Yun Jeong Lim
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.594-604
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    • 2022

  • 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.

  • https://doi.org/10.5946/ce.2021.229 인용 PDF