scholarly journals Composite detection rate as an upper gastrointestinal endoscopy quality measure correlating with detection of neoplasia

2021 ◽  
Author(s):  
Marcin Romańczyk ◽  
Bartosz Ostrowski ◽  
Tomasz Marek ◽  
Tomasz Romańczyk ◽  
Małgorzata Błaszczyńska ◽  
...  
Keyword(s):  
Detection Rate ◽  
Duodenal Bulb ◽  
General Setting ◽  
Quality Measure ◽  
University Hospital ◽  
Gastrointestinal Neoplasms ◽  
Upper Gastrointestinal Endoscopy ◽  
Group 4 ◽  
Upper Gastrointestinal ◽  
Group 1

Abstract Background Esophagogastroduodenoscopy (EGD) is commonly used diagnostic method with no widely accepted quality measure. We assessed quality indicator—composite detection rate (CDR)—consisting of detection of at least one of the following: cervical inlet patch, gastric polyp and post-ulcer duodenal bulb deformation. The aim of the study was to validate CDR according to detection rate of upper gastrointestinal neoplasms (UGN). Methods It was a multicenter, prospective, observational study conducted from January 2019 to October 2019. The endoscopic reports from 2896 symptomatic patients who underwent diagnostic EGD were analyzed. The EGDs were performed in three endoscopy units located in tertiary university hospital, private outpatient clinic and local hospital. Results 64 UGNs were detected. The mean CDR was 21.9%. The CDR correlated with UGN detection rate (R = 0.49, p = 0.045). Based on CDR quartiles, operators were divided into group 1 with CDR < 10%, group 2 with CDR 10–17%, group 3 with CDR 17.1–26%, and group 4 with CDR > 26%. Detection rate of UGN was significantly higher in the group 4 in comparison to group 1 (OR 4.4; 95% CI 2.2 − 9.0). In the multivariate regression model, patient age, male gender and operator’s CDR > 26% were independent risk factors of UGN detection (OR 1.03; 95% CI 1.01 − 1.05, OR 2; 95% CI 1.2 − 3.5, and OR 5.7 95% CI 1.5 − 22.3, respectively). Conclusions The CDR is associated with the detection of upper gastrointestinal neoplasms. This parameter may be a useful quality measure of EGD to be applied in general setting.

EP.WE.718An audit of the photographic documentation of upper gastrointestinal endoscopy at Cork University Hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Stephen O'Brien ◽  
Niamh Foley ◽  
Amy Edwards Murphy ◽  
Morgan McCourt ◽  
Shane Killeen ◽  
...  
Keyword(s):  
Performance Indicator ◽  
Duodenal Bulb ◽  
University Hospital ◽  
British Society ◽  
Gastric Body ◽  
Upper Gastrointestinal Endoscopy ◽  
Anatomical Landmarks ◽  
Technical Failure ◽  
Photographic Documentation ◽  
Upper Gastrointestinal

Abstract Introduction A joint statement by the British Society of Gastroenterology and the Association of Upper Gastrointestinal Surgeons in 2017 recommended that photographic documentation of relevant anatomical landmarks should be a Key Performance Indicator of oesophagogastroduodenoscopy (OGD). The aim of this study was to assess this photodocumentation standard among surgeons and gastroenterologists in a tertiary referral centre. Methods Cork University Hospital endoscopy unit records were examined for a 2-month period from 01/10/20-27/11/20. OGDs were performed by 3 consultant colorectal surgeons and 4 consultant gastroenterologists over the time period. Demographic data and photodoumentation information were obtained from the Endoraad GI reporting tool. Surgeons and gastroenterologists performances was compared using the chi-squared test. Results 104 OGDs were analysed. Fifty-three (51%) OGDs were performed in women and 51(49%) OGDs were performed by surgeons. The documentation for each site was; gastro-oesophageal junction- 68% (69/102), fundus on retroflexion- 71% (72/102), gastric body- 32% (33/102), antrum- 61% (62/102), and duodenal bulb- 35% (36/102), without significant differences (p &gt; 0.05) for these sites between surgeons and gastroenterologists. There was more documentation of the upper oesophagus by surgeons (31% vs.12%, p = 0.030) and there was more documentation of the distal duodenum by gastroenterologists (90% vs.47%, p &lt; 0.01). Pictures were unable to be saved in two patients due to technical failure. Discussion Photodocumentation is increasingly important from a medico-legal viewpoint. There is room for improvement in our centre, but these rates are comparable to other published series. An educational session is being planned and following this adherence to photodocumentation standards will be re-examined.

Duodenal Bulb Adenocarcinoma Benefitted from Neoadjuvant Chemotherapy: A Case Report

Chemotherapy ◽  
2017 ◽  
Vol 62 (5) ◽  
pp. 290-294 ◽  
Author(s):  
Geng-Yuan Zhang ◽  
Jie Mao ◽  
Bin Zhao ◽  
Bo Long ◽  
Hao Zhan ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Comprehensive Evaluation ◽  
Duodenal Bulb ◽  
Treatment Modalities ◽  
Pathological Examination ◽  
Upper Gastrointestinal Endoscopy ◽  
Tumor Type ◽  
Low Incidence ◽  
Rare Malignancy ◽  
Upper Gastrointestinal

Duodenal bulb adenocarcinoma is an extremely rare malignancy in the alimentary tract which has a low incidence rate and nonspecific symptoms. It is difficult to diagnose early, and the misdiagnosis rate is high. CT, MRI, upper gastrointestinal endoscopy, and other advanced imaging modalities should be combined to make a comprehensive evaluation. The diagnostic confirmation of this tumor type mainly depends on the pathological examination. The combination of surgery with other treatment modalities is effective. A review of reports on duodenal bulb adenocarcinoma with chemotherapy revealed 6 cases since 1990. However, there are few reports on neoadjuvant chemotherapy for the disease. In this report, preoperative S-1 in combination with oxaliplatin neoadjuvant chemotherapy achieved a complete pathological response in the treatment of duodenal bulb adenocarcinoma. Neoadjuvant chemotherapy shows a better clinical efficacy in the treatment of duodenal bulb adenocarcinoma, but its value needs to be further verified.

7074 Does new imaging process change the detection rate of disease in upper gastrointestinal endoscopy?

2000 ◽  
Vol 51 (4) ◽  
pp. AB260
Author(s):  
Toyohiro Sakata ◽  
Yasumasa Niwa ◽  
Hiroyuki Kameyama ◽  
Hidemi Goto ◽  
Tomiyasu Arisawa ◽  
...  
Keyword(s):  
Detection Rate ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Process Change ◽  
Upper Gastrointestinal

scholarly journals Prevalence of dual clarithromycin and metronidazole resistance in Helicobacter pylori estimated by molecular methods in Santiago, Chile

2017 ◽  
Author(s):  
Patricio Gonzalez-Hormazabal ◽  
Maher Musleh ◽  
Susana Escandar ◽  
Hector Valladares ◽  
Enrique Lanzarini ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Initial Approximation ◽  
Molecular Methods ◽  
University Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Metronidazole Resistance ◽  
Two Samples ◽  
H Pylori ◽  
Upper Gastrointestinal

AbstractBackgroundCurrent available treatments for Helicobacter pylori eradication are chosen according to local clarithromycin and metronidazole resistance prevalence. The aim of this study was to estimate, by means of molecular methods, both clarithromycin and metronidazole resistance in gastric mucosa from patients infected with H.pylori.MethodsA total of 191 DNA samples were analyzed. DNA was purified from gastric mucosa obtained from patients who underwent an upper gastrointestinal endoscopy at an university hospital from Santiago, Chile, between 2011 and 2014. H.pylori was detected by real-time PCR. A 5’exonuclease assay was developed to detect A2142G and A2143G mutations among Hpylori-positive samples. rdxA gene was sequenced in samples harboring A2142G and A2143G mutations in order to detect mutations that potentially confer dual clarithromycin and metronidazole resistance.ResultsNinety-three (93) out of 191 DNA samples obtained from gastric mucosa were H. pylori-positive (48.7%). Clarithromycin-resistance was detected in 29 samples (31.2% [95%CI 22.0%-41.6%]). The sequencing of rdxA gene revealed that two samples harbored truncating mutations in rdxA, one sample had an in-frame deletion, and 11 had amino acid changes that likely cause metronidazole resistance.ConclusionsWe estimated a prevalence of clarithomycin-resistance of 31.8% in Santiago, Chile. The proportion of dual clarithromycin and metronidazole resistance could be, at least, 15.0%. Our results require further confirmation. Nevertheless, they are significant as an initial approximation in re-evaluating the guidelines for H.pylori eradication currently used in Chile.

scholarly journals Ligation assisted endoscopic mucosal resection of neuroendocrine tumor of duodenal bulb: a case report with a follow up of 24 months

2019 ◽  
Vol 8 (1) ◽  
pp. 18-20
Author(s):  
Umid Kumar Shestha ◽  
Gopi Aryal
Keyword(s):  
Neuroendocrine Tumor ◽  
Distant Metastasis ◽  
Gastrointestinal Endoscopy ◽  
Duodenal Bulb ◽  
Upper Gastrointestinal Endoscopy ◽  
Solitary Lesion ◽  
Free Margin ◽  
Mucosal Resection ◽  
Upper Gastrointestinal

Duodenal neuroendocrine tumor (NET) is a rare solitary lesion arising from the mucosa and submucosa of the duodenum, which is found incidentally during upper gastrointestinal endoscopy. Eendoscopic Mucosal Resection (EMR) has been the commonly used endoscopic procedure for duodenal carcinoid tumors, but the conventional EMR done to resect duodenal NET s is likely to have positive vertical margins. However, the ligation assisted EMR has recently been shown to be a promising technique for the treatment of duodenal NET that can have a negative free margin. In our study, we present a patient of 51-year-old male, who presented with pain over epigastrium and upper gastrointestinal endoscopy revealed a small submucosal lesion of 10 mm in the duodenal bulb. The endoscopic ultrasound showed the lesion arising from the echo layer three. The biopsy was taken which showed the duodenal NET. The computed tomography of abdomen did not show any evidence of distant metastasis. The EMR of duodenal NET was done by band ligation technique. The biopsy from the resected duodenal lesion confirmed the duodenal NET with the margin free of the tumor. The patient was followed at 6, 12, 18 and 24 months. During the follow up visits, the repeat upper gastrointestinal endoscopy did not show recurrence of the lesion and there was no any evidence of distant metastasis either. Ligation assisted EMR is an acceptable treatment in the hands of expert for small duodenal NET without the evidence of metastasis and can ensure the complete removal of the lesion with vertical free margin.

Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1114-1120 ◽  
Author(s):  
Ahmed M. Elsaman ◽  
Ahmed R. Radwan ◽  
Walaa I. Mohammed ◽  
Sarah Ohrndorf
Keyword(s):  
Low Dose ◽  
University Hospital ◽  
Fluid Analysis ◽  
Group 4 ◽  
Knee Effusion ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Musculoskeletal Ultrasonography ◽  
Group 1

Objective.To evaluate the effectiveness of spironolactone as a treatment for osteoarthritis (OA)-related knee effusion in comparison to ibuprofen, cold compresses, and placebo.Methods.This study was carried out on 200 patients, aged 40 years or older, attending the outpatient clinic of the Rheumatology Department of Sohag University Hospital with unilateral knee effusion related to OA based on clinical examination, musculoskeletal ultrasonography (US), and synovial fluid analysis. In group 1, 50 patients received spironolactone 25 mg daily for 2 weeks; in group 2, 50 patients took ibuprofen 1200 mg daily for 2 weeks; in group 3, 50 patients used cold compresses 2 times daily for 2 weeks; and in group 4, 50 patients received placebo for the same duration. Fluid > 4 mm was considered as effusion. Decrease in fluid to reach below 4-mm thickness was considered complete improvement, and any decrease that did not reach below 4 mm thickness was considered partial improvement.Results.The mean age of the participants was 51.2 ± 8.1 years. The mean duration of effusion was 16.5 ± 3.6 days. In group 1, 66% had complete improvement, 20% partial improvement, and 14% no response. In group 2, 24% had complete improvement, 12% partial improvement, and 64% no response. In group 3, 28% had complete improvement, 14% partial improvement, and 58% no response. In group 4, only 6% had complete improvement, 10% partial improvement, and 84% no response.Conclusion.Low-dose spironolactone is a safe and effective medical treatment for OA-related knee effusion.

scholarly journals AB166. SOH21AS166. An audit of the photographic documentation of upper gastrointestinal endoscopy at Cork University Hospital

2021 ◽  
Vol 5 ◽  
pp. AB166-AB166
Author(s):  
Stephen John O’Brien ◽  
Niamh Foley ◽  
Amy Edwards Murphy ◽  
Morgan McCourt ◽  
Shane Killeen ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
University Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Photographic Documentation ◽  
Upper Gastrointestinal

scholarly journals The usage of prior upper gastrointestinal endoscopy among symptomatic patients undergoing cholecystectomy

2020 ◽  
Vol 7 (5) ◽  
pp. 1404
Author(s):  
Ayesha Jule Khan ◽  
Samridhi Gupta ◽  
Manu Kohli ◽  
Gopal S. Bhargava
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Signs And Symptoms ◽  
Biliary Colic ◽  
P Value ◽  
Upper Gastrointestinal Endoscopy ◽  
Gi Endoscopy ◽  
Gastrointestinal Lesions ◽  
Group 2 ◽  
Upper Gastrointestinal ◽  
Group 1

Background: Cholelithiasis is one of the most common problems encountered in surgery. It is an immense challenge to discriminate between signs and symptoms due to gastrointestinal lesions and gallstones diseases. The objective of this study was to evaluate the usage of pre-operative upper gastrointestinal endoscopy (UGE) as a routine in treating symptomatic gallstone patients.Methods: This prospective hospital based observational study was conducted in the Department of General Surgery at Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar from January 2018 to June 2019. 60 symptomatic gallstone patients were selected for cholecystectomy and preoperative upper gastrointestinal (GI) endoscopy evaluation was done for any associated upper gastrointestinal problems.Results: Out of the total patients, females constituted 85% of overall study patients and majority of the patients presented with atypical biliary colic symptoms (55%, group 2) whereas 45% presented with typical biliary colic symptoms (group 1) (p value=0.009). Relief rate was highest in group 1 with abnormal UGE than with group 2.Conclusions: The routine use of upper GI endoscopy in patients with symptomatic cholelithiasis prior to cholecystectomy will help reduce post-operative persistence of symptoms and thus, it is a useful investigation in the overall treatment of gallstone diseases. 

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