scholarly journals Esophageal overtubes provide no benefit to safety or technical success in upper gastrointestinal tract endoscopic suturing

2019 ◽  
Vol 07 (07) ◽  
pp. E919-E921 ◽  
Author(s):  
Andrew C. Storm ◽  
Eric J. Vargas ◽  
Reem Matar ◽  
Louis M. Wong Kee Song ◽  
Tarek Sawas ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Adverse Events ◽  
Defect Closure ◽  
Full Thickness ◽  
Technical Success ◽  
Endoscopic Suturing ◽  
Defect Repair ◽  
Stent Fixation ◽  
Upper Gastrointestinal

Abstract Background and study aim The role of esophageal overtubes in upper gastrointestinal endoscopic suturing is unknown. This study aimed to determine whether overtube use was associated with technical success or adverse events. Patients and methods A retrospective review of consecutive patients who underwent endoscopic suturing for various indications was performed. Results A total of 719 patients underwent endoscopic suturing for various indications, including endoscopic bariatric procedures in 262, stent fixation in 258, defect closure in 190, and hemostasis in nine. An overtube was used in 186 procedures (25.9 %). Technical success was achieved in all cases. Minor mucosal trauma occurred in 15 cases (8.1 %) with use of an overtube, and none without an overtube (P < 0.0001). No full-thickness esophageal perforation or hemorrhage related to overtube use or the suturing device occurred. Conclusions Endoscopic suturing can be performed safely for a variety of indications, including endoscopic bariatric procedures, defect repair, and stent fixation without an esophageal overtube. Minor esophageal mucosal trauma and equipment cost are increased when an overtube is used.

scholarly journals Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

2018 ◽  
Vol 06 (02) ◽  
pp. E217-E223 ◽  
Author(s):  
Saowanee Ngamruengphong ◽  
Reem Sharaiha ◽  
Amrita Sethi ◽  
Ali Siddiqui ◽  
Christopher DiMaio ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Stent Migration ◽  
Metal Stents ◽  
Stricture Formation ◽  
Endoscopic Suturing ◽  
Stent Removal ◽  
Gastrointestinal Conditions ◽  
Significant Difference ◽  
Stent Fixation ◽  
Upper Gastrointestinal

Abstract Background and study aims Self-expandable metallic stents (SEMS) have been increasingly used in benign conditions (e. g. strictures, fistulas, leaks, and perforations). Fully covered SEMS (FSEMS) were introduced to avoid undesirable consequences of partially covered SEMS (PSEMS), but come with higher risk of stent migration. Endoscopic suturing (ES) for stent fixation has been shown to reduce migration of FSEMS. Our aim was to compare the outcomes of FSEMS with ES (FS/ES) versus PSEMS in patients with benign upper gastrointestinal conditions. Patients and methods We retrospectively identified all patients who underwent stent placement for benign gastrointestinal conditions at seven US tertiary-care centers. Patients were divided into two groups: FSEMS with ES (FS/ES group) and PSEMS (PSEMS group). Clinical outcomes between the two groups were compared. Results A total of 74 (FS/ES 46, PSEMS 28) patients were included. On multivariable analysis, there was no significant difference in rate of stent migration between FS/ES (43 %) and PSEMS (15 %) (adjusted odds ratio 0.56; 95 % CI 0.15 – 2.00). Clinical success was similar [68 % vs. 64 %; P = 0.81]. Rate of adverse events (AEs) was higher in PSEMS group [13 (46 %) vs. 10 (21 %); P = 0.03). Difficult stent removal was higher in the PSEMS group (n = 5;17 %) vs. 0 % in the FS/ES group; P = 0.005. Conclusions The proportion of stent migration of FS/ES and PSEMS are similar. Rates of other stent-related AEs were higher in the PSEMS group. PSEMS was associated with tissue ingrowth or overgrowth leading to difficult stent removal, and secondary stricture formation. Thus, FSEMS with ES for stent fixation may be the preferred modality over PSEMS for the treatment of benign upper gastrointestinal conditions.

scholarly journals Corrosive injury of the upper gastrointestinal tract: the evolving role of a radiologist

2020 ◽  
Vol 93 (1114) ◽  
pp. 20200528
Author(s):  
Ayushi Agarwal ◽  
Deep Narayan Srivastava ◽  
Kumble Seetharama Madhusudhan
Keyword(s):  
Gastrointestinal Tract ◽  
Ct Scan ◽  
Upper Gastrointestinal Tract ◽  
Stricture Formation ◽  
Emergency Setting ◽  
Oral Contrast ◽  
Long Term Outcome ◽  
Corrosive Injury ◽  
Upper Gastrointestinal

Corrosive injury is a devastating injury which carries significant morbidity. The upper gastrointestinal tract is predominantly affected with severity ranging from mild inflammation to full thickness necrosis which may result in perforation and death. Among the complications, stricture formation is most common, causing dysphagia and malnutrition. Endoscopy has a pivotal role in the diagnosis and management, with a few shortcomings. Imaging has an important role to play. Besides radiography, there is an increasing role of CT scan in the emergency setting with good accuracy in identifying patients who are likely to benefit from surgery. Further, CT scan has a role in the diagnosis of complications. Oral contrast studies help in assessing the severity and extent of stricture formation and associated fistulous complications in the subacute and chronic phase. The scope of intervention radiology for this condition is increasing. Fluoroscopy-guided balloon dilatation, drainage of collections or mucoceles, endovascular embolization of point bleeders, placement of feeding jejunostomy and image-guided biopsy are among the procedures that are being performed. Through this review we aim to stress the role the radiologist plays in the diagnosis and follow-up of these patients and in performing radiological interventions. Besides this, we have also highlighted few salient points to help understand the pathophysiology and management of such injuries which is paramount to ensure a good long-term outcome.

Tu1116 FULL-THICKNESS RESECTION DEVICE (FTRD) FOR TREATMENT OF UPPER GASTROINTESTINAL TRACT LESIONS: THE FIRST INTERNATIONAL EXPERIENCE

2019 ◽  
Vol 89 (6) ◽  
pp. AB565-AB566 ◽  
Author(s):  
Kaveh Hajifathalian ◽  
Qais M. Dawod ◽  
Danny Issa ◽  
Alexander Meining ◽  
Arthur Schmidt ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
International Experience ◽  
Upper Gastrointestinal Tract ◽  
Full Thickness ◽  
Upper Gastrointestinal

scholarly journals Clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dong Ryeol Yoo ◽  
Chang Bin Im ◽  
Baek Gyu Jun ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
Foreign Bodies ◽  
Early Recognition ◽  
Upper Gastrointestinal Tract ◽  
Endoscopic Management ◽  
Endoscopic Removal ◽  
Foreign Objects ◽  
Upper Gastrointestinal

Abstract Background Ingested foreign objects frequently require emergency removal. This study aimed to investigate the clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract and the risk factors for adverse events. Methods Adults (> 18 years) who underwent endoscopic management of ingested foreign bodies at two centers, one inland and one on the coast, between January 2008 and December 2017 were eligible. Clinical characteristics and procedure-related outcomes were retrospectively reviewed. Patients were divided into two groups, based on whether the foreign bodies were sharp or blunt in shape. Results A total of 853 patients aged 19–96 years were analyzed. Ingestion of fish bones was more common in the coastal area, whereas ingestion of food boluses was more common in the inland area. The duration of impaction ranged from 1 h to over 1 month and was significantly longer in patients who ingested blunt than sharp foreign bodies (15 vs. 5 h, p < 0.001). Most (98.9%) foreign bodies were successfully removed. Adverse events occurred in 31.2 % of patients, including ulcers (4.0%) and perforations (3.3 %). Multivariate analysis showed that age (odds ratio [OR] 1.015, p = 0.012), sharp foreign bodies (OR 5.133, p < 0.001), location in the esophagus (OR 2.723, p = 0.018), and duration of impaction (OR 1.431, p < 0.001) were factors associated with adverse events. Conclusions Early recognition and timely endoscopic removal of ingested foreign bodies, particularly in elderly patients and those with sharp foreign bodies, may improve clinical outcomes.

scholarly journals Increased epithelial permeability syndrome in organic diseases of the upper gastrointestinal tract: systematization of literature data

2021 ◽  
Vol 23 (5) ◽  
pp. 422-427
Author(s):  
Dmitrii N. Andreev ◽  
◽  
Elena V. Ul'iankina ◽  
Keyword(s):  
Gastric Ulcer ◽  
Gastrointestinal Tract ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Comprehensive Analysis ◽  
Upper Gastrointestinal Tract ◽  
Pathophysiological Mechanism ◽  
Epithelial Permeability ◽  
Upper Gastrointestinal

In 2021, the first Multidisciplinary national consensus was published in Russia. The document provides a comprehensive analysis of pathophysiological, clinical and pharmacotherapeutic aspects of the increased epithelial permeability syndrome (IEPS) as one of the main mechanisms of human diseases. A separate chapter of the consensus devoted to the role of IEPS in organic diseases of the upper gastrointestinal tract demonstrates the importance of this pathophysiological mechanism in the genesis of this group of diseases. This review aims to systematize the literature data on the role of IEPS in organic diseases of the upper gastrointestinal tract, including gastroesophageal reflux disease, chronic gastritis and gastric ulcer.

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