How to Learn a Complex Endoscopic Procedure

Background & Aims: Respiratory complications represent an important adverse event of endoscopic procedures. We screened for respiratory complications after endoscopic procedures using a questionnaire and followed-up patients suggestive of respiratory infection.Method: In this prospective observational, multicenter study performed in Outpatient practices of gastroenterology we investigated 15,690 patients by questionnaires administered 24 hours after the endoscopic procedure.Results: 832 of the 15,690 patients stated at least one respiratory symptom after the endoscopic procedure: 829 patients reported coughing (5.28%), 23 fever (0.15%) and 116 shortness of breath (SOB, 0.74%); 130 of the 832 patients showed at least two concomitant respiratory symptoms (107 coughing + SOB, 17 coughing + fever, 6 coughing + coexisting fever + SOB) and 126 patients were followed-up to assess their respiratory complaints. Twenty-nine patients (follow-up: 22.31%, whole sample: 0.18%) reported signs of clinically evident respiratory infection and 15 patients (follow-up: 11.54%; whole sample: 0.1%) received therefore antibiotic treatment. Coughing or vomiting during the endoscopic procedure resulted in a 156.12-fold increased risk of respiratory complications (95% CI: 67.44 - 361.40) and 520.87-fold increased risk of requiring antibiotic treatment (95% CI: 178.01 - 1524.05). All patients of the follow-up sample who coughed or vomited during endoscopy developed clinically evident signs of respiratory infection and required antibiotic treatment while this occurred in a significantly lower proportion of patients without these symptoms (17.1% and 5.1%, respectively).Conclusions: We demonstrated that respiratory complications following endoscopic sedation are of comparably high incidence and we identified major predictors of aspiration pneumonia which could influence future surveillance strategies after endoscopic procedures.

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Open Versus Endoscopic Osteotomy of Posterosuperior Calcaneal Tuberosity for Haglund Syndrome: A Retrospective Cohort Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211001055 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712110010

Author(s):

Yanbin Pi ◽

Yuelin Hu ◽

Qinwei Guo ◽

Dong Jiang ◽

Xin Xie ◽

...

Keyword(s):

Cohort Study ◽

Learning Curve ◽

Endoscopic Surgery ◽

Extent Of Resection ◽

Endoscopic Procedure ◽

Postoperative Outcomes ◽

Open Procedure ◽

Surgery Group ◽

Duration Of Surgery

Background: Although endoscopic calcaneoplasty and retrocalcaneal debridement have been extensively applied to treat Haglund syndrome, evidence of the value of the endoscopic procedure remains to be fully established. Purpose/Hypothesis: The purpose of this study was to compare the postoperative outcomes and the amount of osteotomy between open and endoscopic surgery for the treatment of Haglund syndrome. It was hypothesized that endoscopic calcaneoplasty would lead to higher patient satisfaction and lower complication rates compared with open surgical techniques. Study Design: Cohort study; Level of evidence, 3. Methods: The following postoperative outcomes were compared between the open surgery group (n = 20) and the endoscopic surgery group (n = 27): visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot scale, Foot Function Index, Tegner score, Ankle Activity Score, and 36-Item Short Form Health Survey; postoperative complications; and duration of surgery. To determine the extent of resection, the authors compared the calcaneal height ratio, calcaneal resection ratio, calcaneal resection angle, pitch line, and Haglund deformity height between groups. The learning curve for endoscopic calcaneoplasty was also calculated. Results: There were no significant differences between the open and endoscopic groups on any outcome score. Two patients in the open group reported temporary paresthesia around the incisional site, indicating sural nerve injuries; no complication was reported in the endoscopy group. None of the parameters for extent of resection were statistically significant between the groups. The duration of surgery was 44.90 ± 10.52 and 65.39 ± 11.12 minutes in the open and endoscopy groups, respectively ( P = .001). Regarding the learning curve for endoscopic calcaneoplasty (6 surgeons; 27 follow-up patients; 9 patients lost to follow-up), the duration of surgery reached a steady point of 55.68 ± 4.19 minutes after the fourth operation. Conclusion: The results of this study indicated that the endoscopy procedure was as effective as the open procedure. The endoscopic procedure required significantly more time than the open procedure, and the duration of the endoscopic procedure was shortened only after the fourth operation, suggesting that it requires high technical skills and familiarity with the anatomic relationships.

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Sa1477 Early Endoscopic Procedure Reduces Hospitalization Period in High AIMS65 Scored-Non Variceal Upper Gastrointestinal Bleeding Patients

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.1314 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB230

Author(s):

Hee Seok Moon ◽

Sun Hyung Kang ◽

Jaekyu Sung ◽

Hyun Yong Jeong

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Endoscopic Procedure ◽

Hospitalization Period ◽

Upper Gastrointestinal

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Nosocomial Acinetobacter Genomic Species 13 TU Endocarditis Following an Endoscopic Procedure

Internal Medicine ◽

10.2169/internalmedicine.47.0826 ◽

2008 ◽

Vol 47 (8) ◽

pp. 799-802 ◽

Cited By ~ 13

Author(s):

Lai Yu-Hsien ◽

Chen Te-Li ◽

Chen Chien-Pei ◽

Tsai Chen-Chi

Keyword(s):

Endoscopic Procedure ◽

Genomic Species

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Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children's Hospital experience

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.5.peds1128 ◽

2011 ◽

Vol 8 (2) ◽

pp. 165-170 ◽

Cited By ~ 80

Author(s):

Manish N. Shah ◽

Alex A. Kane ◽

J. Dayne Petersen ◽

Albert S. Woo ◽

Sybill D. Naidoo ◽

...

Keyword(s):

Length Of Stay ◽

Blood Loss ◽

Open Surgery ◽

Operating Time ◽

Endoscopic Procedure ◽

Sagittal Craniosynostosis ◽

Helmet Therapy ◽

Age At Surgery ◽

The Mean ◽

Strip Craniectomy

Object This study investigated the differences in effectiveness and morbidity between endoscopically assisted wide-vertex strip craniectomy with barrel-stave osteotomies and postoperative helmet therapy versus open calvarial vault reconstruction without helmet therapy for sagittal craniosynostosis. Methods Between 2003 and 2010, the authors prospectively observed 89 children less than 12 months old who were surgically treated for a diagnosis of isolated sagittal synostosis. The endoscopic procedure was offered starting in 2006. The data associated with length of stay, blood loss, transfusion rates, operating times, and cephalic indices were reviewed. Results There were 47 endoscopically treated patients with a mean age at surgery of 3.6 months and 42 patients with open-vault reconstruction whose mean age at surgery was 6.8 months. The mean follow-up time was 13 months for endoscopic versus 25 months for open procedures. The mean operating time for the endoscopic procedure was 88 minutes, versus 179 minutes for the open surgery. The mean blood loss was 29 ml for endoscopic versus 218 ml for open procedures. Three endoscopically treated cases (6.4%) underwent transfusion, whereas all patients with open procedures underwent transfusion, with a mean of 1.6 transfusions per patient. The mean length of stay was 1.2 days for endoscopic and 3.9 days for open procedures. Of endoscopically treated patients completing helmet therapy, the mean duration for helmet therapy was 8.7 months. The mean pre- and postoperative cephalic indices for endoscopic procedures were 68% and 76% at 13 months postoperatively, versus 68% and 77% at 25 months postoperatively for open surgery. Conclusions Endoscopically assisted strip craniectomy offers a safe and effective treatment for sagittal craniosynostosis that is comparable in outcome to calvarial vault reconstruction, with no increase in morbidity and a shorter length of stay.

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Digital Recording and Documentation of Endoscopic Procedures: Do Patients and Doctors Think Alike?

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2016/2493470 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Nadav Willner ◽

Maya Peled-Raz ◽

Dan Shteinberg ◽

Michal Shteinberg ◽

Dean Keren ◽

...

Keyword(s):

Endoscopic Procedure ◽

Survey Study ◽

Digital Recording ◽

Background Factors ◽

Endoscopic Procedures ◽

Endoscopy Unit ◽

Number Of Patients ◽

Digital Documentation

Aims and Methods.Conducting a survey study of a large number of patients and gastroenterologists aimed at identifying relevant predictors of interest in digital recording and documentation (DRD) of endoscopic procedures. Outpatients presenting to the endoscopy unit at our institution for an endoscopy examination were anonymously surveyed, regarding their views and opinions of a possible recording of the procedure. A parallel survey for gastroenterologists was conducted.Results.417 patients and 62 gastroenterologists participated in two parallel surveys regarding DRD of endoscopic procedures. 66.4% of the patients expressed interest in digital documentation of their endoscopic procedure, with 90.5% of them requesting a copy. 43.6% of the physicians supported digital recording while 27.4% opposed it, with 48.4% opposing to making a copy of the recording available to the patient. No sociodemographic or background factors predicted patient’s interest in DRD. 66% of the physicians reported having recording facilities in their institutions, but only 43.6% of them stated performing recording. Having institutional guidelines for DRD was found to be the only significant predictor for routine recording.Conclusions.Our study exposes patients’ positive views of digital recording and documentation of endoscopic procedures. In contrast, physicians appear to be much more reluctant towards DRD and are centrally motivated by legal concerns when opposing DRD, as well as when supporting it.

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Considerations Regarding Monitored Anesthesia Care under Endoscopic Sedation : Endoscopic Procedure Rooms Currently at Risk

THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA ◽

10.2199/jjsca.34.151 ◽

2014 ◽

Vol 34 (1) ◽

pp. 151-160 ◽

Cited By ~ 1

Author(s):

Toshiyasu SUZUKI

Keyword(s):

At Risk ◽

Endoscopic Procedure ◽

Anesthesia Care ◽

Monitored Anesthesia Care

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Schwannoma of the arythenoid

Einstein (São Paulo) ◽

10.1590/s1679-45082013000200015 ◽

2013 ◽

Vol 11 (2) ◽

pp. 224-226 ◽

Cited By ~ 5

Author(s):

Carlos Eduardo Molinari Nardi ◽

Alexandre Wakil Burzichelli ◽

Elio Gilberto Pfuetzenreiter ◽

Rogerio Aparecido Dedivitis

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Schwann Cells ◽

Rare Case ◽

Nerve Fibers ◽

Endoscopic Procedure ◽

The Central Nervous System

Schwannoma is a benign encapsulated tumor that originates from the Schwann cells lining nerve fibers outside the central nervous system. We report a rare case of schwannoma that arose from the left arythenoid cartilage The patient underwent excision of the mass through microlaryngeal endoscopic procedure. No recurrence was observed during follow-up.

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