BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used ga...BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.展开更多
With the digestive endoscopic tunnel technique(DETT), many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscular...With the digestive endoscopic tunnel technique(DETT), many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria(MP). Through the tunnel, endoscopic diagnosis or treatment is performed for lesions in the mucosa, in the MP, and even outside the gastrointestinal(GI) tract.At present, the tunnel technique application range covers the following:(1)Treatment of lesions originating from the mucosal layer, e.g., endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis;(2) treatment of lesions from the MP layer, per-oral endoscopic myotomy, submucosal tunnelling endoscopic resection, etc.; and(3) diagnosis and treatment of lesions outside the GI tract, such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity. With the increasing number of DETTs performed worldwide, endoscopic tunnel therapeutics, which is based on DETT, has been gradually developed and optimized. However, there is not yet an expert consensus on DETT to regulate its indications, contraindications, surgical procedure, and postoperative treatment.The International DETT Alliance signed up this consensus to standardize the procedures of DETT. In this consensus, we describe the definition, mechanism,and significance of DETT, prevention of infection and concepts of DETTassociated complications, methods to establish a submucosal tunnel, and application of DETT for lesions in the mucosa, in the MP and outside the GI tract(indications and contraindications, procedures, pre-and postoperative treatments, effectiveness, complications and treatments, and a comparison between DETT and other operations).展开更多
Endoscopic ultrasound(EUS) is one of the most important modalities for the diagnosis of digestive tract diseases.EUS has been evolving ever since it was introduced.New techniques such as elastography and contrast enha...Endoscopic ultrasound(EUS) is one of the most important modalities for the diagnosis of digestive tract diseases.EUS has been evolving ever since it was introduced.New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy.EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions.Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents.This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.展开更多
Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for t...Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy,prov-iding a new direction for the treatment of gastroparesis.With the recent and rapid development of G-POME therapy technology,progress has been made in the treatment of gastroparesis and other upper digestive tract diseases,such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture,with G-POME.This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.展开更多
BACKGROUND Gastric cancer(GC)has high morbidity and mortality.Moreover,because GC has no typical symptoms in the early stages,most cases are already in the advanced stages by the time the symptoms appear,thus resultin...BACKGROUND Gastric cancer(GC)has high morbidity and mortality.Moreover,because GC has no typical symptoms in the early stages,most cases are already in the advanced stages by the time the symptoms appear,thus resulting in poor prognosis and a low survival rate.Endoscopic submucosal dissection(ESD)can realize the early detection and diagnosis of GC and become the main surgical method for early GC.However,ESD has a steep learning curve and high technical skill requirements for endoscopists,which is not conducive to its widespread implementation and advancement.Therefore,a series of auxiliary techniques have been derived.AIM To evaluate the safety and efficacy of magnetic anchor technique(MAT)-assisted ESD in early GC.METHODS This was an ex vivo animal experiment.The experimental models were the isolated stomachs of pigs,which were divided into two groups,namely the study group(n=6)with MAT-assisted ESD and the control group(n=6)with traditional ESD.Comparing the total surgical time,incidence of surgical complications,complete mucosal resection rate,specimen size,and the scores of endoscopist’s satisfaction with the procedure reflected their feelings about convenience during the surgical procedure between the two groups.The magnetic anchor device for auxiliary ESD in the study group comprised three parts,an anchor magnet(AM),a target magnet(TM),and a soft tissue clip.Under gastroscopic guidance,the soft tissue clip and the TM were delivered to the pre-marked mucosal lesion through the gastroscopic operating hole.The soft tissue clip and the TM were connected by a thin wire through the TM tail structure.The soft tissue clip was released by manipulating the operating handle of the soft tissue clip in a way that the soft tissue clip and the TM were fixed to the lesion mucosa.In vitro,ESD is aided by maneuvering the AM such that the mucosal dissection surface is exposed.RESULTS The total surgical time was shorter in the study group than in the control group(26.57±0.19 vs 29.97±0.28,P<0.001),and the scores of endoscopist’s satisfaction with the procedure were higher in the study group than in the control group(9.53±0.10 vs 8.00±0.22,P<0.001).During the operation in the study group,there was no detachment of the soft tissue clip and TM and no mucosal tearing.The magnetic force between the AM and TM provided good mucosal exposure and sufficient tissue tension for ESD.The mucosal lesion was completely peeled off,and the operation was successful.There were no significant differences in the incidence of surgical complications(100%vs 83.3%),complete mucosal resection rate(100%vs 66.7%,P=0.439),and specimen size(2.44±0.04 cm vs 2.49±0.02,P=0.328)between the two groups.CONCLUSION MAT-ESD is safe and effective for early GC.It provides a preliminary basis for subsequent internal animal experiments and clinical research.展开更多
目的为了解决综合性医院内镜中心清洗任务繁重、管理不完善、清洗质量难以达标等出现的诸多问题,使用基于物联网技术的内镜清洗追溯的信息化管理系统,并对系统进行应用效果评价。方法结合物联网、5G通信技术和信息化集成方法,在B/S架构...目的为了解决综合性医院内镜中心清洗任务繁重、管理不完善、清洗质量难以达标等出现的诸多问题,使用基于物联网技术的内镜清洗追溯的信息化管理系统,并对系统进行应用效果评价。方法结合物联网、5G通信技术和信息化集成方法,在B/S架构下构建出以Web网页技术实现的系统应用端,选择SQL server数据库作为服务器系统支撑,同时结合嵌入式ARM架构,由NB⁃IOT联网功能和低功耗的射频识别技术(radio frequency identification,RFID)刷卡功能组成的C⁃Link作为硬件功能模块。采用3种检测方式(生物学检测、ATP抽检检测和追溯合格率)对系统应用进行统计学分析。结果在使用物联网新系统后信息追溯功能满意度提升了12.29%,生物学检测、ATP抽检检测率和追溯合格率分别提升了14.86%、12.71%和17.43%,相比传统的方式有着明显的提升。结论基于物联网技术的内镜清洗追溯系统对提高工作效率、预防医院感染和实现医院规范化管理有着实际价值。展开更多
文摘BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.
基金Supported by National Key R and D Program of China,No.2016YFC1303601
文摘With the digestive endoscopic tunnel technique(DETT), many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria(MP). Through the tunnel, endoscopic diagnosis or treatment is performed for lesions in the mucosa, in the MP, and even outside the gastrointestinal(GI) tract.At present, the tunnel technique application range covers the following:(1)Treatment of lesions originating from the mucosal layer, e.g., endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis;(2) treatment of lesions from the MP layer, per-oral endoscopic myotomy, submucosal tunnelling endoscopic resection, etc.; and(3) diagnosis and treatment of lesions outside the GI tract, such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity. With the increasing number of DETTs performed worldwide, endoscopic tunnel therapeutics, which is based on DETT, has been gradually developed and optimized. However, there is not yet an expert consensus on DETT to regulate its indications, contraindications, surgical procedure, and postoperative treatment.The International DETT Alliance signed up this consensus to standardize the procedures of DETT. In this consensus, we describe the definition, mechanism,and significance of DETT, prevention of infection and concepts of DETTassociated complications, methods to establish a submucosal tunnel, and application of DETT for lesions in the mucosa, in the MP and outside the GI tract(indications and contraindications, procedures, pre-and postoperative treatments, effectiveness, complications and treatments, and a comparison between DETT and other operations).
文摘Endoscopic ultrasound(EUS) is one of the most important modalities for the diagnosis of digestive tract diseases.EUS has been evolving ever since it was introduced.New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy.EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions.Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents.This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.
文摘Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy,prov-iding a new direction for the treatment of gastroparesis.With the recent and rapid development of G-POME therapy technology,progress has been made in the treatment of gastroparesis and other upper digestive tract diseases,such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture,with G-POME.This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.
基金Supported by the Key Research&Development Program-Social Development of Shaanxi Province of China,No.2021SF-163the Innovation Capability Support Plan of Shaanxi Province of China,No.2020KJXX-022.
文摘BACKGROUND Gastric cancer(GC)has high morbidity and mortality.Moreover,because GC has no typical symptoms in the early stages,most cases are already in the advanced stages by the time the symptoms appear,thus resulting in poor prognosis and a low survival rate.Endoscopic submucosal dissection(ESD)can realize the early detection and diagnosis of GC and become the main surgical method for early GC.However,ESD has a steep learning curve and high technical skill requirements for endoscopists,which is not conducive to its widespread implementation and advancement.Therefore,a series of auxiliary techniques have been derived.AIM To evaluate the safety and efficacy of magnetic anchor technique(MAT)-assisted ESD in early GC.METHODS This was an ex vivo animal experiment.The experimental models were the isolated stomachs of pigs,which were divided into two groups,namely the study group(n=6)with MAT-assisted ESD and the control group(n=6)with traditional ESD.Comparing the total surgical time,incidence of surgical complications,complete mucosal resection rate,specimen size,and the scores of endoscopist’s satisfaction with the procedure reflected their feelings about convenience during the surgical procedure between the two groups.The magnetic anchor device for auxiliary ESD in the study group comprised three parts,an anchor magnet(AM),a target magnet(TM),and a soft tissue clip.Under gastroscopic guidance,the soft tissue clip and the TM were delivered to the pre-marked mucosal lesion through the gastroscopic operating hole.The soft tissue clip and the TM were connected by a thin wire through the TM tail structure.The soft tissue clip was released by manipulating the operating handle of the soft tissue clip in a way that the soft tissue clip and the TM were fixed to the lesion mucosa.In vitro,ESD is aided by maneuvering the AM such that the mucosal dissection surface is exposed.RESULTS The total surgical time was shorter in the study group than in the control group(26.57±0.19 vs 29.97±0.28,P<0.001),and the scores of endoscopist’s satisfaction with the procedure were higher in the study group than in the control group(9.53±0.10 vs 8.00±0.22,P<0.001).During the operation in the study group,there was no detachment of the soft tissue clip and TM and no mucosal tearing.The magnetic force between the AM and TM provided good mucosal exposure and sufficient tissue tension for ESD.The mucosal lesion was completely peeled off,and the operation was successful.There were no significant differences in the incidence of surgical complications(100%vs 83.3%),complete mucosal resection rate(100%vs 66.7%,P=0.439),and specimen size(2.44±0.04 cm vs 2.49±0.02,P=0.328)between the two groups.CONCLUSION MAT-ESD is safe and effective for early GC.It provides a preliminary basis for subsequent internal animal experiments and clinical research.
文摘目的为了解决综合性医院内镜中心清洗任务繁重、管理不完善、清洗质量难以达标等出现的诸多问题,使用基于物联网技术的内镜清洗追溯的信息化管理系统,并对系统进行应用效果评价。方法结合物联网、5G通信技术和信息化集成方法,在B/S架构下构建出以Web网页技术实现的系统应用端,选择SQL server数据库作为服务器系统支撑,同时结合嵌入式ARM架构,由NB⁃IOT联网功能和低功耗的射频识别技术(radio frequency identification,RFID)刷卡功能组成的C⁃Link作为硬件功能模块。采用3种检测方式(生物学检测、ATP抽检检测和追溯合格率)对系统应用进行统计学分析。结果在使用物联网新系统后信息追溯功能满意度提升了12.29%,生物学检测、ATP抽检检测率和追溯合格率分别提升了14.86%、12.71%和17.43%,相比传统的方式有着明显的提升。结论基于物联网技术的内镜清洗追溯系统对提高工作效率、预防医院感染和实现医院规范化管理有着实际价值。
