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| 1 | Changes in efficiency and resource utilization after increasing experience with double balloon enteroscopy显示文摘AIM:To investigate changes in efficiency and resource utilization as a single endoscopist's experience increased with each subsequent 100 double balloon enteroscopy(DBE) procedures.METHODS:We reviewed consecutive DBE procedures performed by a single endoscopist at our center over 4 years.DBE was employed when the clinician deemed the procedure was needed for disease management.The approach(oral,anal or both) was chosen based on suspected location of the target lesion.All DBE was performed in a standard endoscopy room with a portable fluoroscopy unit.Fluoroscopy was used to aid in shortening the small intestine and reducing bowel loops.For oral DBE,measurements were taken from the incisors.For anal DBE,measurements were taken from the anal verge.Enteroscopy continued until the target lesion was reached,until the entire small intestine was examined,or until no further progress was deemed possible.The length of small intestine examined(cm),procedure duration(min),and fluoroscopy time(s) were analyzed for sequential groups of 100 DBE.Sub-groups of diagnostic and therapeutic procedures were analyzed using multivariable linear regression.RESULTS:802 consecutive DBE procedures were analyzed.For oral DBE,median [interquartile range(IQR)] length of small bowel examined was 230.8 cm(range:210-248 cm) and for anal DBE was 143.5 cm(range:100-180 cm).No significant increase in length examined was noted for either the oral or anal approach with advancing position in series.In terms of duration of procedure,the median(IQR) for oral DBE was 86 min(range:71-105 min) and for anal DBE was 81.3 min(range:67-105 min).When comparing by the position in series,there was a significant(P value < 0.001) decrease in procedure duration for both upper and lower procedures with increasing experience.Median(IQR) time of exposure to fluoroscopy for oral DBE was 190 s(114-275) compared to anal DBE which was 196.4 s(312-128).This represented a significant(P value < 0.001) decrease in the amount of fluoroscopy used with increasing position in series.For both oral and anal DBE,fluoroscopy time was reduced by greater than 50% over the course of 802 total procedures performed.Sub-group analysis was conducted on therapeutic and diagnostic groups.Out of 802 procedures,a total of 434 were considered therapeutic.Argon plasma coagulation was by far the most common therapeutic intervention performed.There was no evidence of a difference in length examined or fluoroscopy exposure among oral DBE for diagnostic and therapeutic procedures,P = 0.91 and P = 0.32 respectively.The median(IQR) for length was 235 cm(range:178-280 cm) for diagnostic vs 230 cm(range:180-275 cm) for therapeutic procedures;additionally,fluoroscopy time median(IQR) was 180 s(range:110-295 s) and 162 s(range:102-263 s) for no intervention and intervention.However,there was a significant difference in procedure duration among oral DBE(P < 0.001).The median(IQR) was 80 min(range:60-97 min) and 94 min(range:77-110 min) for diagnostic and therapeutic interventions respectively.CONCLUSION:For a single endoscopist,increased DBE experience with number of performed procedures is associated with increased efficiency and decreased resource utilization. | Neal C Patel William C Palmer Kanwar R Gill David Cangemi Nancy Diehl Mark E Stark | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，3： | 2 |
| 2 | De- El / velopment and clinical validation of a real-time PCRusing a uni-molecular Scorpion-based probe for the detection of Mycoplasma pneumoniae in clinical iso- lates显示文摘 | / DIM E CANGEMI G FILIPPETTI M | 2007 | New h4icrobiol2007，30，4： | 1 |
| 3 | Development and clinical validation of a real - time PCR using a uni - molecular Scolpion - based probe for the detection of Mycoplasma pneumoniae in clinical isolates显示文摘 | Di M E Cangemi G Filippetti M | 2007 | New Microbiol2007，30，4： | 1 |
| 4 | De-velopment and clinical validation of a real-time PCR using a unmolecular Scorpion-based probe for the de- tection of Mycoplasma pneumoniae in clinical isolates 显示文摘 | DIM E CANGEMI G FILIPPETTI M | 2007 | NewMicrobiol2007，30，4： | 1 |
| 5 | Development and clinical validation of a real-time PCR using a uni-molecular Scorpion-based probe for the detection of mycoplasma pneumoniae in clinical isolates显示文摘 | Di Marco E Cangemi G Filippetti M | 2007 | New Microbiol2007，30，4： | 1 |
| 6 | Development and clinical validation of a real-time PCR using a unimolecular Scorpion based probe for the detection of mycoplasma pneumoniae in clinical isolates显示文摘 | Di Marco E Cangemi G Filippetti M Melioli G Biassoni R | 2007 | New Microbiol2007，30，： | 1 |
| 7 | Risk of mortality from cardiovascular and respiratory causes in patients with chronic obstructive pulmonary disease submitted to follow-up after lung resection for non-small cell lung cancer显示文摘 | Volpino P Cangemi R Fiori E | 2007 | J Cardiovasc Surg (Torino)2007，48，3： | 1 |
| 8 | Risk of mortality from cardiovascular and respiratory causes in patients with chronic obstructive pulmonary disease submitted to follow-up after lung resection for non-small cell lung caneer显示文摘 | Volpino P Cangemi R Fiori E | 2007 | J Cardiovasc Surg (Torino)2007，48，3： | 1 |
| 9 | Development and clinical validation of a real-time PCR using a uni-molecular Scorpionbased probe for the detection of Mycoplasma pneumoniae in clinical isolates显示文摘 | Di Marco E Cangemi G Filippetti M | 2007 | New Microbiol2007，30，4： | 1 |
| 10 | TOZAL study:an open case control study of an oral antioxidant and omega-3 supplement for dry AMD显示文摘 | Cangemi F E | 2007 | BMC Ophthalmology2007，7，1： | 1 |
| 11 | Risk of mortality from cardiovascular and respiratory causes in patients with chronic obstructive pulmonary disease submitted to follow up after lung resection for nonsmall cell lung cancer 显示文摘 | Volpino P Cangemi R Fiori E | 2007 | J Cardiovasc Surg (Torino)2007，48，3： | 1 |
| 12 | Neuroendocrine (HPA ax?is) and clinical correlates during fluvoxamine and amitriptyline treatment显示文摘 | Rota E Broda R Cangemi L | 2005 | Psychiatry Res2005，133，： | 1 |
| 13 | Gender, lifestyles, illness perception and stress in stable atrial fibrillation显示文摘 | Trovato GM Pace P Cangemi E | 2012 | Clin Ter2012，163，4： | 1 |
| 14 | Early gallbladdercarcinoma:a single-center experience显示文摘 | Cangemi V Fiori E Picchi C | 2006 | Tumori2006，92，6： | 1 |
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