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| 1 | Portal hypertension and gastrointestinal bleeding:Diagnosis,prevention and management显示文摘Bleeding from esophageal varices is a life threatening complication of portal hypertension.Primary prevention of bleeding in patients at risk for a first bleeding episode is therefore a major goal.Medical prophylaxis consists of non-selective beta-blockers like propranolol or carvedilol.Variceal endoscopic band ligation is equally effective but procedure related morbidity is a drawback of the method.Therapy of acute bleeding is based on three strategies:vasopressor drugs like terlipressin,antibiotics and endoscopic therapy.In refractory bleeding,self-expandable stents offer an option for bridging to definite treatments like transjugular intrahepatic portosystemic shunt(TIPS).Treatment of bleeding from gastric varices depends on vasopressor drugs and on injection of varices with cyanoacrylate.Strategies for primary or secondary prevention are based on non-selective beta-blockers but data from large clinical trials is lacking.Therapy of refractory bleeding relies on shuntprocedures like TIPS.Bleeding from ectopic varices,portal hypertensive gastropathy and gastric antral vascular ectasia-syndrome is less common.Possible medical and endoscopic treatment options are discussed. | Erwin Biecker | 2013 | World Journal of Gastroenterology2013，19，31： | 47 |
| 2 | Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis显示文摘Recent advances in endoscopic technology allow detailed observation of the gastric mucosa.Today,endoscopy is used in the diagnosis of gastritis to determine the presence/absence of Helicobacter pylori(H.pylori)infection and evaluate gastric cancer risk.In 2013,the Japan Gastroenterological Endoscopy Society advocated the Kyoto classification,a new grading system for endoscopic gastritis.The Kyoto classification organized endoscopic findings related to H.pylori infection.The Kyoto classification score is the sum of scores for five endoscopic findings(atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness with or without regular arrangement of collecting venules)and ranges from 0 to 8.Atrophy,intestinal metaplasia,enlarged folds,and nodularity contribute to gastric cancer risk.Diffuse redness and regular arrangement of collecting venules are related to H.pylori infection status.In subjects without a history of H.pylori eradication,the infection rates in those with Kyoto scores of 0,1,and≥2 were 1.5%,45%,and 82%,respectively.A Kyoto classification score of 0 indicates no H.pylori infection.A Kyoto classification score of 2 or more indicates H.pylori infection.Kyoto classification scores of patients with and without gastric cancer were 4.8 and 3.8,respectively.A Kyoto classification score of 4 or more might indicate gastric cancer risk. | Osamu Toyoshima Toshihiro Nishizawa Kazuhiko Koike | 2020 | World Journal of Gastroenterology2020，26，5： | 44 |
| 3 | Novel image-enhanced endoscopy with i-scan technology显示文摘i-scan technology is the newly developed imageenhanced endoscopy technology from PENTAX,Japan.This consists of three types of algorithms:surface enhancement (SE),contrast enhancement (CE),and tone enhancement (TE).SE enhances light-dark contrast by obtaining luminance intensity data for each pixel and applying an algorithm that allows detailed observation of a mucosal surface structure.CE digitally adds blue color in relatively dark areas,by obtaining luminance intensity data for each pixel and applying an algorithm that allows detailed observation of subtle irregularities around the surface.Both enhancement functions work in real time without impairing the original color of the organ,therefore,SE and CE are suitable for screening endoscopy to detect gastrointestinal tumors at an early stage.TE dissects and analyzes the individual RGB components of a normal image.The algorithm then alters the color frequencies of each component and recombines the components to a single,new color image.This is designed to enhance minute mucosal structures and subtle changes in color.TE works in real time and consists of three modes such as TE-g for gastric tumors,TE-c for colonic tumors,and TE-e for esophageal tumors.TE is suitable mainly for detailed examination of the lesions that are detected in a screening endoscopy.i-scan technology leads us to easier detection,diagnosis and treatment of gastroi ntestinal diseases. | Shinya Kodashima Mitsuhiro Fujishiro | 2010 | World Journal of Gastroenterology2010，16，9： | 35 |
| 4 | Sedation in gastrointestinal endoscopy: Current issues显示文摘Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate(conscious) sedation.Moderate sedation,using midazolam and an opioid,is the standard method of sedation,although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation.Moreover,the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and,consequently,its low risk of inducing hepatic encephalopathy.In the future,propofol could become the preferred sedation agent,especially for routine colonoscopy.Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam.Among opioids,pethidine and fentanyl are the most popular.A number of other substances have been tested in several clinical trials with promising results.Among them,newer opioids,such as remifentanil,enable a faster recovery.The controversy regarding the administration of sedation by an endoscopist or an experienced nurse,as well as the optimal staffing of en-doscopy units,continues to be a matter of discussion.Safe sedation in special clinical circumstances,such as in the cases of obese,pregnant,and elderly individuals,as well as patients with chronic lung,renal or liver disease,requires modification of the dose of the drugs used for sedation.In the great majority of patients,sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide.In this review,an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. | John K Triantafillidis Emmanuel Merikas Dimitrios Nikolakis Apostolos E Papalois | 2013 | World Journal of Gastroenterology2013，19，4： | 35 |
| 5 | Risk factors for complications associated with upper gastrointestinal foreign bodies显示文摘AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract.METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract,confirmed by endoscopy,at two university hospital in South Korea.Patient demographic data,including age,gender,intention to ingestion,symptoms at admission,and comorbidities,were collected.Clinical features of the foreign bodies,such as type,size,sharpness of edges,number,and location,were analyzed.Endoscopic data those were analyzed included duration of foreign body impaction,duration of endoscopic performance,endoscopic device,days of hospitalization,complication rate,30-d mortality rate,and the number of operationsrelated to foreign body removal.RESULTS: The types of upper gastrointestinal foreign bodies included fish bones,drugs,shells,meat,metal,and animal bones.The locations of impacted foreign bodies were the upper esophagus(57.2%),mid esophagus(28.4%),stomach(10.8%),and lower esophagus(3.6%).The median size of the foreign bodies was 26.2 ± 16.7 mm.Among 194 patients,endoscopic removal was achieved in 189,and complications developed in 51 patients(26.9%).Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding(n = 31,16%),ulcer(n = 11,5.7%),perforation(n = 3,1.5%),and abscess(n = 1,0.5%).Four patients underwent operations because of incomplete endoscopic foreign body extraction.In multivariate analyses,risk factors for endoscopic complications and failure were sharpness(HR = 2.48,95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction(HR = 2.42,95%CI: 1.12-5.25,P = 0.025).CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects,rapid endoscopic intervention should be provided in patients with ingested foreign bodies. | Kyong Hee Hong Yoon Jae Kim Jae Hak Kim Song Wook Chun Hee Man Kim Jae Hee Cho | 2015 | World Journal of Gastroenterology2015，21，26： | 35 |
| 6 | A study of the efficacy of bacterial biofilm cleanout for gastrointestinal endoscopes显示文摘AIM:To compare the influence and clearance effect of enzymatic and non-enzymatic detergents against Escherichia coli (E. coli) biofilm on the inner surface of gastroscopes.METHODS:Teflon tubes were incubated in a mixture of different detergents and E. coli culture (106 CFU/mL) for 72 h at 15℃,and biofilms on the inner surface of the teflon tubes were analyzed by bacterial count and scanning electron microscopy. To evaluate the clear-ance effect of detergents,after biofilms were formed on the inner surface of Teflon tubes by 72 h lavage with E. coli culture,tubes were lavaged by enzymatic and non-enzymatic detergents at a speed of 250 mL/min,then biofilms on the inner surface were analyzed by bacterial count and scanning electron microscopy.RESULTS:Non-enzymatic detergent had a better inhi-bition function on biofilm formation than enzymatic de-tergent as it reduced bacterial burden by 2.4 log compared with the control samples (P = 0.00). Inhibition function of enzymatic detergent was not significantly different to that of control samples and reduced bac-terial burden by 0.2 log on average (P > 0.05). After lavaging at 250 mL/min for 3 min,no living bacteria were left in the tubes. Scanning electron microscopy observation showed biofi lms became very loose by the high shear force effect. CONCLUSION:Non-enzymatic detergent has a better inhibition effect on biofilm formation at room temperature. High speed pre-lavage and detergents are very important in temporal formed biofilm elimination. | Fang, Ying Shen, Zhe Li, Lan Cao, Yong Gu, Li-Ying Gu, Qing Zhong, Xiao-Qi Yu, Chao-Hui Li, You-Ming | 2010 | World Journal of Gastroenterology2010，16，8： | 28 |
| 7 | Endoscopic management of esophageal varices显示文摘The rupture of gastric varices results in variceal hemorrhage, which is one the most lethal complications of cirrhosis. Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). The advantages of EST are that it is cheap and easy to use, and the injection catheter fits through the working channel of a diagnostic gastroscope. Endoscopic variceal ligation obliterates varices by causing mechanical strangulation with rubber bands. The following review aims to describe the utility of EBL and EST in different situations, such as acute bleeding, primary and secondary | Joaquin Poza Cordon Consuelo Froilan Torres Aurora Burgos García Francisco Gea Rodriguez Jose Manuel Suárez de Parga | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，7： | 27 |
| 8 | Modern approach to cholecysto-choledocholithiasis显示文摘Gallstones and common bile duct calculi are found to be associated in 8%-20% of patients, leading to possible life-threatening complications, such as acute biliary pancreatitis, jaundice and cholangitis. The gold standard of care for gallbladder calculi and isolated common bile duct stones is represented by laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography, respectively, while a debate still exists regarding how to treat the two diseases at the same time. Many therapeutic options are also available when the two conditions are associated, including many different types of treatment, which local professionals often administer. The need to limit maximum discomfort and risks for the patients, combined with the economic pressure of reducing costs and utilizing resources, favors single-step procedures. However, a multitude of data fail to strongly demonstrate the superiority of any technique(including a two or multi-step approach), while rigorous clinical trials that include so many different types of treatment are still lacking, and it is most likely unrealistic to conduct them in the future. Therefore, the choice of the best management is often led by the local presence of professional expertise and resources, rather than by a real superiority of one strategy over another. | Lapo Bencini Cinzia Tommasi Roberto Manetti Marco Farsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，2： | 28 |
| 9 | Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding显示文摘Over the past two decades,transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis.Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options,have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications,such as peptic ulcerbleeding,malignant disease,hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding.Transcatheter interventions include the following:selective embolization of the feeding artery,sandwich coil occlusion of the gastroduodenal artery,blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery.Transcatheter embolization is a fast,safe and effective,minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract.This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies. | Romaric F Loffroy Basem A Abualsaud Ming D Lin Pramod P Rao | 2011 | World Journal of Gastrointestinal Surgery2011，3，7： | 28 |
| 10 | Risk of transmission of carbapenem-resistant Enterobacteriaceae and related “superbugs” during gastrointestinal endoscopy显示文摘To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's 'MEDLINE' database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or 'MAUDE'; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at 'Hospital X' located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospi-tal X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including broncho-scopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endos-copy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind andnear the forceps elevator located at the distal end othe ERCP endoscope, are recommended. If the ERCPendoscope features a narrow and exposed channel thathouses a wire connecting the GI endoscope's controhead to this forceps elevator, then this channel's com-plete reprocessing, including its flushing with a deter-gent using a procedure validated for effectiveness, is also emphasized. | Lawrence F Muscarella | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，10： | 26 |
| 11 | Magnifying narrow-band imaging endoscopy is superior in diagnosis of early gastric cancer显示文摘AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy. | Hang Yu Ai-Ming Yang Xing-Hua Lu Wei-Xun Zhou Fang Yao Gui-Jun Fei Tao Guo Li-Qing Yao Li-Ping He Bang-Mao Wang | 2015 | World Journal of Gastroenterology2015，21，30： | 26 |
| 12 | Endoscopic treatment for gastrointestinal stromal tumor: Advantages and hurdles显示文摘One of the most prominent characteristics of gastrointestinal stromal tumors(GISTs) is their unpredictable and variable behavior. GISTs are not classified as 'benign' or 'malignant' but are rather stratified by their associated clinical risk of malignancy as determined by tumor size, location, and number of mitoses identified during surgicalhistology. The difficulty in assessing the malignant potential and prognoses of GISTs as well as the increasing incidence of 'incidental GISTs' presents challenges to gastroenterologists. Recently, endoscopic enucleation has been actively performed as both a diagnostic and therapeutic intervention for GISTs. Endoscopic enucleation has several advantages, including keeping the stomach intact after the removal of GISTs, a relatively short hospital stay, a conscious sedation procedure, relatively low cost, and fewer human resources required compared with surgery. However, a low complete resection rate and the risk of perforation could reduce the overall advantages of this procedure. Endoscopic full-thickness resection appears to achieve a very high R0 resection rate. However, this technique absolutely requires a very skilled operator. Moreover, there is a risk of peritoneal seeding due to large active perforation. Laparoscopy endoscopy collaborations have been applied for more stable and pathologically acceptable management. These collaborative procedures have produced excellent outcomes. Many procedures have been developed and attempted because they were technically possible. However, we should first consider the theoretical basis for each technique. Until the efficacy and safety of sole endoscopic access are proved, the laparoscopy endoscopy collaborative procedure appears to be an appropriate method for minimally destructive GIST surgery. | Hyung Hun Kim | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，3： | 24 |
| 13 | Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia显示文摘AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. METHODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME examination overlooked GIM in 8 cases, but the GIM was less than 5% in 7 of the cases. Moreover, in the 6 false positive cases, the histological examination showed the presence of reactive gastropathy (4 cases) or H. pylori active chronic gastritis (2 cases). The semiquantitative correlation between the rate of LBC appearance and the percentage of GIM was 79% (P < 0.01). CONCLUSION:NBI-ME achieved good sensitivity and specificity in recognising GIM in an unselected population. In routine clinical practice, this technique can reliably target gastric biopsies. | Edoardo Savarino Marina Corbo Pietro Dulbecco Lorenzo Gemignani Elisa Giambruno Luca Mastracci Federica Grillo Vincenzo Savarino | 2013 | World Journal of Gastroenterology2013，19，17： | 23 |
| 14 | Review of the diagnosis and management of gastrointestinal bezoars显示文摘The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola? administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and management.Here we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case series.Recent progress in basic research regarding persimmonphytobezoars is also briefly reviewed. | Masaya Iwamuro Hiroyuki Okada Kazuhiro Matsueda Tomoki Inaba Chiaki Kusumoto Atsushi Imagawa Kazuhide Yamamoto | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，4： | 22 |
| 15 | 非静脉曲张性上消化道出血的诊断和管理:2015年欧洲胃肠道内镜协会指南介绍显示文摘2015年欧洲胃肠道内镜协会(European Society of Gastrointestinal Endoscopy,ESGE)在Endoscopy上发表了非静脉曲张性上消化道出血(NVUGIH)的诊断和管理指南。现将其主要推荐意见介绍如下。 | 朱新影 马欢 刘改芳 | 2017 | 中华消化内镜杂志2017，34，3： | 23 |
| 16 | Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment显示文摘Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel dis-ease(IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dys-plasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures. | Clayton M Spiceland Nilesh Lodhia | 2018 | World Journal of Gastroenterology2018，24，35： | 23 |
| 17 | Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding显示文摘AIM:To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their significance.METHODS: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during DBE.RESULTS: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular lesions.CONCLUSION: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required. | Hoi-Poh Tee Arthur J Kaffes | 2010 | World Journal of Gastroenterology2010，16，15： | 21 |
| 18 | Oral purgative and simethicone before small bowel capsule endoscopy显示文摘AIM:To evaluate small bowel cleansing quality,diagnostic yield and transit time,comparing three cleansing protocols prior to capsule endoscopy.METHODS:Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols:patients in Group A underwent a 24 h liquid diet and overnight fasting;patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol(PEG) the evening before the procedure;patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion.Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor,fair,good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization.When there was no agreement between the two endoscopists,the images were reviewed and discussed until a consensus was reached.The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition.The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images.Positive endoscopic findings,gastric emptying time(GET) and small bowel transit time(SBTT) were recorded for each examination.RESULTS:There was a trend favoring Group B in achieving an acceptable(including fair,good or excellent) level of cleansing(Group A:65%;Group B:83.3%;Group C:68.4%) [P = not significant(NS)] and favoring Group C in attaining an excellent level of cleansing(Group A:10%;Group B:16.7%;Group C:21.1%)(P = NS).The number of patients with an adequate cleansing of the small bowel,corresponding to an excellent or good classification,was 5(25%) in Group A,5(27.8%) in Group B and 4(21.1%) in Group C(P = 0.892).Conversely,7 patients(35%) in Group A,3 patients(16.7%) in Group B and 6 patients(31.6%) in Group C were considered to have poor small bowel cleansing(P = 0.417),with significant fluid or debris such that the examination was unreliable.The proportion of patients with a significant amount of bubbles was 50% in Group A,27.8% in Group B and 15.8% in Group C(P = 0.065).This was significantly lower in Group C when compared to Group A(P = 0.026).The mean GET was 27.8 min for Group A,27.2 min for Group B and 40.7 min for Group C(P = 0.381).The mean SBTT was 256.4 min for Group A,256.1 min for Group B and 258.1 min for Group C(P = 0.998).Regarding to the rate of complete examinations,the capsule reached the cecum in 20 patients(100%) in Group A,16 patients(88.9%) in Group B and 17 patients(89.5%) in Group C(P = 0.312).A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A(12 patients),44.4% in Group B(8 patients) and 57.8% in Group C(11 patients)(P = 0.587).CONCLUSION:Preparation with 2 L of PEG before small bowel capsule endoscopy(SBCE) may improve small bowel cleansing and the quality of visualization.Simethicone may further reduce intraluminal bubbles.No significant differences were found regarding GET,SBTT and the proportion of complete exploration or diagnostic yield among the three different cleansing protocols. | Bruno Joel Ferreira Rosa Mara Barbosa Joana Magalhes Ana Rebelo Maria Joo Moreira José Cotter | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，2： | 21 |
| 19 | Gastric low-grade mucosal-associated lymphoid tissue-lymphoma: Helicobacter pylori and beyond显示文摘The stomach is the most frequently involved site for extranodal lymphomas,accounting for nearly two-thirds of all gastrointestinal cases.It is widely accepted that gastric B-cell,low-grade mucosal-associated lymphoid tissue(MALT)-lymphoma is caused by Helicobacter pylori(H.pylori)infection.MALT-lymphomas may engender different clinical and endoscopic patterns.Often,diagnosis is confirmed in patients with only vague dyspeptic symptoms and without macroscopic lesions on gastric mucosa.H.pylori eradication leads to lymphoma remission in a large number of patients when treatment occurs at an early stage(Ⅰ-Ⅱ1).Neoplasia confined to the submucosa,localized in the antral region of the stomach,and without API2-MALT1 translocation,shows a high probability of remission following H.pylori eradication.When both bacterial infection and lymphoma recur,further eradication therapy is generally effective.Radiotherapy,chemotherapy and,in selected cases,surgery are the available therapeutic options with a high success rate for those patients who fail to achieve remission,while data on immunotherapy with monoclonal antibodies (rituximab)are still scarce.The 5-year survival rate is higher than 90%,but careful,long-term follow-up is required in these patients since lymphoma recurrence has been reported in some cases. | Angelo Zullo Cesare Hassan Francesca Cristofari Francesco Perri Sergio Morini | 2010 | World Journal of Gastrointestinal Oncology2010，2，4： | 21 |
| 20 | Endoscopic surgery for thalamic hemorrhage breaking into ventricles: Comparison of endoscopic surgery, minimally invasive hematoma puncture, and external ventricular drainage显示文摘Purpose:Thalamic hemorrhage breaking into ventricles(THBIV)is a devastating disease with high morbidity and mortality rates.Endoscopic surgery(ES)may improve outcomes,although there is no consensus on its superiority.We investigated the efficacy and safety of ES and compared the outcomes of different management strategies by ES,hematoma puncture and drainage(HPD),and external ventricular drainage(EVD)in patients with THBIV.Methods:We retrospectively analyzed patients with THBIV treated by ES,HPD,or EVD at our hospital from June 2015 to June 2018.Patients were categorized into anteromedial and posterolateral groups based on THBIV location,and then the two groups were further divided into ES,HPD,and EVD subgroups.Individualized surgical approach was adopted according to the location of the hematoma in the ES subgroups.Patient characteristics and surgical outcomes were investigated.Results:We analyzed 211 consecutive patients.There were no significant differences in clinical characteristics or incidence of perioperative procedure-related complications(postoperative rebleeding and intracranial infection)in either anteromedial or posterolateral groups.Compared with other therapeutic methods,the ES subgroups had the highest hematoma evacuation rate,shortest drainage time,and lowest incidence of chronic ventricular dilatation(all p<0.05).Among the three anteromedial subgroups,ES subgroup had the best clinical outcomes which was assessed by the modified Rankin Scale,followed by HPD and EVD subgroups(p<0.01);while in the posterolateral subgroups,clinical outcomes in the ES and HPD subgroups were similar and better than that in the EVD subgroup(p=0.037).Conclusion:Individualized surgical ES approach for removal of thalamic and ventricular hematomas is a minimally invasive,safe,and effective strategy for the treatment of THBIV with a thalamic hematoma volume of 10-30 mL. | Chu-Hua Fu Ning Wang Hua-Yun Chen Qian-Xue Chen | 2019 | Chinese Journal of Traumatology2019，22，6： | 21 |
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