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Ultra-thin caliber endoscopes in daily practice: uses for therapeutic application and beyond on the basis of review of 1028 procedures

机译:日常实践中的超薄口径内窥镜:在1028程序的审查基础上用于治疗应用及其他用途

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摘要

>Background and study aims: Ultra-thin caliber endoscopes (UTCEs) are versatile and applicable in various conditions. However, only limited data exist on the actual daily clinical use of UTCEs. The aim of our study was to determine indications for UTCEs in a large patient cohort. In turn, our 2 main objectives were (1) to evaluate patient comfort and safety and (2) to determine benefits and potential advantages associated with the use of UTCEs in this same cohort. >Patients and methods: We performed a retrospective analysis of our prospective database of 1028 procedures with UTCEs in 457 patients. All procedures were carried out in the Department of Gastroenterology and Hepatology, VU University Medical Center, in Amsterdam, the Netherlands, between May 2008 and May 2014. In these procedures, either the Fujinon (Tokyo, Japan) EG-530N UTCE or the Olympus (Tokyo, Japan) GIF N-180 UTCE was used. >Results: Mean (standard deviation [SD]) age of patients was 64 (20) years, and most (60 %) of the patients were men. Most (61 %) of the underlying diseases, requiring endoscopic procedures, were found in the esophagus. Of the procedures performed, 91 % were successful, and 82 % were therapeutic. In comparison with regular endoscopes, the most important advantage of the UTCE was the ability to pass a stenosis (37 %), followed by nasogastric feeding tube placement (13 %). Newer and more innovative uses of the UTCE were percutaneous endoscopic gastrostomy (PEG)-jejunal extension placement with endoscope introduction through existing PEG tract, retrograde esophageal introduction through existing PEG tract, inspection of colonic neovagina stenosis, and direct inspection of the common bile duct. >Conclusions: In everyday clinical practice, the UTCE has specific advantages over conventional endoscopes because of its small caliber. The 3 main advantages are (1) introduction of high-grade strictures; (2) introduction of fistulas, including PEG fistula; and (3) increased patient comfort. The endoscopist should appreciate these advantages and consider use of the UTCE accordingly.
机译:>背景和研究目的:超薄口径内窥镜(UTCE)用途广泛,可在各种条件下使用。但是,关于UTCE的实际日常临床使用只有有限的数据。我们研究的目的是确定大型患者队列中UTCE的适应症。反过来,我们的两个主要目标是(1)评估患者的舒适度和安全性,以及(2)确定与在同一队列中使用UTCE相关的益处和潜在优势。 >患者和方法:我们对457例1028例使用UTCE的手术的前瞻性数据库进行了回顾性分析。所有程序均于2008年5月至2014年5月之间在荷兰阿姆斯特丹的VU大学医学中心胃肠病学和肝病学系中执行。在这些程序中,使用Fujinon(日本东京)EG-530N UTCE或Olympus (日本东京)使用了GIF N-180 UTCE。 >结果:患者的平均年龄(标准差[SD])为64(20)岁,其中大多数(60 %%)患者为男性。大多数(61%)需要内窥镜检查的基础疾病都在食道中发现。在所执行的程序中,成功的占91%,治疗的占82%。与常规内窥镜相比,UTCE的最重要优势是能够通过狭窄(37%),然后放置鼻胃饲管(13%)。 UTCE的更新和更创新的用途是经皮内镜胃造口术(PEG)-空肠延伸放置,通过现有PEG管道引入内窥镜,通过现有PEG管道逆行食管引入,结肠新阴道狭窄检查,以及直接检查胆总管。 >结论:在日常临床实践中,由于UTCE的口径小,它比常规内窥镜具有特定的优势。 3个主要优点是:(1)引入高级规章制度; (2)引入瘘管,包括PEG瘘管; (3)增加患者的舒适度。内镜医师应意识到这些优势,并考虑相应地使用UTCE。

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