PURPOSE: The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy. MATERIALS AND METHODS: We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification. RESULTS: After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD). CONCLUSION: Endoscopist specialty is an important determinant of high-quality endoscopy in Korea.
Endoscopy/*standards ; Endoscopy, Digestive System/standards ; Humans ; Korea ; Medicine/*standards ; Physicians/*standards

In recent years, the endoscopic treatment, which is based on the endoscopic mucosal resection and endoscopic submucosal dissection, has developed rapidly. Complication of the endoscopic therapy has been increasingly emphasized. When paying attention to the endoscopic technique innovation, we should also concern the standardization of endoscopic therapy and the prevention and treatment of its complications. Continuous improvement in the safety, practicality and efficacy of endoscopic therapy may translate into benefits for the patients.
Endoscopy, Gastrointestinal ; standards ; Humans ; Postoperative Complications ; prevention & control

Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; standards ; Gastrointestinal Diseases ; diagnosis ; therapy ; Humans ; Pediatrics ; standards

OBJECTIVE: To evaluate the efficacy and safety of digestive tract stent implantation under direct visual endoscopy without X-ray monitoring in the treatment of digestive tract stricture. METHODS: The clinical data of patients undergoing digestive tract stent placement under direct visual endoscopy without X-ray monitoring in the First Affiliated Hospital of Zhejiang University School of Medicine from March 2003 to November 2017 were retrospectively analyzed. The process of procedures, the postoperative complications and the postoperative follow-up data were documented. The survival time of patients with malignant gastrointestinal stricture was compared between those with and without stent implantation. RESULTS: Among 562 patients, there were 310 cases of esophagus and cardia stricture, 40 cases of gastroduodenus stricture, 212 cases of colorectum stricture, and 63 cases with esophagus-tracheal fistula,esophagus-mediastinal fistula or anastomotic fistula. The stents were implanted successfully in 560 cases (99.64%) and the symptoms were alleviated in all patients after stent implantation (100%). Postoperative substernal discomfort, chest pain or abdominal pain occurred in 26 cases (4.64%), bleeding in 18 cases (3.21%), displacement of esophageal stents in 9 cases (1.61%), and restenosis in 15 cases (2.68%), in whom the stents were successfully placed again. None of the patients died within 7 days after the procedure. The incidence of postoperative abdominal pain, bleeding and stent displacement in esophageal/cardiac stricture patients was higher than that in the colorectal stricture patients (<0.05). In 284 cases of malignant stenosis, the median survival time of colorectal stricture patients[(27.5±1.94) months] was significantly higher than that of esophagus/cardia stricture patients[(13.40±0.71) months] and gastroduodenal stricture patients[(11.00±1.78) months]. The survival time of stenting patients with upper gastrointestinal malignant stenosis was significantly longer than that of the non-stenting patients (<0.05). CONCLUSIONS Stent implantation under direct visual endoscopy without X-ray monitoring is safe and effective for the treatment of benign and malignant stricture of digestive tract and closure of fistula.
Constriction, Pathologic ; surgery ; Endoscopy ; standards ; Gastrointestinal Tract ; surgery ; Humans ; Retrospective Studies ; Stents ; standards ; Survival Analysis ; Treatment Outcome

The motivation for improving quality of gastrointestinal endoscopy begins with the desire to provide patients with the best possible care. Gastrointestinal endoscopy is an excellent area for quality improvement because of its high volume, significant associated risk and expense, and variability in its performance affecting outcomes. Therefore, the assurance that high-quality endoscopic procedures are performed has taken increased importance. The 'Korean Gastrointestinal Endoscopy Research Foundation' and 'Korean Society of Gastrointestinal Endoscopy', as ladders in promoting the highest quality patient care, formed endoscopy quality evaluation in 'National Cancer Screening Program' and 'Endoscopy Unit Accreditation' in Korea. However, both new systems have not settled down despite efforts of many years and support by the government. In this article, the past and present of quality improvement of gastrointestinal endoscopy will be reviewed, and the future of quality improvement of gastrointestinal endoscopy will be illuminated.
Early Detection of Cancer ; Endoscopy, Gastrointestinal/*standards ; Humans ; Neoplasms/diagnosis ; Quality Improvement ; Quality Indicators, Health Care ; Republic of Korea

BACKGROUND/AIMS: Only a few reports have examined informed consent for gastrointestinal endoscopy in Korea. The aim of this study was to evaluate the appropriateness of the informed consent procedure in Korea. METHODS: A total of 209 patients who underwent endoscopy were asked to answer a self-administered structured questionnaire on the informed consent procedure for gastrointestinal endoscopy. RESULTS: One hundred thirteen patients completed questionnaires and were enrolled. In the survey, 91.2% answered that they understood the procedure, and the degree of understanding decreased with age; 85.8% were informed of the risks of the procedure, and the proportion was higher for inpatients and for those receiving therapeutic endoscopy or endoscopic retrograde cholangiopancreatography; 60.2% were informed of alternative methods, and the proportion was higher in older patients; 76.1% had the opportunity to ask questions during the informed consent procedure, and the proportion was higher in inpatients. The understanding of the risks of the endoscopic procedure was better in the younger and more highly educated groups. About 80% had sedation before endoscopy, and only 56% were informed of the risks of sedation during endoscopy. CONCLUSIONS: The current informed consent process may be reasonably acceptable and understandable to the patients. However, the understanding of the risks of endoscopy was insufficient especially in the cases of older, poorly educated patients and outpatients. The information about alternatives, the opportunity to ask for additional information, and the information about the risks of sedation during endoscopy were also insufficient in the current consent process.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Conscious Sedation ; *Endoscopy, Gastrointestinal ; Female ; Humans ; Informed Consent/*psychology/*standards ; Male ; Middle Aged ; Multivariate Analysis ; Patient Education as Topic/*standards ; *Patient Satisfaction ; Questionnaires ; Republic of Korea ; Risk Factors

In this paper, we aimed to provide professional guidance to practising gastrointestinal (GI) endoscopists for the safe conduct of GI endoscopy procedures during the current coronavirus disease 2019 (COVID-19) pandemic and future outbreaks of similar severe respiratory tract infections in Singapore. It draws on the lessons learnt during the severe acute respiratory syndrome (SARS) epidemic and available published data concerning the COVID-19 pandemic. It addresses measures before, during and after endoscopy that must be considered for both non-infected and infected patients, and provides recommendations for practical implementation.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; transmission ; Disease Transmission, Infectious ; prevention & control ; Endoscopy, Gastrointestinal ; standards ; Gastroenterologists ; standards ; Humans ; Incidence ; Pandemics ; Pneumonia, Viral ; epidemiology ; transmission ; Practice Guidelines as Topic ; Risk Factors ; Singapore ; epidemiology

The concordance between endoscopic and histological gastritis was determined in 52 patients referred for upper gastrointestinal endoscopy. The study was conducted in Northeastern Peninsular Malaysia, an area with a low background prevalence of H. pylori infection. Endoscopic and histological gastritis were assessed in accordance with the Sydney System. The results showed poor concordance between endoscopic and histological gastritis even after reclassifying mild endoscopic gastritis as normal. The low prevalence of H. pylori was validated in this study.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Endoscopy, Gastrointestinal ; standards ; Female ; Gastritis ; diagnosis ; pathology ; Helicobacter Infections ; diagnosis ; epidemiology ; Helicobacter pylori ; Humans ; Malaysia ; epidemiology ; Male ; Middle Aged

OBJECTIVETo assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications.

METHODSData from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who underwent OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients' indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers.

RESULTSCE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for patients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea (85.7% vs 53.3%, P<0.005). Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases.

CONCLUSIONOMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB (small bowel) CE (Given Imaging, Yoqneam, Israel).

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Capsule Endoscopy ; methods ; standards ; Female ; Humans ; Intestinal Diseases ; diagnosis ; pathology ; Intestine, Small ; pathology ; Male ; Middle Aged ; Patient Satisfaction ; Retrospective Studies ; Young Adult

OBJECTIVE: To discuss the perioperative treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. METHOD: Retrospective analysis of perioperative clinical data of 43 cases with CRSwNP and asthma. The admitted and under endoscopic surgery. Patients with preventing perioperative asthma attacks and corresponding standardized treatment were Observed. RESULT: Thirty-five cases were stable during perioperative period and without asthma. Seven patients diagnosed as mild and moderate asthma attacks because of low pulse oximetry (SpO2 92%-95%) and scattered wheeze heard in the lungs. So these patients were sent to ICU for the treatment. They went back to ward after their conditions turned to stable and no asthma during perioperative. One patient diagnosed as severe asthma attack, because irritability and suffocation happened, SpO2 decreased from 99% to 84%-81%, diffuse wheeze could be heard in the whole lung . So we give him tracheal intubation and sent him to ICU for advanced treatment after breathing smooth. Five days later the patient retuned to the ward in stable condition and with no asthma attack again. CONCLUSION Before operation the patients should be give some corresponding standardized comprehensive treatment according to the nasal symptoms and the degree of asthma attack, such as the application of topical steroid and antiallergic medicine. And some special treatment should be given to reduce airway hyperresponsiveness mucosa during anesthesia. These methods can reduce the risk of the asthma attacks and improve perioperative safety, prevent serious complications.
Asthma ; therapy ; Chronic Disease ; Endoscopy ; Humans ; Lung ; physiopathology ; Nasal Polyps ; surgery ; Perioperative Care ; standards ; Retrospective Studies ; Sinusitis ; surgery ; Steroids ; therapeutic use