Bacteremia ; diagnosis ; Endoscopy ; adverse effects ; Humans ; Paranasal Sinuses ; microbiology ; surgery

Endoscopy ; adverse effects ; Humans ; Nasal Surgical Procedures ; adverse effects ; Paranasal Sinuses ; surgery ; Postoperative Complications ; prevention & control ; therapy

Small bowel capsule endoscopy has been now widely applied for patients who are highly suspected of small bowel disease with occult bleeding and unexplained abdominal pain. Capsule retention is a major complication, with an overall incidence of 1%-2%, commonly seen in the detection of Crohn's disease and small bowel tumors. Most cases run asymptomatically after retention, while intestinal obstruction or perforation can occur ralely. Conservative methods, endoscopic or surgical interventions are performed to deal with the retention. Patency capsule is currently used as a novel tool to reduce the risk of capsule retention.
Capsule Endoscopy ; adverse effects ; Capsules ; Crohn Disease ; diagnosis ; Endoscopy, Gastrointestinal ; adverse effects ; Foreign Bodies ; physiopathology ; Humans ; Incidence ; Intestinal Neoplasms ; diagnosis ; Intestinal Obstruction ; diagnosis ; etiology ; Intestine, Small

BACKGROUND/AIMS: Propofol sedation for elderly patients during time-consuming endoscopic procedures is controversial. Therefore, we investigated the safety of using propofol in elderly patients during upper gastrointestinal therapeutic endoscopy. METHODS: The medical records of 160 patients who underwent therapeutic endoscopic procedures under gastroenterologist-guided propofol sedation at a single institution were retrospectively reviewed. The subjects were divided into two groups: a younger group, patients <75 years old; and an elderly group, patients > or =75 years old. The two groups were compared with respect to the therapeutic regimen, circulatory dynamics, and presence/absence of discontinuation of propofol treatment. RESULTS: Although the number of patients with liver dysfunction was higher in the elderly group, there were no other significant differences in the baseline characteristics, including the American Society of Anesthesiologists classification, between the elderly and younger groups. The average maintenance rate of continuous propofol infusion was lower in the elderly patients. No statistically significant differences were found in the occurrence of adverse events between the elderly and younger groups. None of the patients returned to a resedated state after the initial recovery from sedation. CONCLUSIONS: Gastroenterologist-guided propofol sedation in elderly patients can be safely achieved in the same manner as that in younger patients, even for time-consuming upper gastrointestinal therapeutic endoscopic procedures.
Age Factors ; Aged ; Aged, 80 and over ; Conscious Sedation/adverse effects/*methods ; *Endoscopy, Gastrointestinal/methods ; Female ; Humans ; *Hypnotics and Sedatives/adverse effects ; Male ; *Propofol/adverse effects ; Retrospective Studies

A 61 year-old male patient, plasma fibrinogen level was 2.98 g/L, endoscopic sinus surgery was performed under general anesthesia for polypoid of uncinate process with mycotic maxillary sinusitis. Hemocoagulase were given in pre- and post-operative for treatment. The patient was found postoperative drain blood continuously since 3 days after surgery, when the dose of hemocoagulase reach 26 KU, and fibrinogen determined in Plasma was 0.48 g/L. Coagulation returned to normal and nasal bleeding stopped after discontinuation of the hemocoagulase and supplement with fibrinogen.
Batroxobin ; adverse effects ; Blood Coagulation Disorders ; chemically induced ; Endoscopy ; adverse effects ; Fibrinogen ; analysis ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; adverse effects ; Paranasal Sinuses ; surgery

OBJECTIVES: To study the risk factors for complications after endoscopic therapy for upper gastrointestinal subepithelial lesions (SELs). METHODS: Retrospective analysis was performed on 184 patients in the Department of Gastroenterology in the Third Xiangya Hospital, Central South University after therapeutic endoscopy [endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFR), endoscopic submucosal excavation (ESE), and submucosal tunneling endoscopic resection (STER)] for the upper gastrointestinal SELs from 2014-09-01 to 2019-09-30. The clinic data were collected and risk factors for postoperative complications were analyzed. RESULTS: Among the 184 patients, 22 patients were in the complication group (including 3 cases of delayed bleeding, 2 cases of delayed perforation, and 17 cases of electrocoagulation syndrome) and 162 patients were in the non-complication group. There was no significant difference between the complication group and the non-complication group in gender, age over 70 year, basic diseases, lesion location, lesion invasion layers, pathological results, endoscopic therapy, and preventive closure of wounds (all CONCLUSIONS For the patients with upper gastrointestinal SELs after endoscopic minimally invasive therapy with the lesion diameter over 40 mm and the operative time over 120 minutes, it needs to highly alert to the occurrence of postoperative complications.
Endoscopic Mucosal Resection/adverse effects* ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Humans ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Treatment Outcome

Aged ; Endoscopy, Gastrointestinal ; adverse effects ; Facial Dermatoses ; etiology ; Female ; Humans ; Purpura ; etiology

BACKGROUNDThe feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.

METHODSA database searching was performed on MEDLINE, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials. Both comparative and non-comparative studies about endoscopic thyroidectomy were selected and analyzed. For the comparative studies, RevMan 4.2 was used for statistical analysis; and for the non-comparative studies, data analysis was performed by SPSS 13.0.

RESULTSSeven comparative studies involving 367 patients (video-assisted thyroidectomy (VAT), 174 patients; conventional thyroidectomy (CT), 193 patients) were included in VAT-CT group. Age, gender, operative types, and pathological diagnosis were similar. Compared with CT, the mean operative time for VAT was significantly longer (VAT, 80.0 minutes; CT, 61.9 minutes, P < 0.01), but the postoperative hospital stay was shorter (VAT, 1.7 days; CT, 2.5 days, P < 0.01). The complication rate for VAT was 6.9%, while that for CT was 9.3% (P = 0.35). Three studies analyzed the postoperative pain and cosmetic evaluation, and indicated that the VAT group was superior to the CT group, but there was no significant difference after a meta-analysis. Three comparative studies involving 273 patients (totally endoscopic thyroidectomy (TET), 145 patients; CT, 128 patients) were included in TET-CT group and the results generally resembled that of VAT-CT group. There were 18 and 14 non-comparative studies reporting the results of VAT and TET, respectively. The mean operative time for VAT was 76.8 minutes compared with 135.8 minutes for TET. The postoperative hospital stay was 1.8 and 3.8 days for VAT and TET respectively. The rates of conversion to open surgery for VAT and TET were similar (VAT, 2.8%; TET, 3.9%, P = 0.105). The complication rate for VAT was 8.6%, while that for TET was 3.5% (P < 0.01).

CONCLUSIONSThe feasibility and safety of endoscopic thyroidectomy were initially verified and accepted, and it should be considered as a valid option, offering some advantages to patients in terms of cosmetic results and postoperative distress.

Adult ; Endoscopy ; methods ; Humans ; Pain, Postoperative ; drug therapy ; Thyroidectomy ; adverse effects ; methods ; Video-Assisted Surgery

Tunnel endoscopy is a new therapeutic technique developed from natural orifice endoscopic transluminal surgery and endoscopic submucosal dissection. With the quick development in the passing 5 years, tunnel endoscopy has been applied in the treatment of clinical diseases. In this article, our aim was to clarify the indication and method, evaluate the efficacy and safety of tunnel endoscopy for the treatment of esophagogastric diseases, including esophageal achalasia and submucosal tumors originating from the muscularis propria layer.
Endoscopy, Digestive System ; adverse effects ; methods ; Esophageal Diseases ; surgery ; Humans ; Stomach Diseases ; surgery

Breast Neoplasms ; pathology ; surgery ; Endoscopy ; Female ; Humans ; Mastectomy ; adverse effects ; methods ; Neoplasm Metastasis