Since it was described in 1980, percutaneous endoscopic gastrostomy (PEG) has been a widely used method for insertion of a gastrostomy tube in overseas patients who are unable to swallow or maintain adequate nutrition. PEG should be considered when enteral feeding is necessary for longer than 3-4 weeks in difficulty eating patients. However, this method is still not widely used in China. This article describes the indications and benefits of this method. Its possible risks, limitations, contraindications, and complications should also be considered in patients with severe diseases.
Enteral Nutrition ; instrumentation ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Time Factors

OBJECTIVETo evaluate the feasibility of kidney biopsy by transgastric and transvesical combined approach in the porcine model.

METHODSFive female pigs (20 to 30 kg) were included in this study. All procedures were performed with pigs under general anesthesia. The transvesical access was established by the ureteroscope. Then monitored by ureteroscopy, the transgastric access was established by a needle knife with cautery. The puncture dilation was performed with balloon through the gastroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath. The kidney biopsy was finished by the scissor from the transvesical access and the grasping forcep from the work channel of gastroscope.

RESULTSAmong five cases the procedure were successful in three cases with 380 min, 180 min, 78 min respectively. Establishment of transvesical and transgastric accesses took place without complications. The exposure and biopsy of the kidney were easily achieved during operation. The transgastric and transvesical access were not closed in the end.

CONCLUSIONSThis new method is a technically feasible procedure in a porcine model. But the safety and the clinical future of it needs more study.

Animals ; Biopsy, Needle ; methods ; Female ; Gastroscopy ; Kidney ; pathology ; Swine ; Ureteroscopy

Percutaneous endoscopic gastrostomy (PEG) is a well-established microinvasive procedure to provide enteral nutrition for various patients. Anesthetic intervention during PEG not only make patient feel painless but also help to guarantee the safety of patient by anesthetic monitoring. This article summarizes the recent advances in anesthetic techniques, drugs, and monitoring practices for patients under PEG.
Anesthesia ; methods ; Anesthetics ; administration & dosage ; therapeutic use ; Enteral Nutrition ; methods ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans

No abstract available.
Adenoma/pathology ; Dissection/*methods ; Gastric Mucosa/*pathology/surgery ; Gastroscopy/*methods ; Humans ; Stomach Neoplasms/pathology/surgery

It is of great importance to measure the lesion area in scientific research and clinical practice. The present study aims to solve barrel distortion and measure lesion area with the technology of computer visualization. With the ultimate purpose to obtain the precise lesion area, the study, based on the original endoscopy system and digital image processing technology, dealt with the correction of barrel distortion by lens adjustment, calculated the gastric ulcer area with the aid of Qt database and finally developed an image processing software--Endoscope Assistant (EAS). The results showed that the EAS was accurate in vitro. It was employed to measure the gastric ulcer area of 45 patients and the results were compared with the traditional formula method. It could be well concluded that this technology is safe, accurate and economical for measuring gastric ulcer area.
Algorithms ; Gastroscopy ; methods ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; methods ; Software ; Stomach Diseases ; diagnosis ; pathology

In this paper, a new method of contour analysis is presented to find path in endoscopy navigation. At first, edge detection is used to endoscope image. Then we do skeleton extraction and connect the edge skeleton to contours by grouping criteria. At last we can get navigation information by analyzing the contours. Experiments show that this algorithm has good precision and stability.
Algorithms ; Diagnosis, Computer-Assisted ; Endoscopy ; methods ; Gastroscopy ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted

OBJECTIVETo assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy (nPEG) in patients with trimus and/or pharyngeal narrowing.

METHODSNine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy (5 cases) or ultrathin transnasal gastroscopy (4 cases). Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated.

RESULTSThe average procedure time of PEG was 17+/-3.5 min in conventional gastroscopy group and 17+/-3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure.

CONCLUSIONSUltrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.

Aged ; Enteral Nutrition ; Female ; Gastroscopes ; Gastroscopy ; methods ; Gastrostomy ; methods ; Humans ; Male ; Middle Aged

OBJECTIVE: To study the effect of propofol used for painless gastroscopy and colonoscopy on psychomotility recovery. METHODS: One hundred adult patients undergoing painless gastroscopy and colonoscopy were recruited, aged 18-72 years, with American Society of Anesthesiologist (ASA) physical status Ⅰ-Ⅱ. According to age, the patients were divided into youth group (20-39 years old, 27 cases), middle age group (40-54 years old, 37 cases), and elder group (55-64 years old, 36 cases). Propofol was continuously infused according to the patients' condition to mantain the bispectal index (BIS) score 55-64. All the patients received psychomotility assesment 30 min before the operations when the discharge criteria were met including number cancellation test, number connection test and board test. The heart rate, blood pressure, saturation of pulse oximetry, electrocardiograph and BIS were monitored during the operation. The operating time, recovery time, total volume of propofol and discharge time were recorded. If the results obtained were inferior to those before operation, a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. RESULTS: All the patients completed the first and second assessments, and 25 patients had taken the third assessment. There was no statistically significant difference in the results of psychomotility assessment when the patients met the discharge standard. Furthermore, the results were analyzed by grouping with age, and there was no statistical difference in the test results of the youth and middle age groups compared with the preoperative group, among which, the efficiency of the number cancellation test was significantly better than that before operation in the youth group (P < 0.05). However, in the elderly patients the number cancellation efficiency, number connection test and board test were significantly inferior to that before operation (P < 0.05). There was no significant difference in the accuracy of number cancellation compared with that before operation. The patients who needed the third test in the elder group were significantly more than in the other groups (P < 0.05). Compared with the preoperative results, there was no statistical difference in the test results of those who completed the third test. CONCLUSION The psychomotility function of the patients who underwent painless gastroscopy and colonoscopy was recovered when they met discharge criteria. The elderly patients had a prolonged recovery period.
Adult ; Aged ; Middle Aged ; Adolescent ; Humans ; Young Adult ; Propofol ; Hypnotics and Sedatives ; Gastroscopy/methods* ; Conscious Sedation/methods* ; Colonoscopy/methods*

No abstract available.
Carcinoma, Signet Ring Cell/*pathology/*surgery ; Dissection/*methods ; Female ; *Gastroscopy ; Humans ; Male ; Stomach Neoplasms/*pathology/*surgery

OBJECTIVETo assess the diagnostic value of narrow-band imaging with magnifying endoscopy (NBI-ME) for early gastric cancer (EGC).

METHODSWe searched PubMed, Embase, Web of Science and the Cochrane Library for literature of NBI-ME in diagnosis of EGC, and then performed meta-analysis.

RESULTSA total of 12 articles involving 2 278 samples from 2 048 patients were included. The overall sensitivity of NBI-ME for diagnosis of EGC was 0.84 [95% CI: 0.80~0.87], specificity was 0.96 (95% CI: 0.95~0.97),and area under the symmetric receiver operator characteristic curve (AUC) was 0.9592. The AUC value of the NBI-ME plus conventional white light endoscopy (C-WLE) subgroup (0.9706) was higher than that of NBI-ME alone (0.8162). The incremental yield of NBI-ME plus C-WLE over C-WLE was significant (IY = 9.4%, P = 0.011), while NBI-ME alone over C-WLE was not significant (IY = 0.8%, P = 0.498).

CONCLUSIONSThe results show that NBI-ME plus C-WLE is an effective and preferable method for diagnosis of EGC; however, NBI-ME alone is not superior to C-WLE.

Early Detection of Cancer ; Gastroscopy ; methods ; Humans ; Narrow Band Imaging ; Sensitivity and Specificity ; Stomach Neoplasms ; diagnosis