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

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

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

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

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

OBJECTIVETo study the reasons for the discrepancies in pathologic diagnosis of gastric dysplasia/early cancer in endoscopic submucosal dissection (ESD) specimens, and how to cope with the discrepancies.

METHODSThe pathologic diagnoses in 60 cases of ESD specimens according to the three currently used classification systems (namely Western criteria, Japanese criteria and Vienna classification) were compared. The diagnostic discrepancies were analyzed.

RESULTSFifteen of the 17 cases diagnosed as low-grade intraepithelial neoplasia according to the Western criteria were revised as adenoma by the Japanese criteria. Amongst the 43 cases of gastric intramucosal adenocarcinoma diagnosed according to the Japanese criteria, 23 cases had concordant diagnosis by the Western criteria. While the diagnosis of low-grade intraepithelial neoplasia/adenoma was basically similar irrespective of classification system used, there were significant differences in the interpretation of gastric early cancer.

CONCLUSIONSThe diagnostic discrepancies in the gastric dysplasia/early cancer are mainly related to the morphologic criteria applied in different classifications. In order to facilitate clinical and pathologic communication, a consensus using Vienna/WHO classifications, supplemented with Japanese system, is desirable.

Adenoma ; pathology ; Carcinoma in Situ ; pathology ; Dissection ; methods ; Gastroscopy ; Humans ; Hyperplasia ; pathology ; Stomach ; pathology ; Stomach Neoplasms ; pathology

OBJECTIVEEndoscopy was used to study the high incidence area of cancer of gastric cardia.

METHODS417 patients with early cardiac cancer and 451 patients with advanced lesions were analyzed to the high incidence point of cardiac cancer. Verifying endoscopic screening of 205 subjects was performed later in the high incidence area of esophageal cancer.

RESULTS327 of 417 (78.4%) of early cardiac cancer patients and 336 of 451 (74.5%) of advanced lesions were proved to have developed their origin at the root of the mucosal fold in the gastric cardia. Eleven cardiac cancer patients were found by the verifying endoscopic screening, among whom 9 patients (81.8%) developed the primary focus at the root of mucosal fold in the cardia.

CONCLUSIONThe root of mucosal fold in the gastric cardia is proved to be the high incidence point of cancer of gastric cardia, which is very important clinically.

China ; epidemiology ; Gastroscopy ; methods ; Humans ; Incidence ; Stomach Neoplasms ; classification ; diagnosis ; epidemiology ; pathology