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World Journal of Gastroenterology Jun 2014Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require... (Review)
Review
Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the "pull" technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system.
Topics: Device Removal; Enteral Nutrition; Equipment Design; Gastroscopy; Gastrostomy; Humans; Postoperative Complications; Risk Factors; Time Factors; Treatment Outcome
PubMed: 24976711
DOI: 10.3748/wjg.v20.i24.7739 -
Veterinary Journal (London, England :... 2022Many domesticated horses have gastric ulcers which can be diagnosed and graded during gastroscopy. A distinction should be made between equine squamous gastric disease... (Review)
Review
Many domesticated horses have gastric ulcers which can be diagnosed and graded during gastroscopy. A distinction should be made between equine squamous gastric disease (ESGD), which is caused by exposure of the mucosa to acid, and equine glandular gastric disease (EGGD), thought to occur when mucosal defence mechanisms are compromised. Horses with gastric ulcers may, but do not always, show clinical signs such as poor appetite, mild colic, discomfort during girthing, behavioural changes and reduced performance. The mainstay of treatment is blocking acid production using the proton pump inhibitor omeprazole. Treatment is usually successful in cases of ESGD, but less so for EGGD, where treatment duration is longer and for which sucralfate may be added or alternatives necessary, such as misoprostol, a prostaglandin analogue. To prevent recurrence of ulcers known risk factors, such as high concentrate diets, intense exercise and stress should be avoided or minimized.
Topics: Animals; Gastric Mucosa; Gastroscopy; Horse Diseases; Horses; Omeprazole; Stomach Ulcer
PubMed: 35472513
DOI: 10.1016/j.tvjl.2022.105830 -
World Journal of Gastroenterology May 2020Percutaneous endoscopic gastrostomy is an established method to provide nutrition to patients with restricted oral uptake of fluids and calories. Here, we review the... (Review)
Review
Percutaneous endoscopic gastrostomy is an established method to provide nutrition to patients with restricted oral uptake of fluids and calories. Here, we review the methods, indications and complications of this procedure. While gastrostomy can be safely and easily performed during gastroscopy, the right patients and timing for this intervention are not always chosen. Especially in patients with dementia, the indication for and timing of gastrostomies are often improper. In this patient group, clear data for enteral nutrition are lacking; however, some evidence suggests that patients with advanced dementia do not benefit, whereas patients with mild to moderate dementia might benefit from early enteral nutrition. Additionally, other patient groups with temporary or permanent restriction of oral uptake might be a useful target population for early enteral nutrition to maintain mobilization and muscle strength. We plead for a coordinated study program for these patient groups to identify suitable patients and the best timing for tube implantation.
Topics: Enteral Nutrition; Gastroscopy; Gastrostomy; Humans; Patient Selection; Practice Guidelines as Topic; Time Factors; Time-to-Treatment
PubMed: 32523304
DOI: 10.3748/wjg.v26.i20.2464 -
Revista de Gastroenterologia de Mexico... 2020Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune...
Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.
Topics: Adenocarcinoma; Combined Modality Therapy; Delphi Technique; Early Detection of Cancer; Endoscopic Mucosal Resection; Gastroscopy; Humans; Mexico; Neoplasm Staging; Risk Factors; Stomach Neoplasms
PubMed: 31859080
DOI: 10.1016/j.rgmx.2019.10.001 -
Gut Sep 2021This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of...
Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update.
This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.
Topics: Anticoagulants; Atrial Fibrillation; Cholangiopancreatography, Endoscopic Retrograde; Endoscopy; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Platelet Aggregation Inhibitors; Risk Factors; Thrombosis
PubMed: 34362780
DOI: 10.1136/gutjnl-2021-325184 -
Journal of Gastrointestinal and Liver... Dec 2007Percutaneous endoscopic gastrostomy (PEG) has become the modality of choice for providing enteral access to patients who require long-term enteral nutrition. Although... (Review)
Review
Percutaneous endoscopic gastrostomy (PEG) has become the modality of choice for providing enteral access to patients who require long-term enteral nutrition. Although generally considered safe, PEG tube placement can be associated with many potential complications. This review describes a variety of PEG tube related complications as well as strategies for complication avoidance. In addition, the reader is presented with a brief discussion of procedures, techniques, alternatives to PEG tubes, and related issues. Special topics covered in this review include PEG tube placement following previous surgery and PEG tube use in pregnancy.
Topics: Enteral Nutrition; Gastroscopy; Gastrostomy; Humans; Postoperative Complications
PubMed: 18193123
DOI: No ID Found -
Ugeskrift For Laeger Dec 2022Gastric antral vascular ectasia is characterized endoscopically by stripes of dilated blood vessels in the antrum. It is a well-known cause of gastrointestinal blood... (Review)
Review
Gastric antral vascular ectasia is characterized endoscopically by stripes of dilated blood vessels in the antrum. It is a well-known cause of gastrointestinal blood loss, anaemia, and recurrent need for blood transfusion. The treatment may be challenging, and an overview is given in this review. Pharmacological treatment has not been effective, endoscopic treatment is more tolerable than abdominal surgery. The endoscopic modalities, including argon plasma coagulation, endoscopic band ligation, and radiofrequency ablation are safe and relative efficient. Comparative studies are sparse but indicate the modalities as equally effective.
Topics: Humans; Gastric Antral Vascular Ectasia; Treatment Outcome; Gastroscopy; Argon Plasma Coagulation; Anemia; Gastrointestinal Hemorrhage
PubMed: 36621874
DOI: No ID Found -
Revista Espanola de Enfermedades... Sep 2019Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to... (Review)
Review
Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to suggest the structure, process, and results procedures and indicators necessary to implement and assess quality in the gastroscopy setting. First, a chart was designed with the steps to be followed during a gastroscopy procedure. Secondly, a team of experts in care quality and/or endoscopy performed a qualitative review of the literature searching for quality indicators for endoscopic procedures, including gastroscopies. Finally, using a paired analysis approach, a selection of the literature obtained was undertaken. For gastroscopy, a total of nine process indicators were identified (one preprocedure, eight intraprocedure). Evidence quality was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification scale.
Topics: Duodenoscopy; Endoscopy, Gastrointestinal; Esophagoscopy; Gastroscopy; Humans; Quality Improvement; Quality Indicators, Health Care
PubMed: 31190549
DOI: 10.17235/reed.2019.6023/2018 -
Biomedical Engineering Online Feb 2022Gastric disease is a major health problem worldwide. Gastroscopy is the main method and the gold standard used to screen and diagnose many gastric diseases. However,... (Review)
Review
Gastric disease is a major health problem worldwide. Gastroscopy is the main method and the gold standard used to screen and diagnose many gastric diseases. However, several factors, such as the experience and fatigue of endoscopists, limit its performance. With recent advancements in deep learning, an increasing number of studies have used this technology to provide on-site assistance during real-time gastroscopy. This review summarizes the latest publications on deep learning applications in overcoming disease-related and nondisease-related gastroscopy challenges. The former aims to help endoscopists find lesions and characterize them when they appear in the view shed of the gastroscope. The purpose of the latter is to avoid missing lesions due to poor-quality frames, incomplete inspection coverage of gastroscopy, etc., thus improving the quality of gastroscopy. This study aims to provide technical guidance and a comprehensive perspective for physicians to understand deep learning technology in gastroscopy. Some key issues to be handled before the clinical application of deep learning technology and the future direction of disease-related and nondisease-related applications of deep learning to gastroscopy are discussed herein.
Topics: Computers; Deep Learning; Gastroscopes; Gastroscopy
PubMed: 35148764
DOI: 10.1186/s12938-022-00979-8 -
Glasgow Medical Journal Jul 1946
Topics: Gastroscopy; Humans; Muscles; Stomach
PubMed: 20994352
DOI: No ID Found