Gastrointestinal endoscopy clinics of North America
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Gastrointest. Endosc. Clin. N. Am. · Oct 2010
ReviewMaximizing the value of the endoscopist-pathologist partnership in the management of colorectal polyps and carcinoma.
Good communication between clinician and pathologist is essential for optimal patient care and management of colorectal polyps and carcinoma. General principles of communication include making sure that the pathologist and endoscopist have all the information needed to make an accurate diagnosis and that the pathologist communicates the diagnosis back to the endoscopist in a clear and timely fashion. The increasing complexity of classification of colorectal polyps and carcinomas has added to the need for clear communication pathways. The first part of this article is devoted to an outline of general communication issues; the second is a discussion of current concepts in colorectal polyps and carcinomas.
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Gastrointest. Endosc. Clin. N. Am. · Jan 2010
ReviewEndoscopic mucosal resection and endoscopic submucosal dissection for esophageal dysplasia and carcinoma.
Advanced cancer in the esophagus is a serious and fatal disease that invades locally to deeper layers of the esophageal wall with significant risk of nodal metastasis and invasion of adjacent organs. One reliable method of avoiding this is to detect lesions at an early stage of esophageal cancer and then to resect them locally. ⋯ EMR includes strip-off biopsy, double-channel techniques, cap technique, EMR using a ligating device, and so on. ESD is a newly developed technique in which submucosal dissection is carried out using an electrocautery knife to acquire a single-piece specimen.
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Endocytoscopy is a new imaging and magnification technology. It has been developed for observation of cellular structure and applied in the esophageal cancer. In this article we summarize the important aspects of this new modality.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2008
ReviewHuman patient simulation and its role in endoscopic sedation training.
Patient simulation is now considered to be a valid method for the education and evaluation of providers of sedation. Using full-scale human simulators to provide a realistic setting, participants can acquire skills for patient monitoring, administration of sedation medications, and the recognition and management of critical events. Although obstacles to its implementation exist, it appears likely that simulation training will become an integral part of training for providers of procedural sedation.
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The role of sedation in endoscopic procedures has increased and so has the demand for advances in its administration. The pursuit of new agents or administration techniques and their study specific to endoscopic nonsurgical procedures is necessary to improve patient comfort and safety. The science of moderate and deep sedation specific to endoscopy is fledgling but approaching new horizons.