Gastrointestinal endoscopy clinics of North America
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The subject of endoscopic sedation for colonoscopy remains controversial because of unresolved questions concerning the relative benefits, risks, and cost of service. There is also disagreement about the most appropriate sedation drug(s), delegation of responsibility for drug administration, and patient monitoring. This article examines recent trends in endoscopic sedation; the impact of sedation on the quality, safety, and patient tolerability of colonoscopy; and reviews the economic implications of current sedation practices.
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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
ReviewPropofol use by gastroenterologists-the European experience.
The administration of propofol as a sedative in gastrointestinal endoscopies became very popular in many European countries during the last years. Nevertheless there are huge regional differences in the way that the drug is used. Switzerland, the country with highest propagation of gastroenterologist guided propofol sedation, serves as a case study of its safe use in daily practice. The experiences of this spread are summarized in this article.
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Gastrointest. Endosc. Clin. N. Am. · Oct 2008
ReviewPatient monitoring during gastrointestinal endoscopy: why, when, and how?
Patient monitoring is intended to reduce the risk of sedation-related cardiopulmonary complications. Physiological monitoring and visual assessment by a qualified individual should be routine during endoscopic procedures. Additionally, ventilatory monitoring should be considered for high-risk patients and those receiving sedation with propofol.