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Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia.

Background To investigate the efficacy and safety of Paclitaxel (albumin binding type) combined with S-1 compared with SOX regimen in the treatment of Lauren diffuse-type advanced gastric cancer. Methods The clinical data of 50 patients with advanced Lauren type diffuse gastric cancer in our hospital from August 2018 to June 2020 were retrospectively analyzed. According to the first-line treatment plan, they were divided into treatment group (n=25) and control group (n=25). The treatment group was treated with Paclitaxel (albumin binding type) combined with S-1 compared chemotherapy. The control group was treated with Oxaliplatin combined with S-1 chemotherapy. Then the adverse reaction and clinical efficacy were recorded. Results Total 50 patients were evaluated for efficacy. The disease control rate of the treatment group was 68.0% (17/25), and the control group was 48.0% (12/25). The disease control rate of the treatment group was higher than the control group, and the difference was statistically significant (P < 0.05). The main side effects of the two groups were myelosuppression and gastrointestinal reactions, mostly grade I-II. The incidence of leucopenia, hemoglobin reduction and thrombocytopenia in the treatment group was significantly lower than that in the control group (P < 0.05). Other toxicities were similar. Conclusions Paclitaxel (albumin binding type) combined with S-1 compared with SOX regimen has a significant effect in the first-line treatment of advanced Lauren type diffuse gastric cancer, with no increase in the incidence of adverse reactions, has good safety. It is worthy of clinical promotion. Although the efficacy was better, it should be confirmed by well-controlled randomized clinical trials with more patients.

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