Endoluminal Therapy for Esophageal Disease: An Introduction

Wolfsen, Herbert C.

doi:10.1016/j.giec.2009.07.006

Cited by 5 publications

(6 citation statements)

References 74 publications

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“…Major centers in the United States and Europe offer endoscopic therapy as a first-line therapy for intramucosal EAC. Ablative therapies with RFA, PDT, and cryotherapy have also been well studied and published 7,8,12,13,14,16,18…”

Section: Discussionmentioning

confidence: 99%

“…Methods of EMR have been described in detail 13. Most EMR procedures were performed with the multiband mucosectomy method (DT-6-5F; Cook Medical, Bloomington, IN, USA) to remove the most suspicious lesions.…”

Section: Methodsmentioning

confidence: 99%

“…Before ablation therapy, which included RFA, PDT, APC, and cryotherapy,10,13,14,15,16,17,18 patients were prescribed high doses of a proton pump inhibitor medication, such as 40 mg omeprazole by mouth twice daily, once before the morning and evening meals, to aggressively control acid reflux. Patients returned for treatment every 3 to 6 months until all esophageal glandular mucosa had been successfully ablated and replaced with a neosquamous epithelium.…”

Section: Methodsmentioning

confidence: 99%

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Predictors of Esophageal Stricture Formation Post Endoscopic Mucosal Resection

et al. 2014

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Background/AimsStricture formation is a common complication after endoscopic mucosal resection. Predictors of stricture formation have not been well studied.MethodsWe conducted a retrospective, observational, descriptive study by using a prospective endoscopic mucosal resection database in a tertiary referral center. For each patient, we extracted the age, sex, lesion size, use of ablative therapy, and detection of esophageal strictures. The primary outcome was the presence of esophageal stricture at follow-up. Multivariate logistic regression was used to analyze the association between the primary outcome and predictors.ResultsOf 136 patients, 27% (n=37) had esophageal strictures. Thirty-two percent (n=44) needed endoscopic dilation to relieve dysphagia (median, 2; range, 1 to 8). Multivariate logistic regression analysis showed that the size of the lesion excised is associated with increased odds of having a stricture (odds ratio, 1.6; 95% confidence interval, 1.1 to 2.3; p=0.01), when controlling for age, sex, and ablative modalities. Similarly, the number of lesions removed in the index procedure was associated with increased odds of developing a stricture (odds ratio, 2.3; 95% confidence interval, 1.3 to 4.2; p=0.007).ConclusionsStricture formation after esophageal endoscopic mucosal resection is common. Risk factors for stricture formation include large mucosal resections and the resection of multiple lesions on the initial procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Predictors of Esophageal Stricture Formation Post Endoscopic Mucosal Resection

et al. 2014

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“…The EMR method varied by location within the GI tract. Methods of esophageal EMR have been described elsewhere . In the esophagus, most EMR were performed using Duette™ Multi‐Band Mucosectomy (DT‐6‐5F; Cook Medical, Bloominton, IN, USA), with or without a saline injection lift, to remove the most suspicious lesions.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with increased bleeding post‐endoscopic mucosal resection

Qumseya

Wolfsen

Wang

et al. 2013

J of Digest Diseases

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“…The percentage of colonoscopies performed with the participation of anesthesia professionals is expected to rise from 23.9 % in 2007 to 53.4 % by 2015, respectively [19]. In view of this dramatic increase, health insurance companies are attempting to restrict coverage for anesthesia professional-delivered sedation [18].…”

Section: Introductionmentioning

confidence: 99%

Analgesia without sedatives during colonoscopies: worth considering?

et al. 2012

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Colonoscopy is a proven method for bowel cancer screening and is often experienced as a painful procedure. Today, there are two main strategies to facilitate colonoscopy. First, deep sedation results in satisfied patients but increases sedation-associated risks and raises costs for healthcare providers. Second, there is the advocacy for colonoscopies without any form of sedation. This might be an option for a special group of patients, but does not hold true for everybody. Following Moerman’s hypothesis: “If pain is the crucial point, why do we need sedation?” this review shows the analgesic options for a painless procedure, increasing success rates without increasing risk of sedation. There are two agents, with the potential to be a nearly ideal analgesic agent for colonoscopy: alfentanil and nitrous oxide (N2O). Administration of either substance causes the patient to be comfortable yet alert and facilitates a short turnover. Advantages of these drugs include rapid onset and offset of action, analgesic and anxiolytic effects, ease of titration to desired level, rapid recovery, and an excellent safety profile.

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Endoluminal Therapy for Esophageal Disease: An Introduction

Cited by 5 publications

References 74 publications

Predictors of Esophageal Stricture Formation Post Endoscopic Mucosal Resection

Predictors of Esophageal Stricture Formation Post Endoscopic Mucosal Resection

Factors associated with increased bleeding post‐endoscopic mucosal resection

Analgesia without sedatives during colonoscopies: worth considering?

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