The use of carbon dioxide in gastrointestinal endoscopy

Lo, Simon K.; Fujii-Lau, Larissa L.; Enestvedt, Brintha K.; Hwang, Joo Ha; Konda, Vani J.; Manfredi, Michael A.; Maple, John T.; Murad, Faris; Pannala, Rahul; Woods, Karen; Banerjee, Subhas

doi:10.1016/j.gie.2016.01.046

Cited by 84 publications

(37 citation statements)

References 81 publications

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“…Traumatic antimesenteric tears of the colonic wall are less common elsewhere but can occur at the flexures because of excessive tip force or in the rectum during retroflexion [216]. Cecal perforation can also occur because of barotrauma, particularly if gas is introduced above an area of stenosis [217]; barotrauma is probably less likely when CO2 is used compared to air, as the former is absorbed more quickly [40].…”

Section: Colorectal Iatrogenic Perforationsmentioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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Summary of Recommendations 1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforations, including the definition of procedures that carry a higher risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 ESGE recommends that in the case of an endoscopically identified perforation, the endoscopist reports its size and location, with an image, and statement of the endoscopic treatment that has been applied. 3 ESGE recommends that symptoms or signs suggestive of iatrogenic perforation after an endoscopic procedure should be rapidly and carefully evaluated and documented with a computed tomography (CT) scan. 4 ESGE recommends that endoscopic closure should be considered depending on the type of the iatrogenic perforation, its size, and the endoscopist expertise available at the center. Switch to carbon dioxide (CO2) endoscopic insufflation, diversion of digestive luminal content, and decompression of tension pneumoperitoneum or pneumothorax should also be performed. 5 ESGE recommends that after endoscopic closure of an iatrogenic perforation, further management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of an iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical consultation are recommended.

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Section: Colorectal Iatrogenic Perforationsmentioning

confidence: 99%

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020

et al. 2020

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“…If POEM is carried out with air insufflation, given that air is absorbed more slowly than CO 2 , the risks are higher for gas embolism, severe pneumothorax, subcutaneous emphysema, and abdominal compartment syndrome, which could be fatal . Air insufflation is therefore contraindicated; CO 2 insufflation should always be used.…”

Section: Clinical Questions and Statementsmentioning

confidence: 99%

Clinical practice guidelines for peroral endoscopic myotomy

Inoue

Shiwaku

Iwakiri

et al. 2018

Digestive Endoscopy

131

155

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Peroral endoscopic myotomy (POEM) is a novel clinical technique developed in Japan used to treat esophageal achalasia and esophageal motility disorders. This technique has been rapidly accepted and widely disseminated throughout our clinical practice because of its low invasiveness, technical novelty, and high efficacy. Since the advent of POEM, there have been no clinical guidelines that clearly indicated its standard of care, and these guidelines have been anticipated both nationally and internationally by clinicians who engage in POEM practice. In 2017, to meet these needs, the Japan Gastroenterological Endoscopy Society (JGES) launched the guideline committee for POEM. Based on the guideline development process proposed by the Medical Information Network Distribution Service (MINDS), the guideline committee initially created research questions on POEM and conducted a systematic review and meta-analysis on each topic. The clinical research extracted from databases for these clinical questions and the systematic review mainly comprised a few retrospective studies with a small number of participants and short trial periods; hence, the strength of the evidence and recommendations derived from these results was low. Throughout this process, the guideline committee met thrice: once on May 13, 2017, and again on September 17, 2017, to formulate the draft. A consensus meeting was then held on January 14, 2018, in Tokyo to establish the guideline statements and finalize the recommendations using the modified Delphi method. This manuscript presents clinical guidelines regarding current standards of practice and recommendations in terms of the nine chief topics in POEM.

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“…Patients with hernias may experience looping within the hernia which can be assisted with external abdominal pressure. 115,116 The colonoscope is advanced to the cecum and terminal ileum and then carefully withdrawn while carefully inspecting the colonic mucosa. Inspection for polyps or mucosal changes include erythema, erosions, ulcers, diverticula, melanosis coli, hemorrhoids, and condyloma should be noted and pictures taken.…”

Section: General Techniquementioning

confidence: 99%