The present consensus represents practical recommendations for performing IGB procedures and reflects Brazil's significant experience with this device. The experience of over 40,000 cases shows that the device leads to satisfactory weight loss with a low rate of adverse events.

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Introduction. To compare the accuracy of digital and real-time chromoendoscopy for the differential diagnosis of diminutive (<5 mm) neoplastic and nonneoplastic colorectal lesions. Materials and Methods. This is a prospective randomized study comparing the Fujinon intelligent color enhancement (FICE) system (65 patients/95 lesions) and indigo carmine (69 patients/120 lesions) in the analysis of capillary meshwork and pit pattern, respectively. All lesions were less than 5 mm in diameter, and magnification was used in both groups. Histopathology was the gold standard examination. Results. Of 215 colorectal lesions, 153 (71.2%) were adenomas, and 62 were hyperplastic polyps (28.8%). Morphological analysis revealed 132 (61.4%) superficial lesions, with 7 (3.3%) depressed lesions, and 83 (38.6%) protruding lesions. Vascular meshwork analysis using FICE and magnification resulted in 91.7% sensitivity, 95.7% specificity, and 92.6% accuracy in differentiating neoplastic from nonneoplastic lesions. Pit pattern analysis with indigo carmine and magnification showed 96.5% sensitivity, 88.2% specificity, and 94.2% accuracy for the same purpose. Conclusion. Both magnifying virtual chromoendoscopy and indigo carmine chromoendoscopy showed high accuracy in the histopathological diagnosis of colorectal lesions less than 5 mm in diameter.

A 53 year old woman with respiratory failure and stridor caused by a tracheal plasmacytoma was treated by endoscopic loop polypectomy and neodymium YAG laser therapy, followed by local irradiation. Two years later there was no evidence of recurrence of disease.Extramedullary plasmacytomas are uncommon tumours that affect widely varying tissues. In the respiratory tract most arise in the upper airways; primary tracheal lesions are rare." We report a case of tracheal plasmacytoma successfully treated by bronchoscopic polypectomy and neodymium YAG laser therapy followed by local irradiation. Case reportA 53 year old woman was admitted to hospital with respiratory failure, inspiratory stridor, decreased breath sounds, and fever. She had been treated for asthma for three years with bronchodilators but over the preceding 15 days her respiratory symptoms had worsened. She had smoked 20 cigarettes a day for 30 years and had lost 20 kg in three years.At emergency fibreoptic bronchoscopy numerous polypoid nodules 2-5 mm in diameter were seen in the tracheal mucosa, and 2 cm above the carina there was a larger lobulated mass occluding 75% of the tracheal lumen. An endoscopic loop polypectomy was performed, followed by two applications of neodymium YAG laser therapy to the larger mass. After these procedures there was immediate symptomatic relief.Histopathological and immunoperoxidase studies of the larger mass showed a plasmacytoma with an IgG and lambda

RESUMO -Contexto -O uso da cromoscopia virtual com sistema de imagem multibanda poderia auxiliar no diagnóstico in vivo de neoplasias colônicas. Objetivo -Avaliar a exatidão da magnificação associada à cromoendoscopia eletrônica ou com índigo-carmin na distinção entre lesões neoplásicas e não-neoplásicas do cólon e reto. INTRODUÇÃONos últimos anos, a magnificação de imagens com ou sem o emprego da cromoscopia, tem ganho grande importância como recurso propedêutico para endoscopia digestiva, em especial, da colonoscopia (6,9,11,16,19,20) . Maior precisão diagnóstica requer detecção de pequenas alterações estruturais ou de coloração (8) , que podem ser diagnosticadas por meio da colonoscopia de alta resolução aliada à magnificação de imagens. Esta tecnologia permite o aumento de uma porção da imagem e sua visualização com grande riqueza de detalhes, seja ela obtida óptica ou digitalmente. A imagem endoscópica depende dos comprimentos de onda da luz que são refletidos pelo tubo digestivo. O sistema FICE ® ("Fuji Intelligent Color Enhancement"), por meio de filtros específicos para diferentes combinações de comprimentos de onda entre o vermelho, o verde e o azul, converte imagens ópticas em imagens espectrais altamente contrastadas. Desta forma, o FICE ® se apresenta como verdadeiro método de cromoscopia virtual, dispensando o emprego de corantes, o que levaria a ganho de tempo, redução dos custos e maior praticidade durante a colonoscopia.Neste estudo, pretende-se comparar a precisão diagnóstica desta nova ferramenta com o método clássico de magnificação de imagens aliada à cromoscopia com índigo-carmin na distinção entre lesões neoplásicas e não-neoplásicas do cólon e reto. MÉTODOS

Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples.

OBJECTIVES:To disseminate transesophageal ultrasound-guided fine needle aspiration (EUS-FNA) as an alternative to investigate mediastinal tumoral lesions because it is an underused modality that has been available in Brazil for more than 15 years.METHODS:Descriptive analysis of a single endoscopy service's experience since 1997 in the accomplishment of EUS-FNA for mediastinal staging of previously known malignancies (Group 1) or diagnostic definition of suspect lymph nodes and masses (Group 2).RESULTS:EUS-FNA was performed in 51 patients between 26 and 87 years of age. The diameter of the lesions ranged between 1.1 and 9.8 cm (mean 3.9 cm). Their location corresponded to the following stations: higher paratracheal (4 cases), lower paratracheal (7), aortic window (12), para-aortic (6), subcarinal (9), paraesophageal (8), and hilar (5). In Group 1, 17 patients had previously diagnosed primary lung (9), breast (4), kidney (2), colon (1), and bladder (1) cancer. Fifteen of these punctures were positive for malignity. Two others were later submitted to mediastinoscopy, which identified metastases not detected by EUS-FNA. Group 2 comprised 34 patients. Among these patients, EUS-FNA diagnosed 22 neoplasms, five cases of tuberculosis and two duplication cysts. Cytology was inconclusive or without a specific diagnosis in five other cases. Mediastinoscopy identified two undiagnosed cases of oat-cell carcinoma, one lymphoma and one cryptococcosis, and confirmed one reactive lymphadenitis. There were no complications related to the method.CONCLUSIONS:EUS-FNA obviated the need for surgical procedures in 86.3% of cases. Therefore, oncologists, pulmonologists, and thoracic surgeons should always remember the technique's potential and availability.

Background and study aims Regardless of size, duodenal neuroendocrine tumors (dNETs) should be considered potentially malignant. A complete resection without complications is essential to increase safety procedures. The aim of this review was to describe effectiveness and possible complications of endoscopic techniques resection for resectioning dNETs in patients with tumors ≤ 20 mm in diameter. Methods An electronic bibliographic search was conducted using MEDLINE (via PubMed), Embase, Cochrane Central, and Google Scholar virtual databases. The types of intervention were endoscopic mucosal resection alone (EMR) or with cap (EMR-C), with a ligation device (EMR-L), with previous elevation of the tumor (EMR-I) or with endoscopic submucosal dissection (ESD); argon plasm coagulation (APC), and polypectomy. The outcome measures adopted were presence of free margin associated with tumor resection, tumor recurrence, complications (bleeding and perforation), and length of the procedure. Results Ten publications were included with the result of 224 dNET resections. EMR alone and polypectomy resulted in the most significantly compromised margin. The most frequent complication was bleeding (n = 21), followed by perforation (n = 8). Recurrence occurred in 13 cases, the majority of those under EMR or EMR-I. Conclusions EMR-C or EMR-I should be preferred for resectioning of dNETs. Polypectomy should not be indicated for resection of dNETs due to the high occurrence of incomplete resections. EMR alone must be avoided due a higher frequency of compromised margin and recurrent surgery. ESD was associated with no recurrence, however, but an increased occurrence of bleeding and perforation.