The endoscopic management of leakages or fistulas after esophageal surgery reached an efficacy rate of 68.8 %, mostly using stents, without significant adverse events. The mortality rate could be decreased from 40-100 to 17 %.
BackgroundCurrently, colonoscopy and polypectomy are the gold standard methods for the prevention of incident cases of colorectal cancer. The use of a new colonoscope (Fuse®, EndoChoice®) with a larger view of up to 330° appears to improve the adenoma detection rate (ADR). We performed a prospective observational study concerning this scope. The primary endpoint was potentially omitted adenomas (POA), i.e. adenomas seen on the side screens that will not appear on the central display during colonoscopy withdrawal without oriented movements. Secondary endpoints included our ADR, Fuse® impact on ADR, time to cecal intubation and withdrawal time.MethodsWe performed a single-center prospective study in one French center. We enrolled patients over 18 years of age between January 2015 and March 2016.ResultsWe included 141 patients; 3 were excluded because their colonoscopies were incomplete. Our study included 78 men and 60 women (sex ratio 1.3). The mean age was 60.4 years. A total of 130 polyps were resected. In all, 88/130 were adenomas (68%) and 34/88 adenomas (39%) were POA. The mean time to cecum was 10 min, and the mean withdrawal time was 12 min. ADR was 35% for men and 31% for women. The estimated ADR without POA was 29% for men and 19% for women.ConclusionsThe Fuse® system appears to be safe and efficient. POA represented 39% of all adenomas. The impact of the panoramic view on the ADR was considered substantial. The main limitations are the lack of randomization and the absence of a control group.
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Efficacité du traitement endoscopique dans la prise en charge des fistules digestives anastomotiques après chirurgie pour cancer de l'oesophageCécilia Servajean-Defranchi
To cite this version:Cécilia Servajean-Defranchi. Efficacité du traitement endoscopique dans la prise en charge des fistules digestives anastomotiques après chirurgie pour cancer de l'oesophage. Sciences du Vivant [q-bio]. 2015.
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