Comparison of Postoperative Complications after Endoscopic Submucosal Dissection: Differences of Insufflations and Anesthesias

Mori, Hideki; Kobara, Hideki; Muramatsu, A.; Inoue, Hirokazu; Kobayashi, Mitsuyoshi; Nomura, Takako; Hagiike, Masanobu; Izuishi, Kunihiko; Suzuki, Yasuyuki; Gong, Jianping; Masaki, Tsutomu

doi:10.1155/2011/709237

Cited by 10 publications

(6 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In endoscopic therapy and in ESD, which requires a prolonged duration of treatment, CO 2 use has been reported to be safe [ 10 ]. In particular, in colorectal ESD, the perforation rate has been reported to be high [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Precise tumor size measurement under constant pressure by novel real-time micro-electro-mechanical-system hood for proper treatment (with videos)

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundTumor size determination is subject to the measurement method used by endoscopists and is especially dependent on the air quantity. As the intraluminal pressure must be measured objectively to obtain an accurate tumor size measurement, insufflation can affect the results. Thus, we examined the utility of a micro-electro-mechanical-system (MEMS) pressure sensor hood.MethodsTwenty consecutive air insufflation/deflation tests were performed in vivo using a dog’s stomach. Correlations between the actual pressure measured and the signal strength of the MEMS hood were measured. We marked 2 points 20 mm on the antrum and another 3 points, with insufflation corresponding to the maximum stable distance of two markings. We performed five insufflation/deflation tests to obtain the relationship between pressure and distances to accurately measure the distance under constant pressure.ResultsIn the air insufflation/deflation test performed 20 consecutive times, the MEMS hood signal strength (V) and the pressure measurement sensor values (mmHg) showed good correlation. There was good correlation between intraluminal pressures of 2.5–40 mmHg and the two marking distances on the antrum (correlation coefficient 0.952) (P < 0.05). However, once the intraluminal pressure reached a certain level (40 mmHg), expansion of the two marking distances ceased. The same measurements were conducted on the greater curvatures of the lower body and middle body and on the lesser curvature of the lower body.ConclusionsCorrect tumor size measurements using a MEMS hood enable a more accurate diagnosis, which can be used to develop suitable treatment strategies.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-014-3642-3) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Precise tumor size measurement under constant pressure by novel real-time micro-electro-mechanical-system hood for proper treatment (with videos)

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…The intragastric pressure at the time of strong gastric wall extension was measured using the method developed in Part 1 (the in vitro study). CO 2 was used for insufflation 6 . If adverse events including abdominal pain, Mallory-Weiss syndrome, and mucosal injury occurred during the experiments, the examination was immediately discontinued.…”

Section: Methodsmentioning

confidence: 99%

Measurement of intragastric pressure: an objective method to ascertain whether gastric wall extension is sufficient for assessment of the non-extension sign

et al. 2021

View full text Add to dashboard Cite

Background and study aims The optimal intragastric pressure (IP) for strong gastric wall extension is unclear. We aimed to develop an accurate method to measure IP using endoscopy and determine the pressure required for strong gastric wall extension. Methods An in vitro experiment using an endoscope with a rubber attached at its tip was conducted. The process of inserting the pressure measurement probe into the forceps channel was skipped, and the tube of the pressure measurement device was directly connected to the forceps channel. In vivo, the pressure in 51 consecutive patients at the time of strong gastric wall extension was measured. Strong extension of the gastric wall was defined as when the folds in the greater curvature were flattened as a result of sufficient extension of the gastric wall by insufflated air during upper gastrointestinal endoscopy. The IP at that time was measured. Results In vitro, 20 mL of tap water was injected once into the forceps channel and then aspirated for 10 seconds. Pressure measurement after irrigation of the forceps channel as well as the measurement by inserting the probe procedure were accurately performed. In vivo, among the 51 included patients, the mean IP (range) was 14.7 mmHg (10–23). Strong extension of the gastric wall was obtained in 96.1 % of patients when the IP was 20 mmHg. Conclusions We developed an accurate method to measure IP using upper gastrointestinal endoscopy. Strong extension of the gastric wall was obtained in almost all patients when the IP was 20 mmHg.

show abstract

“…The eligibility criteria for the included studies relied on previously published guidelines for systematic reviews and was based on the PICO framework; P (population–patients with early gastric cancer undergoing ESD), I (interventions–CO 2 insufflation), C (comparative interventions–control group, air insufflation), and O (outcomes–procedure-related primary or secondary adverse events including post-procedural pain and discomfort and pulmonary dysfunction) [ 19 ]. Studies that did not compare CO 2 insufflation with air were excluded [ 11 , 20 - 22 ]. A total of four randomized control trials (RCTs) met the inclusion criteria [ 23 - 26 ].…”

Section: Methodsmentioning

confidence: 99%

Carbon Dioxide versus Air Insufflation in Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Baniya¹,

Upadhaya²,

Khan³

et al. 2017

Clin Endosc

View full text Add to dashboard Cite

Background/AimsEndoscopic submucosal dissection (ESD) with air insufflation is commonly used for the staging and treatment of early gastric carcinoma. However, carbon dioxide (CO2) use has been shown to cause less post-procedural pain and fewer adverse events. The objective of this study was to compare the post-procedural pain and adverse events associated with CO2 and air insufflation in ESD.MethodsA systematic search was conducted for randomized control trials (RCTs) comparing the two approaches in ESD. The Mantel-Haenszel method was used to analyze the data. The mean difference (MD) and odds ratio (OR) were used for continuous and categorical variables, respectively.ResultsFour RCTs with a total of 391 patients who underwent ESD were included in our meta-analysis. The difference in maximal post-procedural pain between the two groups was statistically significant (MD, -7.41; 95% confidence interval [CI], -13.6 – -1.21; p=0.020). However, no significant differences were found in the length of procedure, end-tidal CO2, rate of perforation, and postprocedural hemorrhage between the two groups. The incidence of overall adverse events was significantly lower in the CO2 group (OR, 0.51; CI, 0.32–0.84; p=0.007).Conclusions:CO2 insufflation in gastric ESD is associated with less post-operative pain and discomfort, and a lower risk of overall adverse events compared with air insufflation.

show abstract

Comparison of Postoperative Complications after Endoscopic Submucosal Dissection: Differences of Insufflations and Anesthesias

Cited by 10 publications

References 11 publications

Precise tumor size measurement under constant pressure by novel real-time micro-electro-mechanical-system hood for proper treatment (with videos)

Precise tumor size measurement under constant pressure by novel real-time micro-electro-mechanical-system hood for proper treatment (with videos)

Measurement of intragastric pressure: an objective method to ascertain whether gastric wall extension is sufficient for assessment of the non-extension sign

Carbon Dioxide versus Air Insufflation in Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Contact Info

Product

Resources

About