Ultrasound Image Features under Decomposition Algorithm to Analyze the Nursing Intervention on Patients with Colon Polyps Undergoing Endoscopic Resection
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Based on the ultrasonic imaging and endoscopic resection of the intelligent segmentation algorithm, this study is aimed at exploring whether nursing intervention can promote the good recovery of patients with colon polyps, hoping to find a new method for clinical treatment of the colon polyps. Patients with colon polyps were divided into an experimental group (fine nursing) and a control group (general nursing). The colonoscopy polyp ultrasound image was preprocessing to select the seed points and background points. The random walk decomposition algorithm was applied to calculate the probability of each marked point, and then, the marked image was outputted. The accuracy of the intelligent segmentation algorithm was 81%. The incidence of complications in the experimental group was 4.83%, which was lower than 16.66% in the control group, and the difference was statistically obvious (P < 0.05). Perioperative refined nursing intervention for colon polyp patients undergoing endoscopic electrosurgical resection can decrease postoperative adverse reactions; reduce postoperative mucosal perforation, blood in the stool, abdominal pain, and small bleeding; lower the incidence of postoperative complications; and allow patients to recover quickly, enhancing the life comfort of patient.Keywords:
Perforation
Endoscopic mucosal resection
Abstract The reported rates of incomplete colonoscopy (IC) range from 4% to 25% for both screening and nonscreening colonoscopy. Colonic neoplasm can be found in up to 53% on successful repeat colonoscopy. Transparent cap‐assisted colonoscopy (TCAC) and water‐exchange colonoscopy (WEC) have been applied seperately for repeat colonoscopy in the setting of failed difficult colonoscopy, but combination of these two methods for previous incomplete difficult colonoscopy has not been reported. The aim of this study is to report the success rate, time‐to cecum duration, polyp detection rate, and any complications using the combined methods of TCAC and WEC for previous incomplete difficult colonoscopy. Eight cases of incomplete difficult colonoscopy were enrolled from November 2016 to October 2018. Water exchange method (air‐less colonoscopy) performed during insertion of Cap‐fitted colonoscope, and after reaching the cecum, CO 2 was insufflated for examination during withdrawal. The mean age of all eight female patients was 59 years (39‐72 year). One patient had failed colonoscopy twice previously, four had previous abdominal surgery. Six cases were performed by gastroenterologists, and two by colorectal surgeons previously. The cecal intubation rate was 100% on repeat colonoscopy with the combined TCAC and WEC methods without complications. The mean duration time to reach the ceum was 12.5 minutes (6.8‐23.3 minutes). Out of the eight patients, four had colon polyps, all confined to proximal colon. Two patients have advanced colon adenoma. Combining cap‐assisted colonoscopy (TCAC), and water exchange colonoscopy (WEC) are useful in previous incomplete colonoscopy cases.
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Objective: We aimed to determine the efficacy and safety of early (within the first 24 hour from application) endoscopy and colonoscopy in very elderly patients with GIS bleeding.Methods: In this study, 95 patients were included who underwent early endoscopy with the pre‑diagnosis of upper GIS bleeding or endoscopy-colonoscopy with the pre-diagnosis of lower GIS bleeding between 2012 and 2016. Endoscopy and colonoscopy procedures were compared in terms of the development of complications, tolerance of procedure, detection of bleeding site, and rate of therapeutic interventions performed for bleeding. In addition, the adequacy of colonoscopy preparation was evaluated.Results: There was no significant difference between endoscopy and colonoscopy on procedural complication (2.1% vs 2.8%) and tolerance rates (81% vs 74.2), (p>0.05). The bleeding site was detected during endoscopy in 34(56.6%) patients, and an endoscopic intervention was required for 15(25%) of these patients. The bleeding site was detected during colonoscopy in 12(34.3%) patients, and an endoscopic intervention was performed for two (5.7%) patients (p<0.05). In addition, the colonoscopy procedure was suboptimal in 26 of 35 patients (74.2%) because of poor preparations.Conclusion: Early endoscopy and colonoscopy are safe and well tolerated in very elderly patients with GIS bleeding. Upper GIS endoscopy in this patient population enables the detection of the bleeding site and an endoscopic intervention for the bleeding. However, colonoscopy is insufficient for detecting bleeding sites, and colonoscopic treatment of bleeding sites is difficult because of poor or no preparation in this patient population.doi: https://doi.org/10.12669/pjms.331.11616How to cite this:Celik M. Efficacy of early endoscopy and colonoscopy in very elderly patients with gastrointestinal bleeding. Pak J Med Sci. 2017;33(1):187-190. doi: https://doi.org/10.12669/pjms.331.11616This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gastrointestinal bleeding
Therapeutic Endoscopy
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Endoscopic submucosal dissection
Endoscopic mucosal resection
Perforation
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Bowel preparation
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Objective To summarize the technique of one-man colonoscopy. Method The data of one-man colonoscopy and two-men colonoscopy on 360 patients were comparatively analyzed. Results The success rate of one-man colonoscopy was up to 96.9%, while two-men colonoscopy was 85.5%. The rate of reaching the end of ileum by one-man colonoscopy was 85%, and that of two-men colonoscopy was 56.0%. Eight minutes and eight seconds were spent for one-man colonoscopy to reach ileocecus on average, which was faster than two-men colonoscopy(11.5 minutes on average). The incidence of complication caused by two-men colonoscopy was 0%, whereas two-men colonoscopy was 0.88%. All results of one-man colonoscopy were superior to those of the control group. Conclusion One-man colonoscopy is not only time-saving and manpower-saving, but also safe and efficient.
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Endoscopic mucosal resection
Perforation
Endoscopic submucosal dissection
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Objective To compare the clinical choosing principles of sedated colonoscopy with con-ventional colonoscopy. Methods Outpatients who were willing to accept colonoscopy with or without seda-tion were prospectively recruited,which were assigned to sedated colonoscopy group(n=362)and conven-tional colonoscopy group(n=323). All patients and endoscopists were asked to answer a self-administered questionnaire. The colonoscopy completion,operation time,procedure-related discomfort,and questionnaire results of the two groups were compared and statistically analyzed. Results The completion rate was 98. 9%in the sedated colonoscopy group(358/362)and 89. 8% in the conventional colonoscopy group(290/323) ( P=0. 337 ). The operation time of sedated and conventional group were( 5. 60 ± 3. 25 ) minutes and (7. 71 ± 5. 70)minutes respectively(P<0. 001). And the average cost was CNY 886. 54 per patient in se-dated group and CNY 386. 00 per patient in the conventional group. Patient satisfaction score of conventional group and sedated group were 4(3-4)and 3(2-3)points(P<0. 001),while endoscopist satisfaction score was 4(3-4)and 4(4-4)(P<0. 001). A total of 354 patients(97. 79%)in the sedated group and 225 pa-tients(69. 66%)in the conventional group showed willingness to repeat the identical colonoscopy( P <0. 001). Patients who were male(P=0. 035),having no past abdominal operations(P<0. 001),or no ab-dominal pain during colonoscopy( P =0. 015 )in the conventional group preferred to repeat conventional colonoscopy. Conclusion Although the examination time of conventional colonoscopy is longer than sedated colonoscopy,it could reduce anesthesia risk and the cost. Conventional colonoscopy remains an irreplaceable examination of colorectal diseases in developing countries. Physicians should not only focus on patients'com-fort during endoscopy,but also help patients make a decision based on their actual situation and endoscopic indications to make the best of medical resources.
Key words:
Colonoscopy ; Toleration ; Patient satisfaction ;
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As the significance of the quantitative fecal immunochemical test (FIT) in patients who previously underwent a colonoscopy is unknown, this study aimed at investigating the association between fecal hemoglobin concentration and the risk of colorectal cancer (CRC).We retrospectively analyzed FIT-positive patients who underwent a colonoscopy through our opportunistic annual screening program from April 2010 to March 2017 at the Kyoto Second Red Cross Hospital. We stratified them into no colonoscopy and past colonoscopy (>5 years or ≤5 years) groups based on whether they had a history of undergoing a colonoscopy and analyzed the correlation between fecal hemoglobin concentration and advanced neoplasia or invasive cancer detection in each group. We analyzed 1248 patients with positive FIT results. There were 748 (59.9%), 198 (15.9%), and 302 (24.2%) patients in the no colonoscopy, past colonoscopy (>5 years), and past colonoscopy (≤5 years) groups, respectively. In the no colonoscopy group, the advanced neoplasia detection rate significantly increased with the fecal hemoglobin concentration (P < 0.001). However, no significant trend was observed in the past colonoscopy (both >5 years and ≤5 years) group (P = 0.982). No invasive cancer was detected in the past colonoscopy (≤5 years) group.The risk of CRC might be low even if fecal hemoglobin concentration was high, especially in those who underwent colonoscopy within 5 years.
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BACKGROUND: Colonoscopy is the standard examination to detect mucosal pathology in the colon. However, failure to complete colonoscopy may reach more than 10% in population-based endoscopy practices. The reasons for incomplete conventional colonoscopy are diverse and result in missed diagnosis of colonic polyps and carcinoma. OBJECTIVE: Recent endoscopic developments have shown that the use of specialized overtubes may help to reach the cecum in the case of a difficult colonoscopy, even with less discomfort. Several types of overtubes are currently available, whereas other types are being developed and clinically evaluated. The current review highlights the development of overtubes for colonoscopy and the available clinical data on overtube-assisted colonoscopy in the case of incomplete conventional colonoscopy. DATA SOURCES: Data were derived from a PubMed search through November 2012. STUDY SELECTION: Available clinical literature data on recent developments in overtube-assisted colonoscopy were studied. INTERVENTION: A descriptive comparison was made of currently available endoscopy systems used for overtube-assisted colonoscopy. MAIN OUTCOME MEASURES: The primary outcomes measured were the feasibility and safety of different endoscopy systems to perform overtube-assisted colonoscopy. RESULTS: Several overtube-assisted colonoscopy systems have recently been developed to complete colonoscopy in the case of difficult conventional colonoscopy. Literature data show excellent feasibility to reach the cecum with very low complication rates and good patient tolerance for the different overtube systems. LIMITATIONS: The majority of available studies are uncontrolled case series describing 7 to 110 patients undergoing overtube-assisted colonoscopy with only 1 direct comparison between 2 overtube systems. CONCLUSIONS: Overtube-assisted colonoscopy has been shown to be useful in performing colonoscopy by increasing the cecal intubation rate and patient tolerance and by decreasing the need for sedation. There is no standardized superior overtube system at this moment.
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