iGIE最新文献

{"title":"Experimental model in porcines to evaluate solutions used in endoscopic resections","authors":"Annita Cavalcante Farias Leoncio MD,&nbsp;Carlos Kiyoshi Furuya PhD,&nbsp;Christiano Makoto Sakai PhD,&nbsp;Paulo Sakai PhD,&nbsp;Edson Ide MS","doi":"10.1016/j.igie.2024.06.004","DOIUrl":"10.1016/j.igie.2024.06.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Injection of solution into the submucosa is an essential step in endoscopic resections and aims to separate the mucosal layer from the muscular layer avoiding, above all, perforatNOVA Nions. This study compares the durability of the solution in bubble formation, endoscopists' opinions on the quality of the bubble during resections, and the electrical resistance of the solutions.</div></div><div><h3>Methods</h3><div>This double-blind study compared the following solutions: Blue Eye (B-bluee), Voluven (Voluv; 6% hydroxyethyl starch solution), 10% mannitol with .45% sodium chloride (Ma-Na45), and mannitol 20% with .9% sodium chloride (Ma-Na90). In Phase 1, a total of 5 mL of the solution was injected into the gastric antrum of a live pig; in Phase 2, two endoscopists performed 20 resections over 5 weeks; and during Phase 3, the study measured the electrical resistance of pure solutions and after injections into the submucosa of ex vivo gastric tissue.</div></div><div><h3>Results</h3><div>Ma-Na90 lasted the longest (28 minutes), while Ma-Na45 had the shortest duration (10 minutes). Ma-Na45 was satisfactory, and Voluv was unsatisfactory. Ma-Na90 produced the most foam, and Voluv required the longest dissection time. There was no perforation. Ma-Na45 had the highest average electrical resistance (89.62 Ω) in both the solution and tissue (391 Ω), while Ma-Na90 exhibited lower values (23 Ω and 55.75 Ω, respectively).</div></div><div><h3>Conclusions</h3><div>This experiment shows the level of complexity in choosing the best solution based on a combination of variables. Mannitol with sodium chloride stood out as a highlighted option due to its favorable overall results and easy accessibility.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 346-351"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced practice provider angle: American Society for Gastrointestinal Endoscopy advanced practice provider case of the month","authors":"Stacia Sackmaster APN-BC ,&nbsp;Sarah Enslin PA-C ,&nbsp;Joseph Vicari MD, MBA, FASGE","doi":"10.1016/j.igie.2024.07.002","DOIUrl":"10.1016/j.igie.2024.07.002","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 445-446"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence–based skeletal muscle estimates and outcomes of EUS-guided treatment of pancreatic fluid collections","authors":"Mamoru Takenaka MD, PhD ,&nbsp;Wataru Gonoi MD, PhD ,&nbsp;Tatsuya Sato MD, PhD ,&nbsp;Tomotaka Saito MD, PhD ,&nbsp;Shouhei Hanaoka MD, PhD ,&nbsp;Tsuyoshi Hamada MD, MPH, PhD ,&nbsp;Shunsuke Omoto MD, PhD ,&nbsp;Atsuhiro Masuda MD, PhD ,&nbsp;Masahiro Tsujimae MD, PhD ,&nbsp;Takuji Iwashita MD, PhD ,&nbsp;Shinya Uemura MD, PhD ,&nbsp;Shogo Ota MD ,&nbsp;Hideyuki Shiomi MD, PhD ,&nbsp;Toshio Fujisawa MD, PhD ,&nbsp;Sho Takahashi MD, PhD ,&nbsp;Saburo Matsubara MD, PhD ,&nbsp;Kentaro Suda MD ,&nbsp;Akinori Maruta MD, PhD ,&nbsp;Kensaku Yoshida MD, PhD ,&nbsp;Keisuke Iwata MD, PhD ,&nbsp;Yuhei Iwasa","doi":"10.1016/j.igie.2024.06.006","DOIUrl":"10.1016/j.igie.2024.06.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Skeletal muscle status may affect clinical outcomes of a variety of pancreatic diseases. Skeletal muscle quality and quantity have not been fully examined in relation to the outcomes of EUS-guided treatment of pancreatic fluid collections (PFCs).</div></div><div><h3>Methods</h3><div>Using a multi-institutional cohort of 372 patients receiving EUS-guided treatment of PFCs in 2010 to 2020, we examined the association of skeletal muscle status with adverse outcomes, including clinical treatment failure and in-hospital mortality. We used an in-house deep learning–based platform for preprocedural CT images, and skeletal muscle density (SMD) and skeletal muscle index (SMI; height-adjusted muscle area) were calculated as surrogates for muscular quality and quantity, respectively. Multivariable logistic regression analysis was conducted to calculate odds ratios (ORs) for adverse outcomes.</div></div><div><h3>Results</h3><div>Lower-level SMD was associated with higher risks of clinical failure and in-hospital mortality (<em>P</em>_trend &lt; .001). The adjusted OR for clinical failure comparing the extreme quartiles was 3.64 (95% confidence interval, 1.52-8.72). Compared with patients in the top 2 quartiles, patients in the lowest quartile had an adjusted OR for in-hospital mortality of 12.4 (95% confidence interval, 3.43-44.8). No effect modification according to the PFC types on the SMD–outcome relationship (<em>P</em>_interaction &gt; .16) was observed. SMD was not associated with the risk of procedure-related adverse events or PFC recurrence. SMI was not associated with adverse outcomes (<em>P</em>_trend &gt; .39).</div></div><div><h3>Conclusions</h3><div>In patients with endoscopically managed PFCs, SMD (but not SMI) was associated with the risks of clinical failure and in-hospital mortality, supporting the prognostic role of skeletal muscle quality.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 382-392.e8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cecal intubation rates: data from the New Hampshire Colonoscopy Registry","authors":"Alexander Miller MD ,&nbsp;Nima Kamalpour MD ,&nbsp;Lynn F. Butterly MD ,&nbsp;Joseph C. Anderson MD","doi":"10.1016/j.igie.2024.07.003","DOIUrl":"10.1016/j.igie.2024.07.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Women and older or thinner patients have lower colonoscopy cecal intubation rates. We used data from the New Hampshire Colonoscopy Registry (NHCR) to examine the association between these and other endoscopist factors and trends of colonoscopy cecal intubation rates.</div></div><div><h3>Methods</h3><div>Our sample included patients ≥40 years from the NHCR with an adequate bowel preparation. We examined colonoscopy completion rates over quartiles (2004-2011, 2012-2014, 2015-2017, and 2018-2021) as stratified by men versus women and body mass index (BMI). In addition to these factors, we also adjusted for age and year of examination. Other variables of interest were specialty of the endoscopist and adenoma detection rates (ADRs).</div></div><div><h3>Results</h3><div>Our sample included 143,095 individuals (52.5% women [n = 75,180]). Multivariable analysis showed that BMI &lt;25 (odds ratio [OR], .87; 95% confidence interval [CI], .76-.99), obesity (BMI ≥30) (OR, .88; 95% CI, .77-.99), and older age (per year) (OR, .96; 95% CI, .96-.97) were associated with a decreased likelihood of having a complete colonoscopy. Men were more likely than women to have a higher completion rate (OR, 1.46; 95% CI, 1.30-1.63). Gastroenterology specialty (OR, 1.78; 95% CI, 1.56-2.03) and an ADR ≥25% (OR, 2.01; 95% CI, 1.79-2.26) were associated with an increased likelihood of cecal intubation. These endoscopist-related factors were also observed to be predictive of cecal intubation in a subset of thin (BMI &lt;25) women. Men and obese patients (BMI ≥30) were more likely to have incomplete examinations halted in the right-sided versus left-sided colon.</div></div><div><h3>Conclusions</h3><div>Even after adjusting for endoscopist factors, our study demonstrated that older or female patients and those with a BMI &lt;25 or ≥30 had lower colonoscopy completion rates. Our data also suggest that colonoscopies performed in thin women were more likely to be completed if they were performed by a gastroenterologist as opposed to a nongastroenterologist.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 393-400.e1"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic stricturotomy and strictureplasty for Crohn’s disease–related duodenal strictures","authors":"Shanshan Wang MD ,&nbsp;Nan Lan PhD, MD ,&nbsp;Bo Shen MD","doi":"10.1016/j.igie.2024.06.001","DOIUrl":"10.1016/j.igie.2024.06.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Duodenal stricturing in Crohn’s disease is rare, and its management has been challenging. Fibrotic or mixed inflammatory/fibrotic primary strictures of Crohn’s disease do not respond well to medical therapy, eventually requiring endoscopic or surgical intervention. Endoscopic balloon dilation has been considered a middle-of-the-road strategy between medical and surgical approaches but is limited by its efficacy in primary stricture, recurrence, and frequent need for redilation. To address these issues, novel strategies, including endoscopic stricturotomy and strictureplasty utilizing electroincision, have been developed. This study aimed to analyze the effectiveness and safety of endoscopic electroincision therapy in Crohn’s disease–related duodenal strictures in a small cohort of consecutive patients.</div></div><div><h3>Methods</h3><div>Data on patients diagnosed with Crohn’s disease and duodenal strictures who were treated with endoscopic electroincision were consecutively extracted from the interventional inflammatory bowel disease unit from December 2, 2019, to January 31 of 2024. All patients with anastomotic stricture were excluded from the study. The primary outcomes were surgery-free survival and postprocedural adverse events.</div></div><div><h3>Results</h3><div>Eight endoscopic electroincision therapies were performed in 5 patients for Crohn’s disease–induced duodenal stricture. The study found a technical success rate of 88%, and a clinical response rate of 100%. The adverse event rate was unremarkable. The rate of endoscopic retreatment was 60%, with a minimum 6-month interval. In follow-up, no patient required surgical intervention.</div></div><div><h3>Conclusions</h3><div>Both endoscopic stricturotomy and strictureplasty seem to be effective and safe therapeutic modalities for Crohn’s disease–associated duodenal stricture.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 342-345"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and sex differences in endoscopy-related injuries: comprehensive systematic review and meta-analysis","authors":"Azizullah Beran MD ,&nbsp;Mouhand F. Mohamed MD ,&nbsp;John J. Guardiola MD ,&nbsp;Tarek Aboursheid MD ,&nbsp;Alejandra Vargas MD ,&nbsp;Tarek Nayfeh MD ,&nbsp;Khaled Elfert MD ,&nbsp;Mohammad Shaear MD ,&nbsp;Hala Fatima MD ,&nbsp;Jeffrey J. Easler MD ,&nbsp;Mohammad Al-Haddad MD ,&nbsp;Nabil Fayad MD ,&nbsp;Patrick Young MD ,&nbsp;Samir A. Shah MD ,&nbsp;Douglas K. Rex MD","doi":"10.1016/j.igie.2024.07.004","DOIUrl":"10.1016/j.igie.2024.07.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastroenterologists are at risk for endoscopy-related injury (ERI). The aim of this meta-analysis was to assess the prevalence, characteristics, and burden of ERI.</div></div><div><h3>Methods</h3><div>We searched PubMed, EMBASE, and Web of Science databases for studies reporting ERI prevalence among GI endoscopists. The primary outcome was the pooled ERI prevalence. We also assessed ERI types and treatments. We compared ERI based on sex. Finally, we compared musculoskeletal injury (MSI) prevalence between GI endoscopists and nonendoscopists. The pooled rates were generated using a proportion meta-analysis with the random-effects model. Prevalence ratios (PRs) with the corresponding confidence intervals (CIs) were used for comparative data.</div></div><div><h3>Results</h3><div>We included 26 studies with 6246 endoscopists. Overall, ERI prevalence was 67.9% (95% CI, 60.7-74.4). ERI prevalence in advanced endoscopists was 77.8% (95% CI, 55.1-90.9). A higher trend of ERI prevalence was observed in more recent studies (after 2015) (71.7%; 95% CI, 63.3-78.9). Neck pain (36.7%) was the most common ERI, followed by low back pain (35.6%) and thumb pain (33.1%). Although women reported higher incidences of De Quervain tenosynovitis and carpal tunnel syndrome and wrist, thumb, shoulder, and neck pain, men reported higher incidences of elbow pain. GI endoscopists had a higher MSI prevalence than nonendoscopists (PR, 1.56; 95% CI, 1.01-2.41). Female endoscopists reported higher ERIs (PR, 1.21; 95% CI, 1.10-1.32). Only 19.1% of endoscopists reported receiving prior ergonomic training.</div></div><div><h3>Conclusions</h3><div>ERI is increasingly prevalent in gastroenterology, particularly in female gastroenterologists with significant sex disparities in ERI types noted. These findings underscore the significance of incorporating ergonomic principles into gastroenterology practices to mitigate ERI risks, particularly considering the shortage of gastroenterologists.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 401-412.e22"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of phosphorus-32 microparticle intratumoral implantation added to chemotherapy in patients with metastatic pancreatic adenocarcinoma","authors":"Amanda Huoy Wen Lim MBBS, FRACP, MMedStats ,&nbsp;Nimit Singhal MBBS, FRACP ,&nbsp;Dylan Bartholomeusz MBBS, FRACP, PhD ,&nbsp;Joshua Zobel BMedSc, GradDipBiostats ,&nbsp;Jeevinesh Naidu MB ChB, MRCP ,&nbsp;William Hsieh BPharmSc ,&nbsp;Benjamin Crouch BSc(Hons), MPhil ,&nbsp;Harpreet Wasan MBBS, MRCP ,&nbsp;Daniel Croagh MBBS, PhD, FRACS ,&nbsp;Adnan Nagrial MBBS, FRACP, PhD ,&nbsp;Morteza Aghmesheh MBBS, FRACP, PhD ,&nbsp;Edmund Tse MBBS, FRACP, PhD ,&nbsp;Christopher K. Rayner MBBS, FRACP, PhD ,&nbsp;Nam Quoc Nguyen MBBS, FRACP, PhD","doi":"10.1016/j.igie.2024.06.005","DOIUrl":"10.1016/j.igie.2024.06.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metastatic pancreatic ductal adenocarcinoma (mPDAC) has a 5-year survival rate of 3%. In nonmetastatic, locally advanced pancreatic cancer, the addition to chemotherapy of EUS-guided intratumoral phosphorus-32 (³²P) microparticle implantation has achieved good local disease control. The aim of this study was to report the clinical outcomes of this treatment in patients with mPDAC.</div></div><div><h3>Methods</h3><div>Patients with mPDAC treated with chemotherapy and intratumoral ³²P-microparticles from 5 centers in Australia and the United Kingdom were analyzed retrospectively.</div></div><div><h3>Results</h3><div>Fourteen patients were treated (7 female subjects; median age, 64.5 years; Eastern Cooperative Oncology Group performance status scores 0/1/2, 21.4%/57.1%/21.4%). The median baseline primary tumor longest diameter was 40.5 mm. Patients had a median of 3 metastases (interquartile range, 2.25 to 5) and received either 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (n = 4) or gemcitabine/nab-paclitaxel (n = 10). ³²P microparticles were implanted at a median 3.1 months from chemotherapy commencement. Local disease control rate at 3 months’ postimplantation was 100%. Primary tumor longest diameter decreased by 25% (interquartile range, –31.4% to –16.7%; <em>P</em> = .008), and serum cancer antigen 19-9 levels declined from 134 U/mL to 66 U/mL (<em>P</em> = .018). Local progression-free survival was 12.2 months (95% CI, 9.0-15.4 months) from chemotherapy commencement and 8.3 months (95% CI, 2.6-16.0 months) from ³²P microparticle implantation. Therapy was associated with improved quality of life, including global health status at 12 weeks’ postimplantation (<em>P</em> = .037). Median overall survival was 13.8 months (95% CI, 10.5-17.1 months) from chemotherapy commencement and 11 months (95% CI, 5.6-17.4 months) from ³²P microparticle implantation. No grade 4/5 acute toxicities were observed.</div></div><div><h3>Conclusions</h3><div>This first multicenter analysis of combined chemotherapy and EUS-guided ³²P microparticle implantation in mPDAC shows the potential clinical benefits of local tumor control in a cohort for whom outcomes are historically poor.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 373-381"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic vacuum therapy","authors":"the American Society for Gastrointestinal Endoscopy Technology Committee,&nbsp;Samuel Han MD, MS ,&nbsp;Mohit Girotra MD, FASGE ,&nbsp;Maaza Abdi MD ,&nbsp;Venkata S. Akshintala MD ,&nbsp;Dennis Chen MD ,&nbsp;Yen-I Chen MD ,&nbsp;Koushik K. Das MD, FASGE ,&nbsp;David J. Desilets MD, PhD, FASGE ,&nbsp;Daniela Guerrero Vinsard MD ,&nbsp;Galen Leung MD ,&nbsp;Girish Mishra MD, MSc, FASGE ,&nbsp;V. Raman Muthusamy MD, MAS ,&nbsp;Frances U. Onyimba MD ,&nbsp;Swati Pawa MD, FASGE ,&nbsp;Tarun Rustagi MD ,&nbsp;Sonali Sakaria MD ,&nbsp;Nikrad Shahnavaz MD ,&nbsp;Ryan J. Law DO","doi":"10.1016/j.igie.2024.06.003","DOIUrl":"10.1016/j.igie.2024.06.003","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 333-341"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural ablation as a mechanism of action for antral myotomy in the treatment of obesity","authors":"Pichamol Jirapinyo MD, MPH,&nbsp;Christopher C. Thompson MD, MSc,&nbsp;Sohail Shaikh MD,&nbsp;Nitin Kumar MD","doi":"10.1016/j.igie.2024.07.006","DOIUrl":"10.1016/j.igie.2024.07.006","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Page 366"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hard candy on saliva production and gastric fluid volume: implications for safe endoscopy","authors":"Saleh Alghsoon MD ,&nbsp;Madeline Alizadeh PhD ,&nbsp;William H Scott, MA ,&nbsp;Guofeng Xie MD ,&nbsp;Jean-Pierre Raufman MD ,&nbsp;Erik C. von Rosenvinge MD","doi":"10.1016/j.igie.2024.07.008","DOIUrl":"10.1016/j.igie.2024.07.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patients presenting for endoscopic procedures consuming or having recently consumed hard candy may have their procedures delayed or canceled because of concern for aspiration. Our aim is to determine the time needed after ingestion of hard candy for the safe performance of sedated endoscopy.</div></div><div><h3>Methods</h3><div>A 2-phase institutional review board–approved study was performed. In phase 1, healthy adults collected their oral secretions before and after ingestion of hard candy to measure the impact of hard candy on saliva production. In phase 2, patients undergoing clinical upper endoscopy were randomized to receive hard candy (HC group) or not receive hard candy (no-HC group) approximately 30 minutes before endoscopy. Blinded endoscopists aspirated gastric fluid immediately after gastric intubation and measured its volume and weight. Participants were assessed for adverse events.</div></div><div><h3>Results</h3><div>Ten healthy volunteers (6 women; median age, 28 years) were enrolled in phase 1. Saliva production peaked at the collection 10 minutes after initiating hard candy. The mean time from candy completion for saliva production to return to within 10% of unstimulated levels was 32 minutes (standard deviation, 12). In phase 2, 63 participants were randomized and had gastric fluid volumes and weights measured. The mean gastric fluid volume was 23.3 mL in the HC group and 17.6 mL in the no-HC group (<em>P</em> = .21). No adverse events were attributable to study participation.</div></div><div><h3>Conclusions</h3><div>Our results suggest that endoscopic procedures can be safely performed after ingestion of hard candy and should not be delayed by more than 30 minutes.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 418-423.e1"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}