iGIE最新文献

英文中文

Improvement in documentation rates for resumption of antithrombotic agents after elective endoscopy using an electronic health record–based intervention 使用基于电子健康记录的干预改善选择性内窥镜检查后恢复抗血栓药物的记录率

iGIE

Pub Date : 2025-06-01 DOI: 10.1016/j.igie.2025.03.004

Jeffrey Than MD , Terrance Rodrigues MD , Mary Kwasny PhD , Srinadh Komanduri MD

Background and Aims

Resumption recommendations for anticoagulants (ACs) and antiplatelet agents (APAs) after endoscopy are inconsistently documented, which has been associated with a small but clinically significant number of adverse events (AEs). Clinical decision support systems must be implemented properly to ensure high adoption and clinically appropriate use. This study aimed to improve the rate of documentation of resumption recommendations for ACs and APAs using an electronic health record–based intervention integrated into the existing clinical workflow.

Methods

We implemented a soft-stop endoscopy software alert to trigger if resumption recommendations were not initially documented in patients on ACs and APAs. The rates of documentation of resumption recommendations were compared between pre- and postintervention periods.

Results

Across 1238 encounters for elective outpatient endoscopy, there was no difference in AC and APA use between pre- and postintervention periods. More endoscopies were performed in patients taking ACs (77.9%) compared with those taking APAs (25.3%). The intervention led to a significant increase in documentation of resumption recommendations postintervention from 47.1% (95% confidence interval [CI], 42.6-51.6) and 41.6% (95% CI, 34.1-49.6) to 70.5% (95% CI, 66.3-74.4; P < .001) and 73.1% (95% CI, 65.6-79.4; P < .001) in patients on ACs and APAs, respectively. Patients who were older, undergoing colonoscopy, or female were more likely to have documentation of recommendations, whereas those undergoing endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP) on ACs were less likely to have recommendations documented. Sedation type and the presence of a fellow did not impact documentation rates.

Conclusions

Implementing an electronic health record–based intervention into the existing endoscopy workflow improved the documentation of resumption recommendations for antithrombotic medications after elective outpatient endoscopy.

背景和目的内窥镜检查后抗凝血剂（ACs）和抗血小板药物（APAs）的恢复建议不一致，这与少量但临床显着的不良事件（ae）相关。临床决策支持系统必须正确实施，以确保高采用率和临床适当使用。本研究旨在通过将电子健康记录为基础的干预措施整合到现有的临床工作流程中，提高ACs和APAs恢复建议的记录率。方法：我们实施了软停止内窥镜检查软件警报，如果ACs和APAs患者最初没有记录恢复建议，则触发该软件。在干预前和干预后期间比较恢复建议的文件率。结果在1238例选择性门诊内窥镜检查中，干预前后AC和APA的使用没有差异。服用ac的患者（77.9%）比服用APAs的患者（25.3%）进行了更多的内窥镜检查。干预导致干预后恢复推荐的文件显著增加，从47.1%（95%可信区间[CI]， 42.6-51.6）和41.6% （95% CI, 34.1-49.6）增加到70.5% (95% CI, 66.3-74.4；P & lt;.001)和73.1% (95% CI, 65.6-79.4；P & lt;.001)。年龄较大、接受结肠镜检查或女性患者更有可能有推荐文件，而在ACs上接受内窥镜超声（EUS）或内窥镜逆行胆管造影（ERCP）的患者则不太可能有推荐文件。镇静类型和同伴的存在不影响记录率。结论：在现有的内窥镜检查工作流程中实施基于电子健康记录的干预，改善了选择性门诊内窥镜检查后抗血栓药物恢复建议的文件记录。

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引用次数: 0

Impact of novel lightweight disposable gastroscope and duodenoscope on endoscopist muscle activation: a comparative study 新型轻型一次性胃镜与十二指肠镜对内窥镜师肌肉活动影响的比较研究

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2024.08.008

Veronica Bessone PhD , Robin Rusnak MSc , Sven Adamsen MD, FASGE

Background and Aims

Musculoskeletal injuries are common among endoscopists, and reducing the endoscope weight is considered to be a preventive measure. We aimed to assess the impact on muscle activation of recently developed lightweight gastroscopes and duodenoscopes, compared with standard endoscopes in a 2-part study.

Methods

In the first part, 14 participants performed a protocol using a lightweight disposable and a standard reusable gastroscope in a random order. The protocol constituted of 3 equal working blocks with repetitive and standardized movements. In the second part, 15 endoscopists used a lightweight disposable and a reusable duodenoscope in an artificial model and at rest. For both protocols, the subjects wore a sleeve with embedded superficial electromyographic sensors on the left arm.

Results

Wrist flexor muscle activation was significantly lower when using the lightweight single-use endoscopes during the protocol tasks (P < .05). The extensor muscles were also significantly less activated while using the single-use gastroscope (P < .05), but there was no difference when using the duodenoscopes.

Conclusions

Standardized operation with lightweight endoscopes reduces the load on the left forearm muscles and favors muscle rest compared with heavier standard endoscopes. These improvements in user ergonomics may aid in preventing or delaying the development of tremor, fatigue, and injuries.

背景与目的内窥镜医师常见肌肉骨骼损伤，减轻内窥镜重量被认为是一种预防措施。我们的目的是评估最近开发的轻型胃镜和十二指肠镜对肌肉激活的影响，并与标准内窥镜进行比较。方法在第一部分中，14名参与者按随机顺序使用轻型一次性胃镜和标准可重复使用胃镜。协议由3个相等的工作块组成，动作重复、标准化。在第二部分中，15名内窥镜医师在人工模型和静止状态下使用轻型一次性和可重复使用的十二指肠镜。在两种方案中，受试者都在左臂上佩戴了嵌入浅表肌电图传感器的套筒。结果在方案任务中使用轻型一次性内窥镜时腕屈肌激活明显降低(P <；. 05)。使用一次性胃镜时，伸肌的激活程度也明显降低(P <；0.05)，但在十二指肠镜下无差异。结论与较重的标准内窥镜相比，轻型内窥镜的标准化操作减轻了左前臂肌肉负荷，有利于肌肉休息。这些使用者人体工程学方面的改进有助于预防或延缓震颤、疲劳和损伤的发展。

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引用次数: 0

Comparison of quality performance metrics in screening and surveillance colonoscopy: a single-center experience 筛选和监测结肠镜检查质量绩效指标的比较：单中心经验

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2024.08.007

James Stephen Love MD , Michael Siegel DO , Meredith Yellen MD , Jeffrey Rebhun MD , Asim Shuja MD

Background and Aims

Screening colonoscopy guidelines recommend a minimum adenoma detection rate (ADR) of 35%. There are no established benchmarks for surveillance colonoscopies, and data surrounding the utility of other quality metrics are limited. We aimed to define the relationship between ADR and alternative quality measures in the setting of screening and surveillance colonoscopies and to determine whether validated screening quality benchmarks can be extrapolated to surveillance procedures.

Methods

A retrospective review of outpatient screening and surveillance colonoscopies at a tertiary health center was performed. ADR, adenomas per colonoscopy, adenomas per positive participant, polyp detection rate, right-sided polyp detection rate, and colonoscopy withdrawal times (CWTs) were analyzed for screening and surveillance colonoscopies.

Results

In total, 2646 procedures (1884 screening, 762 surveillance) were analyzed. Surveillance ADR (CADR) was higher than screening ADR (65.6% ± 0.02% vs 47.0% ± 0.01%; P < .001). All alternate quality measures except CWT were higher in surveillance procedures. Among surveillance procedures, there was a strong correlation between CADR and polyp detection rate (r = .956, P < .01) and right-sided polyp detection rate (r = .771, P = .003); correlations between CADR and other alternate quality measures were not significant.

Conclusions

Colonoscopy quality measures were significantly higher in surveillance procedures compared with screening procedures despite similar CWTs. Higher benchmarks should be considered to ensure quality surveillance colonoscopies.

背景和目的筛选结肠镜检查指南建议腺瘤检出率（ADR）最低为35%。目前还没有结肠镜检查监测的既定基准，有关其他质量指标效用的数据也很有限。我们的目的是确定在筛查和监测结肠镜检查中，不良反应和其他质量措施之间的关系，并确定有效的筛查质量基准是否可以外推到监测程序中。方法对某三级卫生中心门诊筛查和结肠镜检查进行回顾性分析。分析不良反应（ADR）、每次结肠镜检查腺瘤数、每次阳性参与者的腺瘤数、息肉检出率、右侧息肉检出率和结肠镜停镜次数（CWTs），用于结肠镜筛查和监测。结果共分析2646例，其中筛查1884例，监测762例。监测ADR （CADR）高于筛查ADR(65.6%±0.02% vs 47.0%±0.01%)；P & lt;措施)。除CWT外，所有替代质量措施在监督程序中均较高。在监测程序中，CADR与息肉检出率有很强的相关性(r = .956, P <；.01)、右侧息肉检出率（r = .771, P = .003）；CADR与其他替代质量测量之间的相关性不显著。结论尽管CWTs相似，但监测程序的结肠镜检查质量指标明显高于筛查程序。应考虑更高的基准，以确保结肠镜检查监测的质量。

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引用次数: 0

Laser-assisted endoscopic removal of a foreign body impacted in the esophagus 激光辅助内镜下食管异物清除术

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.004

Rohit Gupta MD, DM , Sugata Narayan Biswas MD, DM

引用次数: 0

A systematic review of the clinical effectiveness of a novel rigidizing overtube in completing difficult colonoscopies and for challenging colorectal polyp resection 一种新型刚性覆盖管在完成困难的结肠镜检查和具有挑战性的结直肠息肉切除术中的临床效果的系统回顾

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.010

Eleazar E. Montalvan-Sanchez MD , Dalton A. Norwood MD , Diego Izquierdo-Veraza MD , Renato Beas MD , Mirian Ramirez-Rojas MILS , Sergio A. Sánchez-Luna MD , Shajan Peter MD , Douglas R. Morgan MD , Douglas K. Rex MD

Background and Aims

Completing colonoscopy in redundant colons and resecting complex precancerous lesions are 2 challenging areas in the technical performance of colonoscopy. In this study, we conducted a systematic review to assess the clinical success of a rigidizing overtube (ROT) to facilitate completion of difficult colonoscopy insertions and challenging polyp resections.

Methods

We used multiple electronic databases from August 2019 through June 2024 to identify studies evaluating the use of the novel ROT for colonoscopies.

Results

Five studies were included with a total of 163 patients. Three studies evaluated the ROT system in challenging colonoscopies, with a combined cecal intubation rate of 100%. There were no adverse events. Four studies evaluated ROT for challenging colorectal polyp resection. The overall clinical success was 94.7%. Procedure facilitation was reported in 3 studies, with an average of 92.5% facilitation. One study compared endoscopic submucosal dissection (ESD) with and without ROT and reported similar en-bloc resection and curative rates with the use of ROT (92% and 88%, respectively) compared with conventional ESD (96% and 92%, respectively). In other studies that evaluated ROT in the removal of challenging polyps (60 patients), technical success was achieved in all cases.

Conclusions

ROT is safe, shows potential in enhancing the clinical success of completing difficult colonoscopies, and may be useful for facilitating ESD and endoscopic mucosal resection of some colonic lesions. The mechanism of any benefit is likely in reducing looping in the case of previous incomplete colonoscopies and providing stability in the case of the complex resections. Further controlled studies are warranted and needed to confirm benefit.

背景与目的完成冗余结肠结肠镜检查和切除复杂的癌前病变是结肠镜检查技术性能中具有挑战性的两个领域。在这项研究中，我们进行了一项系统回顾，以评估刚性管（ROT）的临床成功，以促进完成困难的结肠镜检查插入和挑战性的息肉切除。方法：我们使用2019年8月至2024年6月的多个电子数据库来识别评估新型ROT用于结肠镜检查的研究。结果纳入5项研究，共163例患者。三项研究评估了ROT系统在具有挑战性的结肠镜检查中的应用，合并盲肠插管率为100%。没有不良事件发生。四项研究评估了ROT在结肠息肉切除术中的应用。临床总成功率为94.7%。3项研究报告了手术的便捷性，平均便捷性为92.5%。一项研究比较了内镜下粘膜剥离（ESD）有和没有ROT，并报告了与传统ESD（分别为96%和92%）相比，使用ROT的整体切除和治愈率（分别为92%和88%）相似。在其他研究中，评估了ROT在去除挑战性息肉（60例）中的作用，所有病例都取得了技术上的成功。结论srot是安全的，可提高临床完成困难结肠镜检查的成功率，并可用于促进ESD和内镜下粘膜切除某些结肠病变。任何有益的机制可能是在以前不完全结肠镜检查的情况下减少环，并在复杂切除的情况下提供稳定性。需要进一步的对照研究来证实其益处。

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引用次数: 0

Efficacy and safety of a multi-degree-of-freedom articulating forceps for endoscopic submucosal dissection and closure of large mucosal defects in a porcine model 多自由度关节钳用于猪模型内镜下粘膜下剥离和大粘膜缺损闭合的有效性和安全性

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.006

Shunsuke Kamba MD, PhD, Manus Rugivarodom MD, Louis M. Wong Kee Song MD, Nayantara Coelho-Prabhu MBBS, Andrew C. Storm MD, Elizabeth Rajan MD

Background and Aims

Multi-degree-of-freedom (MDOF) articulating forceps for flexible endoscopy feature a unique device combining rotating and bending articulation to provide active traction. This study aimed to evaluate the efficacy and safety of the MDOF articulating forceps for endoscopic submucosal dissection (ESD) and closure of large post-ESD mucosal defects using a linearized closure technique.

Methods

Four rectal sites (20-50 mm) and 3 gastric sites (20-40 mm) were resected in explanted porcine models. ESD was performed by applying active traction of the articulating forceps to the mucosal flap. After ESD, the articulating forceps were used for defect closure by grasping an edge of the mucosal defect and pulling it toward the luminal cavity, allowing submucosal tissue apposition within the defect and configuration of the linear defect for easy through-the-scope clip closure.

Results

The mean procedure times of the gastric and rectal ESD were 16.1 ± 8.7 minutes and 20.7 ± 4.3 minutes, respectively. The mean sizes of the post-ESD gastric and rectal mucosal defects were 38.0 ± 12.6 mm and 43.8 ± 10.2 mm. No injury to the muscularis propria or perforations occurred. Complete clip closure was achieved in all mucosal defects. The mean procedure time for defect closure was 29.3 ± 5.4 minutes in the stomach and 15.5 ± 5.2 minutes in the rectum. The mean combined procedure times for ESD and clip closure were 45.4 ± 13.5 minutes in the stomach and 36.3 ± 7.9 minutes in the rectum.

Conclusions

The MDOF articulating forceps seem to be an effective and safe adjunct traction tool for ESD and closure of large mucosal defects. Future clinical studies are needed to validate the efficiency, safety, and durability of this approach.

背景与目的用于柔性内窥镜的多自由度（MDOF）关节钳具有独特的装置，结合旋转和弯曲关节提供主动牵引。本研究旨在评估MDOF关节钳用于内镜下粘膜剥离（ESD）的有效性和安全性，并采用线性封闭技术封闭ESD后粘膜缺损。方法切除4个直肠部位（20 ~ 50 mm）和3个胃部位（20 ~ 40 mm）。应用关节钳主动牵引粘膜瓣进行ESD。ESD手术后，使用关节钳钳抓住粘膜缺损的边缘，将其向腔内拉，使缺损内粘膜下组织靠近，并配置线性缺损，便于过镜夹闭合。结果胃和直肠ESD的平均手术时间分别为16.1±8.7 min和20.7±4.3 min。esd后胃粘膜缺损和直肠粘膜缺损的平均尺寸分别为38.0±12.6 mm和43.8±10.2 mm。未发生固有肌层损伤或穿孔。在所有粘膜缺损中，夹子完全闭合。胃的平均手术时间为29.3±5.4分钟，直肠的平均手术时间为15.5±5.2分钟。ESD和夹子闭合的平均联合手术时间在胃为45.4±13.5分钟，在直肠为36.3±7.9分钟。结论mof关节钳是一种安全有效的ESD辅助牵引工具，可用于大面积粘膜缺损的闭合。需要进一步的临床研究来验证这种方法的有效性、安全性和持久性。

{"title":"Efficacy and safety of a multi-degree-of-freedom articulating forceps for endoscopic submucosal dissection and closure of large mucosal defects in a porcine model","authors":"Shunsuke Kamba MD, PhD, Manus Rugivarodom MD, Louis M. Wong Kee Song MD, Nayantara Coelho-Prabhu MBBS, Andrew C. Storm MD, Elizabeth Rajan MD","doi":"10.1016/j.igie.2025.01.006","DOIUrl":"10.1016/j.igie.2025.01.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Multi-degree-of-freedom (MDOF) articulating forceps for flexible endoscopy feature a unique device combining rotating and bending articulation to provide active traction. This study aimed to evaluate the efficacy and safety of the MDOF articulating forceps for endoscopic submucosal dissection (ESD) and closure of large post-ESD mucosal defects using a linearized closure technique.</div></div><div><h3>Methods</h3><div>Four rectal sites (20-50 mm) and 3 gastric sites (20-40 mm) were resected in explanted porcine models. ESD was performed by applying active traction of the articulating forceps to the mucosal flap. After ESD, the articulating forceps were used for defect closure by grasping an edge of the mucosal defect and pulling it toward the luminal cavity, allowing submucosal tissue apposition within the defect and configuration of the linear defect for easy through-the-scope clip closure.</div></div><div><h3>Results</h3><div>The mean procedure times of the gastric and rectal ESD were 16.1 ± 8.7 minutes and 20.7 ± 4.3 minutes, respectively. The mean sizes of the post-ESD gastric and rectal mucosal defects were 38.0 ± 12.6 mm and 43.8 ± 10.2 mm. No injury to the muscularis propria or perforations occurred. Complete clip closure was achieved in all mucosal defects. The mean procedure time for defect closure was 29.3 ± 5.4 minutes in the stomach and 15.5 ± 5.2 minutes in the rectum. The mean combined procedure times for ESD and clip closure were 45.4 ± 13.5 minutes in the stomach and 36.3 ± 7.9 minutes in the rectum.</div></div><div><h3>Conclusions</h3><div>The MDOF articulating forceps seem to be an effective and safe adjunct traction tool for ESD and closure of large mucosal defects. Future clinical studies are needed to validate the efficiency, safety, and durability of this approach.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 11-15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697899","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}

引用次数: 0

Overall survival and margin status in resected gastric stromal tumors 切除胃间质瘤的总体生存和边缘状况

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.013

Fiyinfoluwa O. Abraham MD , Tarrant McPherson PhD , Leslie Blackshear MD , Yuan Liu PhD , Theresa Gillespie PhD , Preeyanka Sundar MD , Vaishali Patel MD , Jordan Orr MD , Saurabh Chawla MD , Steven A. Keilin MD , Field F. Willingham MD, MPH, FASGE

Background and Aims

Studies assessing gastrointestinal stromal tumors (GISTs) have found no survival differences based on margin status; however, small sample sizes, merged anatomic locations, and limited follow-up have been limitations. This study examined the impact of margin status on overall survival in a large national cohort of patients with resected gastric GISTs.

Methods

Data on patients with gastric GISTs were abstracted from the National Cancer Database, with data collected over a 16-year period (2004-2020). Exclusion criteria included the presence of other primary tumors, unknown patient/tumor characteristics, macroscopic residual margins, metastasis at diagnosis, and prior chemotherapy. The cohort was stratified according to tumor size. R0 is defined as microscopically negative margin, and R1 is microscopically positive margin.

Results

After exclusions, there were 8448 patients in the analysis cohort: 8221 (97.3%) had R0 resections, and 227 (2.7%) had R1 resections. On univariate analysis, tumor size ≤5 cm (P < .001), T1 stage (P < .001), low grade (P < .001), and low mitotic index (P < .001) were associated with a decreased risk of death. Margin status (R0 vs R1) did not have an impact on survival in the combined (P = .249), ≤5 cm (P = .961), ≤3 cm (P = .595), or ≤2 cm (P = .614) cohorts. There was also no difference in the risk of death based on the resection margin, in which the hazard ratio (R1 vs R0) with a 95% confidence interval was 1.206 (.862-1.633). In multivariate analysis, the resection margin status did not affect overall survival (P = .666).

Conclusions

Congruent with prior studies, there was no difference in survival when comparing R0 with R1 resections in gastric GIST patients without metastasis over an extended follow-up period. These data may be helpful in assessing suitability for endoscopic resection for patients with gastric GISTs.

背景和目的评估胃肠道间质瘤（gist）的研究没有发现基于边缘状态的生存差异；然而，小样本量，合并的解剖位置和有限的随访是局限性的。本研究考察了切缘状态对切除胃间质瘤患者总体生存率的影响。方法从美国国家癌症数据库（National Cancer Database）中提取16年（2004-2020年）胃间质间质瘤患者的数据。排除标准包括其他原发肿瘤的存在、未知的患者/肿瘤特征、肉眼残余边缘、诊断时的转移和既往化疗。根据肿瘤大小对队列进行分层。定义R0为显微镜下的负缘，R1为显微镜下的正缘。结果排除后，分析队列中有8448例患者，其中R0切除8221例（97.3%），R1切除227例（2.7%）。单因素分析：肿瘤大小≤5 cm (P <；.001)， T1期(P <；.001)，低档(P <；.001)，有丝分裂指数低(P <；.001)与死亡风险降低相关。切缘状态（R0 vs R1）对合并（P = 0.249）、≤5 cm （P = .961）、≤3 cm （P = .595）或≤2 cm （P = .614）队列的生存率没有影响。基于切除边缘的死亡风险也无差异，95%可信区间的风险比（R1 vs R0）为1.206（.862-1.633）。在多变量分析中，切除边缘状态不影响总生存率（P = .666）。结论与先前的研究一致，在延长的随访期内，比较R0和R1切除无转移的胃间质瘤患者的生存率没有差异。这些数据可能有助于评估胃胃肠道间质瘤患者内镜切除的适宜性。

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引用次数: 0

Lumen-apposing metal stent placement in severe sepsis secondary to afferent limb syndrome 传入肢体综合征继发严重脓毒症的腔旁金属支架置入

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.003

Nicholas Noverati MD, Faisal Kamal MD

引用次数: 0

Successful endoscopic therapy for esophagotracheal fistula using polyglycolic acid sheets 应用聚乙醇酸片成功治疗食管气管瘘

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.007

Zhenkai Wang PhD, Xiang Liu MD, Wanzhen Chen PhD, Quanzhao Di MD, Xiaoqian Yang BSN, Dan Liu BSN

引用次数: 0

Recommendations for endoscopy and sedation in the lactating patient 哺乳期患者内窥镜检查和镇静的建议

iGIE

Pub Date : 2025-03-01 DOI: 10.1016/j.igie.2025.01.008

Lauren D. Feld MD , Katherine M. Cooper MD , Shara I. Feld MD, PhD , Sarah Gray MD , Amy S. Oxentenko MD

Lactation is common amongst patients of childbearing age, providing a valuable nutrition source for their infants. There are several concerns to balance with lactating patients in the procedural setting, including interrupted lactation, milk supply, and child safety. However, clinicians have variable comfort with and training in counseling regarding periprocedural lactation. Anecdotally, the authors have noted many endoscopy centers do not use a standardized or guideline-based approach with lactating patients. In this article, we will (1) briefly review the safety and impact of periendoscopy medications on breastmilk and breastmilk supply, and (2) describe our approach for the lactating patient undergoing endoscopy.

哺乳在育龄患者中很常见，为婴儿提供了宝贵的营养来源。在程序设置中，有几个问题需要与泌乳患者平衡，包括泌乳中断，牛奶供应和儿童安全。然而，临床医生对围术期泌乳的咨询有不同的舒适度和培训。有趣的是，作者注意到许多内窥镜检查中心对哺乳期患者没有使用标准化或基于指南的方法。在本文中，我们将(1)简要回顾内镜药物对母乳和母乳供应的安全性和影响，(2)描述我们对接受内镜检查的哺乳期患者的治疗方法。

引用次数: 0

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