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Health-Care Utilization and Complications of Endoscopic Esophageal Dilation in a National Population
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Abhinav Goyal, Kshitij Chatterjee, Sujani Yadlapati, Shailender Singh
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Clin Endosc 2017;50(4):366-371. Published online March 17, 2017
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DOI: https://doi.org/10.5946/ce.2016.155
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 Abstract
 PDF PubReader ePub
- Background
/Aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown.
Methods
We used National Inpatient Sample (NIS) database for 2007–2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures. Logistic regression was used to assess association between hospital/patient characteristics and utilization of esophageal dilation.
Results
There were 591,187 hospitalizations involving esophageal stricture; 4.2% were malignant. Endoscopic dilation was performed in 28.7% cases. Dilation was more frequently utilized (odds ratio [OR], 1.36; p<0.001), had higher in-hospital mortality (3.1% vs. 1.4%, p<0.001), and resulted in longer hospital stays (5 days vs. 4 days, p=0.01), among cases of malignant strictures. Esophageal perforation was more common in the malignant group (0.9% vs. 0.5%, p=0.007). Patients with malignant compared to benign strictures undergoing dilation were more likely to require percutaneous endoscopic gastrostomy or jejunostomy (PEG/J) tube (14.1% vs. 4.5%, p<0.001). Palliative care services were utilized more frequently in malignant stricture cases not treated with dilation compared to those that were dilated.
Conclusions
Inpatient endoscopic dilation was utilized in 29% cases of esophageal stricture. Esophageal perforation, although infrequent, is more common in malignant strictures.
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Citations
Citations to this article as recorded by  - Safety of a Novel Upper Esophageal Sphincter Balloon Dilator
Grace M. Wandell, Janeth Garcia Swartwood, Ashar Singh Brar, Gregory N. Postma, Peter C. Belafsky
The Laryngoscope.2025; 135(1): 66. CrossRef - Diffuse Esophageal Spasm: An Alternative Treatment Approach
McKenzie K Allen , Wayne Frei
Cureus.2024;[Epub] CrossRef - Adverse events associated with EGD and EGD-related techniques
Nayantara Coelho-Prabhu, Nauzer Forbes, Nirav C. Thosani, Andrew C. Storm, Swati Pawa, Divyanshoo R. Kohli, Larissa L. Fujii-Lau, Sherif Elhanafi, Audrey H. Calderwood, James L. Buxbaum, Richard S. Kwon, Stuart K. Amateau, Mohammad A. Al-Haddad, Bashar J.
Gastrointestinal Endoscopy.2022; 96(3): 389. CrossRef - Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020
Gregorios A. Paspatis, Marianna Arvanitakis, Jean-Marc Dumonceau, Marc Barthet, Brian Saunders, Stine Ydegaard Turino, Angad Dhillon, Maria Fragaki, Jean-Michel Gonzalez, Alessandro Repici, Roy L.J. van Wanrooij, Jeanin E. van Hooft
Endoscopy.2020; 52(09): 792. CrossRef - Acute coronary syndromes in the peri‐operative period after kidney transplantation in United States
Abhinav Goyal, Kevin Bryan Lo, Kshitij Chatterjee, Roy O. Mathew, Peter A. McCullough, Sripal Bangalore, Janani Rangaswami
Clinical Transplantation.2020;[Epub] CrossRef - Five-year single-centre experience of carcinoma of the oesophagus from Blantyre, Malawi
John David Chetwood, Peter J Finch, Anstead Kankwatira, Jane Mallewa, Melita A Gordon, Leo Masamba
BMJ Open Gastroenterology.2018; 5(1): e000232. CrossRef - Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation
Jae Jin Hwang
Clinical Endoscopy.2017; 50(4): 309. CrossRef
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Predicting Colonoscopy Time: A Quality Improvement Initiative
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Deepanshu Jain, Abhinav Goyal, Stacey Zavala
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Clin Endosc 2016;49(6):555-559. Published online March 2, 2016
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DOI: https://doi.org/10.5946/ce.2015.110
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Abstract
PDFPubReaderePub
- Background
/Aims: There is lack of consensus on the optimal time allotted for colonoscopy, which increases patient wait times. Our aim was to identify and quantify the individual pre-procedural factors that determine the total procedure time (TPT) of colonoscopy.
Methods
This retrospective study involved 4,494 subjects, undergoing outpatient colonoscopy. Effects of age, sex, body mass index, abdominal surgery history, procedure indication (screening, surveillance, or diagnostic), procedure session (morning or afternoon), and endoscopist’s experience (fellow or attending) on TPT were evaluated using multiple regression analysis. A p<0.05 was considered significant.
Results
A total of 1,239 subjects satisfied the inclusion/exclusion criteria. Women, older individuals, and those with a history of abdominal surgery were found to have a shorter TPT (p>0.05) as did afternoon session colonoscopies (p=0.004). Less experienced endoscopists had longer TPTs (p>0.05). Screening (p=0.01) and surveillance (p=0.008) colonoscopies had a longer TPT than diagnostic procedures. Overall, the F-value of the regression model was 0.0009.
Conclusions
The indication for colonoscopy and the time of day have statistically significant associations with TPT. These results will help in streamlining workflow, reduce wait time, and improve patient satisfaction.
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Citations
Citations to this article as recorded by - MorphGI: A Self-Propelling Soft Robotic Endoscope Through Morphing Shape
Julius E. Bernth, Guokai Zhang, Dionysios Malas, George Abrahams, Bu Hayee, Hongbin Liu
Soft Robotics.2024; 11(4): 670. CrossRef - A Chemical Reaction-Driven Untethered Volume Changing Robotic Capsule for Tissue Dilation
Kaan Esendag, Mark E. McAlindon, Daniela Rus, Shuhei Miyashita, Dana D. Damian
IEEE Transactions on Medical Robotics and Bionics.2024; 6(4): 1300. CrossRef - A review on model-based and model-free approaches to control soft actuators and their potentials in colonoscopy
Motahareh Asgari, Ludovic Magerand, Luigi Manfredi
Frontiers in Robotics and AI.2023;[Epub] CrossRef - Disparities in colonoscopy utilization for lower gastrointestinal bleeding in rural vs urban settings in the United States
Nagapratap Ganta, Mina Aknouk, Dina Alnabwani, Ivan Nikiforov, Veera Jayasree Latha Bommu, Vraj Patel, Pramil Cheriyath, Christopher S Hollenbeak, Alan Hamza
World Journal of Gastrointestinal Endoscopy.2022; 14(8): 474. CrossRef - Endorobots for Colonoscopy: Design Challenges and Available Technologies
Luigi Manfredi
Frontiers in Robotics and AI.2021;[Epub] CrossRef - The efficacy of music as a non-pharmacological intervention in the endoscopy setting: a literature review
Dale Ware, John Habron
Gastrointestinal Nursing.2020; 18(Sup1): S16. CrossRef - Use of rapid reading software to reduce capsule endoscopy reading times while maintaining accuracy
Sabina Beg, Ewa Wronska, Isis Araujo, Begona González Suárez, Ekaterina Ivanova, Evgeny Fedorov, Lars Aabakken, Uwe Seitz, Jean-Francois Rey, Jean-Christophe Saurin, Roberto Tari, Tim Card, Krish Ragunath
Gastrointestinal Endoscopy.2020; 91(6): 1322. CrossRef - Quality measures improving endoscopic screening of colorectal cancer: a review of the literature
Marcello Maida, Gaetano Morreale, Emanuele Sinagra, Gianluca Ianiro, Vito Margherita, Alfonso Cirrone Cipolla, Salvatore Camilleri
Expert Review of Anticancer Therapy.2019; 19(3): 223. CrossRef - Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative
Michal F Kaminski, Siwan Thomas‐Gibson, Marek Bugajski, Michael Bretthauer, Colin J Rees, Evelien Dekker, Geir Hoff, Rodrigo Jover, Stepan Suchanek, Monika Ferlitsch, John Anderson, Thomas Roesch, Rolf Hultcranz, Istvan Racz, Ernst J Kuipers, Kjetil Garbo
United European Gastroenterology Journal.2017; 5(3): 309. CrossRef - Colonoscopy Procedure Time: Does the Learning Environment Matter?
Neel Sharma
Clinical Endoscopy.2017; 50(3): 308. CrossRef - What Is the Mean Procedure Time to Optimize Colonoscopy?
Taehyun Kim, Beom Jae Lee
Clinical Endoscopy.2016; 49(6): 500. CrossRef
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107
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11
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Obesity and Cecal Intubation Time
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Deepanshu Jain, Abhinav Goyal, Jorge Uribe
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Clin Endosc 2016;49(2):187-190. Published online February 12, 2016
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DOI: https://doi.org/10.5946/ce.2015.079
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Abstract
PDFPubReaderePub
- Background
/Aims: Obesity is a much-debated factor with conflicting evidence regarding its association with cecum intubation rates during colonoscopy. We aimed to identify the association between cecal intubation (CI) time and obesity by eliminating confounding factors.
Methods
A retrospective chart review of subjects undergoing outpatient colonoscopy was conducted. The population was categorized by sex and obesity (body mass index [BMI, kg/m2 ]: I, <24.9; II, 25 to 29.9; III, ≥30). CI time was used as a marker for a difficult colonoscopy. Mean CI times (MCT) were compared for statistical significance using analysis of variance tests.
Results
A total of 926 subjects were included. Overall MCT was 15.7±7.9 minutes, and it was 15.9±7.9 and 15.5±7.9 minutes for men and women, respectively. MCT among women for BMI category I, II, and III was 14.4±6.5, 15.5±8.3, and 16.2±8.1 minutes (p=0.55), whereas for men, it was 16.3±8.9, 15.9±8.0, and 15.6±7.2 minutes (p=0.95), respectively.
Conclusions
BMI had a positive association with CI time for women, but had a negative association with CI for men.
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Citations
Citations to this article as recorded by - Investigation of the relationship between colonoscopy insertion difficulty factors and endoscope shape using an endoscopic position detection unit
Takashi Kawai, Yusuke Kawai, Yoshika Akimito, Mariko Hamada, Eri Iwata, Ryota Niikura, Naoyoshi Nagata, Mitsushige Sugimoto, Kyosuke Yanagisawa, Masakatsu Fukuzawa, Takao Itoi
Journal of Clinical Biochemistry and Nutrition.2024; 74(3): 245. CrossRef - A randomized prospective study comparing single‐balloon‐assisted colonoscopy and cap‐assisted colonoscopy in patients with previous incomplete conventional colonoscopy
Tsz Fai Cheng, Ka Shing Cheng
Journal of Gastroenterology and Hepatology.2023; 38(2): 225. CrossRef - Factors affecting cecal intubation time during colonoscopy
Ke Wang, Wen-Tao Xu, Wen-Jing Kou, Xing-Shun Qi
World Chinese Journal of Digestology.2023; 31(3): 105. CrossRef - Dexmedetomidine–Oxycodone combination for conscious sedation during colonoscopy in obese patients: A randomized controlled trial
Xinran Wang, Manman Zhang, Han Sun, Rui Zhang, Yangzi Zhu, Zhen Zhang, Rongxia Shi
Heliyon.2023; 9(5): e16370. CrossRef - Efficacy and tolerability of colonoscopies in overweight and obese patients: Results from a national database on gastrointestinal endoscopic outcomes
Monica Passi, Farial Rahman, Christopher Koh, Sheila Kumar
Endoscopy International Open.2022; 10(04): E311. CrossRef - Impact of obesity in colorectal endoscopic submucosal dissection: single-center retrospective cohort study
Jun Tachikawa, Hideyuki Chiba, Naoya Okada, Jun Arimoto, Keiichi Ashikari, Hiroki Kuwabara, Michiko Nakaoka, Takuma Higurashi, Toru Goto, Atsushi Nakajima
BMC Gastroenterology.2021;[Epub] CrossRef - Cecal intubation time in screening colonoscopy
Hyun Young Kim
Medicine.2021; 100(19): e25927. CrossRef - Factors affecting bowel preparation adequacy and procedural time
Mohammadali Zad, Cuong N Do, Aaron Heffernan, Lucy Johnston, Mohammed Al‐Ansari
JGH Open.2020; 4(2): 206. CrossRef - Fecal immunochemical test in colorectal cancer screening: Colonoscopy findings by different cut‐off levels
Hanna Ribbing Wilén, Johannes Blom, Jonas Höijer, Rolf Hultcrantz
Journal of Gastroenterology and Hepatology.2019; 34(1): 103. CrossRef - Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy
Hassan Tariq, Muhammad Umar Kamal, Binita Sapkota, Fady ElShikh, Usman Ali Pirzada, Nanda Pullela, Sara Azam, Aiyi Zhang, Ahmed Baiomi, Hafsa Abbas, Jasbir Makker, Bhavna Balar, Ariyo Ihimoyan, Myrta Daniel, Anil Dev
BMJ Open Gastroenterology.2019; 6(1): e000254. CrossRef - Factors for cecal intubation time during colonoscopy in women: Impact of surgical history
JiHyung Nam, JungHyeon Lee, JaeHak Kim, HyounWoo Kang, DongKee Jang, YunJeong Lim, Moon-Soo Koh, HyunSoo Park, Eun-Cheol Park, JunKyu Lee, JinHo Lee
Saudi Journal of Gastroenterology.2019; 25(6): 377. CrossRef - Risk factors associated with longer cecal intubation time: a systematic review and meta-analysis
Veeravich Jaruvongvanich, Tomoki Sempokuya, Passisd Laoveeravat, Patompong Ungprasert
International Journal of Colorectal Disease.2018; 33(4): 359. CrossRef - Papel del digestólogo en el manejo del paciente obeso
Antonio López-Serrano, Inmaculada Ortiz Polo, Javier Sanz de la Vega, Eduardo Moreno-Osset
Gastroenterología y Hepatología.2017; 40(6): 409. CrossRef - Role of the gastroenterologist in the management of the obese patient
Antonio López-Serrano, Inmaculada Ortiz Polo, Javier Sanz de la Vega, Eduardo Moreno-Osset
Gastroenterología y Hepatología (English Edition).2017; 40(6): 409. CrossRef - Predictors for difficult cecal insertion in colonoscopy: The impact of obesity indices
Soo Yun Moon, Byung Chang Kim, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Chang Won Hong, Bum Joon Park, Kum Hei Ryu, Ji Hyung Nam
World Journal of Gastroenterology.2017; 23(13): 2346. CrossRef - Cecal intubation time between cap-assisted water exchange and water exchange colonoscopy: a randomized-controlled trial
Chih-Wei Tseng, Malcolm Koo, Yu-Hsi Hsieh
European Journal of Gastroenterology & Hepatology.2017; 29(11): 1296. CrossRef - Can Body Mass Index Predict the Difficulty of Colonoscopy?
Eui Joo Kim, Yoon Jae Kim
Clinical Endoscopy.2016; 49(2): 106. CrossRef - Predicting Colonoscopy Time: A Quality Improvement Initiative
Deepanshu Jain, Abhinav Goyal, Stacey Zavala
Clinical Endoscopy.2016; 49(6): 555. CrossRef
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