Clinical Endoscopy

Thawatchai Akaraviputh

3 Articles

Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand: Tharathorn Suwatthanarak, Chainarong Phalanusitthepa, Chatbadin Thongchuam, Thawatchai Akaraviputh, Vitoon Chinswangwatanakul, Thikhamporn Tawantanakorn, Somchai Leelakusolvong, Monthira Maneerattanaporn, Piyaporn Apisarnthanarak, Jitladda Wasinrat; Clin Endosc 2024;57(5):610-619. Published online June 14, 2024; DOI: https://doi.org/10.5946/ce.2023.236

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Background
/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM.
Methods
This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up.
Results
Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017).
Conclusions
These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

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Never judge a book by its cover: the role of timed barium esophagography in patients with complete symptom relief after peroral endoscopic myotomy
Tae Hee Lee
Clinical Endoscopy.2024; 57(5): 604. CrossRef

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Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial: Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Varut Lohsiriwat, Vitoon Chinswangwatanakul; Clin Endosc 2024;57(3):335-341. Published online June 21, 2023; DOI: https://doi.org/10.5946/ce.2023.018

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy.
Methods
Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 µm). Differences in particle counts between time points were recorded.
Results
During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54–385] vs. 579 [213–1,379]×103/m3; p=0.056). However, the intervention group had a significant decrease in 0.3-µm particles (68 [–25–185] vs. 242 [72–588]×103/m3; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients.
Conclusions
This modified N95 respirator reduced the number of particles, especially 0.3-µm particles, generated during upper gastrointestinal endoscopy.

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Management of aerosol generation during upper gastrointestinal endoscopy: Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Thawatchai Akaraviputh; Clin Endosc 2022;55(5):588-593. Published online August 24, 2022; DOI: https://doi.org/10.5946/ce.2022.062

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In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

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Citations to this article as recorded by

Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn,
Clinical Endoscopy.2024; 57(3): 335. CrossRef
Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019
Shahnaz Sultan
Gastroenterology Clinics of North America.2023; 52(1): 157. CrossRef
Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?
Shintaro Fujihara, Hideki Kobara, Noriko Nishiyama, Naoya Tada, Yasuhiro Goda, Kazuhiro Kozuka, Takanori Matsui, Taiga Chiyo, Nobuya Kobayashi, Tatsuo Yachida, Tsutomu Masaki
Journal of Clinical Medicine.2023; 12(7): 2574. CrossRef

3,002 View
197 Download
3 Web of Science
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