Clinical Endoscopy

Original Article

Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study: Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef; Clin Endosc 2023;56(5):658-665. Published online July 3, 2023; DOI: https://doi.org/10.5946/ce.2023.006

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: We aimed to study the effects of sedation on endoscopic ultrasound–guided tissue acquisition.
Methods
We conducted a retrospective study evaluating the role of sedation in endoscopic ultrasound–guided tissue acquisition by comparing two groups: anesthesia care provider (ACP) sedation and endoscopist-directed conscious sedation (CS).
Results
Technical success was achieved in 219/233 (94.0%) in the ACP group and 114/136 (83.8%) in the CS group (p=0.0086). In multivariate analysis, the difference in technical success between the two groups was not significant (adjusted odds ratio [aOR], 0.5; 95% confidence interval [CI], 0.234–1.069; p=0.0738). A successful diagnostic yield was present in 146/196 (74.5%) in the ACP group and 66/106 (62.3%) in the CS group, respectively (p=0.0274). In multivariate analysis, the difference in diagnostic yield between the two groups was not significant (aOR, 0.643; 95% CI, 0.356–1.159; p=0.142). A total of 33 adverse events (AEs) were observed. The incidence of AEs was significantly lower in the CS group (5/33 CS vs. 28/33 ACP; OR, 0.281; 95% CI, 0.095–0.833; p=0.022).
Conclusions
CS provided equivalent technical success and diagnostic yield for malignancy in endoscopic ultrasound–guided tissue acquisition. Increased AEs were associated with anesthesia for the endoscopic ultrasound–guided tissue acquisition.

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Case Report

Perforation of a Gastric Tear during Esophageal Endoscopic Submucosal Dissection under General Anesthesia: Tomoaki Yamasaki, Yuhei Sakata, Takehisa Suekane, Hiroko Nebiki; Clin Endosc 2021;54(6):916-919. Published online November 12, 2020; DOI: https://doi.org/10.5946/ce.2020.220

Abstract PDF PubReader ePub

Mallory-Weiss tears (MWT) are occasionally encountered during endoscopic procedures. Esophageal endoscopic submucosal dissection (ESD) is widely performed under general anesthesia to avoid unexpected body movements. We present the case of a 68-year-old woman with squamous cell carcinoma. Although ESD was performed under general anesthesia, a gastric perforation at the MWT caused by gastric inflation was observed after the procedure. The perforation was closed endoscopically, and she was discharged without any sequelae. Although general anesthesia is useful for esophageal ESD, it should be noted that it can cause MWT, and in rare cases, gastric perforation, due to gastric inflation during the procedure.

Citations

Citations to this article as recorded by

Gastric Perforation Encountered during Duodenal Stent Insertion
Sung Woo Ko, Hoonsub So, Sung Jo Bang
The Korean Journal of Gastroenterology.2022; 80(5): 221. CrossRef

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1 Crossref

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