Dissertations / Theses on the topic 'Colonoscopy'
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Arévalo, Carlo, Natalia Chunga, Steven Alarcón, Omar Rodríguez, Fernando Arévalo, Pedro Montes, and Eduardo Monge. "Localización y tamaño de los adenomas del colon como factores asociados a displasia de alto grado." Sociedad de Gastroenterología del Perú (SGP), 2017. http://hdl.handle.net/10757/622552.
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Objetivo: Determinar si la localización y el tamaño de los adenomas de colon se asocian con la presencia de displasia de alto
grado en los pacientes de un hospital peruano. Materiales y Métodos: Se realizó un estudio trasversal mediante la revisión
de informes de colonoscopías de los años 2014-2015 del Hospital Nacional Daniel Alcides Carrión, incluyéndose los pólipos
de pacientes mayores de 18 años; y excluyéndose los de pacientes con cáncer de colon, antecedente de cirugía oncológica,
enfermedad inflamatoria intestinal y poliposis (6 o más). Se extrajeron los datos de localización (colon proximal y distal, división
a partir del ángulo esplénico), tamaño (menos de 10 mm y 10 mm o más), forma (pediculados y sésiles) y grado de displasia
(bajo y alto grado). Se calculó la fuerza de asociación mediante OR, se determinó si existía asociación a través de la prueba
Chi cuadrado, con nivel de significancia menor a 0,05. Resultados: De un total de 1710 informes de colonoscopías revisadas,
378 personas tuvieron pólipos, calculando una tasa de detección de adenomas de 22,1%. De los 458 pólipos encontrados
254 fueron adenomas. Se demostró una asociación significativa entre la localización en colon distal y displasia de alto grado
(OR 2,68 IC 1,12-6,42, p<0.05); asimismo, los adenomas mayores o iguales a 10 mm tuvieron más riesgo de displasia de
alto grado (OR 7,75 IC 3,05-19,69, p<0.05). No se encontró asociación entre la forma de los adenomas y grado de displasia.
Conclusión: Se concluye que el tamaño de 10 mm o más y la localización en colon distal se asocian a displasia de alto grado
en los adenomas.Objective: To determine whether localization and size are related to the presence of high-grade dysplasia of colon adenomas in patients of a Peruvian hospital. Materials and methods: This is a descriptive transversal study. We checked colonoscopy reports of 2014-2015 years of Hospital Daniel Alcides Carrion, we included the polyps found in patients older than 18 years old, and excluded reports from patients with colorectal cancer, an antecedent of oncological surgery, inflammatory bowel disease and polyposis (6 or more). We used data based on localization (proximal and distal colon, based on the splenic angle), size (less than 10 mm and 10 mm or more), shape (pediculate and sessile) and grade of dysplasia (low and high-grade). We calculated the strength of association by OR, and we determined whether there was association by Chi-square test with a significance value less than 0.05. Results: We reviewed a total of 1710 of colonoscopy reports, 378 patients had polyps, so the adenoma detection rate was 22.1%. There were 458 polyps, from which 254 were adenomas. From these adenomas, we found an association between distal colon localization and high-grade dysplasia (OR 2.68 IC 1.12-6.42, p<0.05); likewise, there was an association between the size of the adenomas and high-grade dysplasia (OR 7.75 IC 3.05-19.69, p<0.05). We did not find any association between the shape and grade of dysplasia. Conclusion: This study concludes that there is an association between the size of 10 mm or more and localization in the distal colon with high-grade dysplasia of adenomas.
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Pakleppa, Markus. "Development of a colonoscopy simulator for the evaluation of colonoscopy devices." Thesis, University of Dundee, 2016. https://discovery.dundee.ac.uk/en/studentTheses/33a20ce1-cb9e-4f55-8714-3f6762a16b75.
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Colonoscopy is the current standard for colorectal cancer screening. This procedure requires improvement since it causes patient pain and can even result in injury. Novel colonoscopy devices have to be evaluated to gain information about their performance. At the preclinical stage of the device development the evaluation is typically performed in laboratory experiments. For these experiments an artificial environment is required which can recreate the anatomical and biomechanical features of the colon. A colonoscopy simulator for the evaluation of colonoscopy devices was developed within the ERC funded CoDIR project (Colonic Disease Investigation by Robotic Hydrocolonoscopy). The here developed simulator had to provide a colon phantom with realistic biomechanical properties as well as a sensor setup to measure signals which can be used to quantify the performance of devices which are tested within the simulator. Related literature was reviewed and possible tissue mimicking materials were selected. The suitability of the selected materials was evaluated by testing the frictional and elastic properties of the materials and subsequently comparing the results to those of colon tissue. PVA cryogel was selected as the most suitable material as it exhibits comparable elasticity and coefficients of friction. The tissue mimicking materials were mould casted into phantoms which were designed to represent the anatomical features of the colon. A simulator environment was developed which integrates the phantom as well as force and pressure sensors into a functional system. The sensors measure mesenteric forces and intraluminal pressures which can be related to the performance of tested devices. The simulator allows the arrangement of the sensors and the phantoms in an adjustable, modular approach. The simulator environment was successfully applied in the evaluation of a novel colonoscopy device. The results indicate that PVA cryogels exhibit unique mechanical properties which can be compared to those of colon tissue. The developed colonoscopy simulator provides a promising tool which can aid the development of novel colonoscopy devices.
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East, Dr James Edward. "Dysplasia detection at colonoscopy." Thesis, Imperial College London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511993.
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Ball, Alex. "Improving the quality of colonoscopy." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/11201/.
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Colonoscopy has an important role in the assessment of colonic symptoms and screening for colorectal cancer. Studies suggest that the quality of colonoscopy is variable. The focus of this thesis is improvement of colonoscopy quality, in particular patient comfort and polyp detection which are both important measures of colonoscopy quality. The studies within this thesis examine current medication practices and attitudes towards these and then assess whether simple interventions can improve the quality of colonoscopy. Discomfort during colonoscopy is common and influenced by many factors including the use of medication but practice varies between colonoscopists. Chapter three examines the relationships between medication practice and patient comfort during colonoscopy examinations performed within the English Bowel Cancer Screening Programme. Wide variation in patient comfort and medication use between colonoscopists are noted but with little apparent correlation. Deficiencies in the measurement of patient comfort are highlighted and strategies for improvement are suggested. Many strategies are available to manage discomfort during colonoscopy. Entonox (50:50 combination of nitrous oxide and oxygen) has advantages associated with its rapid elimination but is used in only a minority of examinations. Chapter four examines perceptions and attitudes towards Entonox use among English Bowel Cancer Screening Colonoscopists and explores whether these may explain its low utilisation. Attitudes towards Entonox use varied widely but were generally positive although it appears that Entonox is often selected for patients expected to have little discomfort. Colonoscopists’ attitudes towards Entonox use did not appear to explain its low utilisation. The method of Entonox use during colonoscopy varies between previous studies. Obstetric studies report that the method of Entonox use may influence its efficacy but this had not been examined during colonoscopy. The efficacy and side effects of ‘continuous’ versus ‘as required’ Entonox administration were compared in chapter five. Continuous Entonox administration did not increase potency but was associated with an excess of side effects. Despite colonoscopy being the gold standard technique to examine the colon, polyps may be missed. This is of paramount importance since polyp removal is associated with colorectal cancer prevention. Optimising polyp detection is therefore an important aim of colonoscopy. Polyp detection is influenced by bowel cleanliness. There are many bowel-cleansing agents available including low-volume bowel preparations, which have been advocated as a means to improve patient experience, but their effect on bowel cleanliness is debated. A comparison of bowel cleanliness following a low volume and standard volume bowel preparation before screening colonoscopy is detailed in Chapter six. Minor differences in efficacy were found between bowel preparations in a single colonic segment but there were major differences according to whether the bowel preparation was administered as a single or split dose. Previous studies have suggested position change may aid polyp detection but results are conflicting. Chapter seven compares routine patient position change, during colonoscope withdrawal, versus withdrawal in the supine position throughout. Routine position change significantly increased polyp and adenoma detection in the right colon. The studies within this thesis explore the utility of simple interventions that could easily be adopted by all colonoscopists, and may therefore lead to changes in practice that improve colonoscopy quality.
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Núñez, Do Rio Joan M. "Vascular pattern characterization in colonoscopy images." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/325145.
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El càncer de còlon és el tercer amb més incidència al món i el segon tipus de tumor maligne més comú a Europa. Les tècniques d'exploració directa del còlon han demostrat la seva eficiència en la reducció del nombre de víctimes mortals, permetent la detecció de pòlips en estadis prematurs. Entre les diferents tècniques d'exploració, la colonoscòpia és considerada actualment l'estàndard clínic, tot i que diferents estudis revelen la incidència d'alguns factors en la qualitat de l'exploració. La navegació al llarg del còlon i el recte evidencia una sèrie de reptes per als endoscopistes que provoquen un augment en la taxa d'errors. L'acurada inspecció del còlon ha de ser certificada per tal de minimitzar les possibilitats que alguna lesió no sigui detectada. La inspecció de les imatges de colonoscòpia pot aportar informació crucial per als endoscopistes i donar suport a la navegació durant el procediment.
Els vasos sanguinis i els seus patrons de ramificació poden aportar potencial descriptiu per desenvolupar marcadors biomètrics. Els marcadors anatòmics basats en vasos sanguinis podrien ser utilitzats per identificar escenes en vídeos de colonoscòpia i donar suport per a la navegació generant una seqüència d'imatges ordenades en el recorregut de les seccions del colon. Verificant la presència de contingut vascular a l'escena endoluminal també és possible certificar una acurada inspecció de les mucoses i millorar la localització de pòlips. Considerant els usos potencials de la descripció dels vasos sanguinis, aquesta contribució estudia la caracterització del contingut vascular i l'anàlisi de la capacitat descriptiva dels seus patrons de ramificació.
La caracterització dels vasos sanguinis en imatges de colonoscòpia suposa reptes importants. L'escena endoluminal inclou diferents objectes amb característiques similars, fet que dificulta el desenvolupament de models diferents per a cadascun d'aquests objectes. Per afrontar aquestes dificultats, proposem l'ús dels patrons de ramificació dels vasos sanguinis com a trets a baix nivell per a la descripció de formes. Hem creat dues bases de dades d'imatges que inclouen la segmentació manual dels arbres vasculars, així com la localització manual de dos tipus de punts d'interès: encreuaments i punts finals. Presentem un model per a la caracterització dels punts d'encreuament en patrons binaris. La implementació del model ens permet desenvolupar un mètode de localització de punts d'encreuament. El mètode supera els algorismes existents a la literatura en experiments en dues bases de dades: una de creació pròpia i la base de dades DRIVE, d'imatges de fons d'ull. En el segon cas, hem creat una extensió amb la localització manual dels punts d'encreuament. Pel fet que volem explorar la capacitat descriptiva de patrons vasculars i punts d'encreuament, proposem una aproximació basada en grafs per crear marcadors anatòmics. En el context de la localització de pòlips, establim un nou mètode per inhibir la influència dels vasos sanguinis en l’extracció d'informació de baix nivell. Els resultats mostren que la nostra metodologia disminueix la influència dels vasos sanguinis, augmenta la informació als pòlips i millora els mètodes de localització de pòlips.Colorectal cancer is the third most common cancer worldwide and the second most common malignant tumor in Europe. Screening tests have shown to be very effective in reducing the amount of deaths since they allow an early detection of polyps. Among the different screening techniques, colonoscopy is considered the gold standard although clinical studies mention several problems that have an impact in the quality of the procedure. The navigation through the rectum and colon track can be challenging for the physicians which can increase polyp miss rates. The thorough visualization of the colon track must be ensured so that the chances of missing lesions are minimized. The visual analysis of colonoscopy images can provide important information to the physicians and support their navigation during the procedure. Blood vessels and their branching patterns can provide descriptive power to potentially develop biometric markers. Anatomical markers based on blood vessel patterns could be used to identify a particular scene in colonoscopy videos and to support endoscope navigation by generating a sequence of ordered scenes through the different colon sections. By verifying the presence of vascular content in the endoluminal scene it is also possible to certify a proper inspection of the colon mucosa and to improve polyp localization. Considering the potential uses of blood vessel description, this contribution studies the characterization of the vascular content and the analysis of the descriptive power of its branching patterns. Blood vessel characterization in colonoscopy images is shown to be a challenging task. The endoluminal scene is conformed by several objects whose similar characteristics hinders the development of particular models for each of them. To overcome such difficulties we propose the use of the blood vessel branching characteristics as low-level features for pattern description. We created two data sets including manually labeled vessel information as well as manual ground truths of two types of keypoint landmarks: junctions and endpoints. We present a model to characterize junctions in binary patterns. The implementation of the junction model allows us to develop a junction localization method. The proposed method outperforms the available algorithms in the literature in experiments in both, our newly created colon vessel data set, and in DRIVE retinal fundus image data set. In the latter case, we created manual ground truth of junction coordinates. Since we want to explore the descriptive potential of junctions and vessels, we propose a graph-based approach to create anatomical markers. In the context of polyp localization, we present a new method to inhibit the influence of blood vessels in the extraction of low-level profile information. The results show that our methodology decreases vessel influence, increases polyp information and leads to an improvement in state-of-the-art polyp localization performance.
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Patel, Kinesh Pradip. "Developing and evaluating expertise in colonoscopy." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/44961.
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The quality and safety of colonoscopy have become of paramount importance with the worldwide expansion in the utilisation of this procedure, especially with the introduction of colorectal cancer screening in many countries. It is well known that colonoscopic performance varies significantly between practitioners. This thesis explores the effects of assessment in colonoscopy and polypectomy on performance and practice as well as trying to define the factors which differentiate the very best practitioners from the clinically competent. Until 2011, there was no formalised way of certifying polypectomy competence. We looked at the effects of the introduction of mandatory polypectomy assessment on trainee endoscopists applying for certification of competency in the United Kingdom. This work showed that documentation of polypectomy competence significantly improved after these changes were introduced. A global survey of polypectomy practice was undertaken to evaluate international guidance on polypectomy skills training and how trainers deliver teaching on polypectomy around the world, as well as trainees’ experience of gaining polypectomy skills. Significant variability in endoscopists’ experience of polypectomy training was found with few formal national guidelines published. This led to an evaluation of expert endoscopists who underwent an accreditation process with some similarities before commencing Bowel Cancer Screening (BCS). We examined whether it was possible to predict future performance from a single assessment and found that criteria used to assess whether candidates were competent could not predict the best performers from those who passed. Several hundred expert BCS colonoscopists were then monitored over a three year period to determine changes in performance over time and whether long-term performance could be predicted. The best predictors of performance over time for all metrics were initial performance. In order to identify key features of expertise in endoscopy, experienced colonoscopists were interviewed to distinguish characteristics of true endoscopic experts. These interviews revealed the importance of both technical and non-technical skills in defining expertise.
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Khosla, Manraj. "Hemoperitoneum as a Consequence of Colonoscopy." AMER COLL GASTROENTEROLOGY, 2016. http://hdl.handle.net/10150/622922.
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Hemoperitoneum without evidence of organ damage is a rare complication of colonoscopy. It is most frequently seen in association with splenic rupture due to traction on the splenocolic ligament. In our case, we present a 48-year-old cirrhotic man who developed peritoneal bleeding during a diagnostic colonoscopy for iron deficiency anemia. However, he was without signs of splenic damage or colon perforation. We suggest that the most likely source of bleeding is a ruptured portal-caval collateral vessel based on a computed tomography performed following the procedure.
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Al-Madi, Majid. "Factors effecting adenoma detection during screening colonoscopy." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104588.
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Background. Adenoma detection rate (ADR) has been associated with the incidence of interval colorectal cancer (CRC) in patients undergoing screening colonoscopy. Objective. This study aimed to identify factors that effect adenoma detection during screening colonoscopy. Methods. A retrospective cross sectional study was conducted of patients who underwent screening colonoscopy between June 1st and August 25th 2009 at the McGill University Health Center. Variables were abstracted from two electronic databases: Endoworks (for colonoscopy reports) and OACIS (for pathology reports for polyps removed). Multivariable logistic regression analysis was performed using the software R to determine the association between patient, colonoscopy, endoscopist related variables, and adenoma detection.Results. 430 sequentially performed colonoscopies met eligibility criteria and were included. In univariable analysis, higher likelihood of detecting adenomas was associated with male patients, increasing patient age, prior polyp removal, photo-documentation of the cecum, and increasing number of polyps detected; a lower likelihood of detecting adenomas was associated with average risk for CRC, colonoscopy performed by surgeon, increasing number of endoscopies and colonoscopies before the index colonoscopy, and increasing duration of time in the endoscopy unit. In multivariable analysis, increased likelihood of adenoma detection was associated with increasing patient age (in years) OR 1.04 (95%CI, 1.02 to 1.07), the more polyps detected the higher the odds of detecting an adenoma (OR 3.71 (95%CI, 2.70 to 5.10), while lower likelihood for detecting adenoma was increased time (in hours) from the beginning of the endoscopy session till the index colonoscopy (OR 0.51 (95%CI, 0.31 to 0.79). Conclusions. In addition to patient characteristics, operator fatigue, as evidenced by a decrease in adenoma detection as time progresses from the start of the endoscopy session, is an important factor that should be considered in endoscopy scheduling. Further research is required to evaluate factors that would optimize the adenoma detection and performance of colonoscopy as a screening tool for CRC.Contexte. Le taux de détection d'adénome (TDA) a été associé avec l'incidence intervalle subséquente du cancer colorectal (CRC) chez les patients subissant une coloscopie de dépistage. Objectif. Cette étude visait à identifier les facteurs affectant la détection d'adénome au cours d'une coloscopie de dépistage.Méthodes Une étude rétrospective transversale a été menée chez les patients ayant subi une coloscopie de dépistage entre le 1er Juin et 25 août 2009 au Centre universitaire de Santé McGill. Les variables ont été extraites à partir de deux bases de données électroniques Endoworks (pour les rapports de coloscopie) et OACIS (rapports de pathologie pour les polypes enlevés). Une analyse multivariable de régression logistique a été effectuée en utilisant le logiciel R. Résultats. 430 coloscopies effectuées successivement rencontrèrent les critères d'admissibilité et ont été incluses. En analyse univariable, une probabilité de détection d' adénomes accrue a été notée chez les patients de sexe masculin, plus àgés, ayant eu une ablation de polypes antécédente, s'il y avait eu photo-documentation du caecum, et avec la présence d'un nombre de polypes plus élevés. La probabilité de détecter un adénome était affaiblie chez les patients à risque moyen de CCR, si la coloscopie était effectuée par un chirurgien, et avec un nombre croissant d'endoscopies et coloscopies complétées avant la coloscopie le même jour, ainsi qu'en augmentant la durée de temps passé ce jour-là dans l'unité d'endoscopie. En analyse multivariable, une augmentation de la probabilité de détection d'adénome a été associée avec l' augentation de l'âge du patient (en années) (OR=1,04 (IC 95% (1,02 à 1,07)), un nombre accru de polypes détectés (OR = 3,71 ( 95% IC, 2,70 à 5,10), tandis qu'une plus faible probabilité de détection d'adénome était associée avec une augmentation du temps (en heures) passé depuis le début de la session endoscopie jusqu'à la coloscopie de dépistage donnée (OR 0,51 (IC 95%: 0,31 à 0,79). Conclusions. En plus des caractéristiques de patients reconnus, la fatigue de l'endoscopiste, telle que reflétée par le temps écoulé depuis le début de la session d'endoscopie est associée avec une diminution significative du taux de détection d' adénomes. Ce facteur important doit donc être pris en compte dans la planification de la liste d'endoscopie dans un contexte de dépistage. D'autres recherches sont nécessaires pour évaluer les facteurs qui permettent d'optimiser la détection des adénomes et la performance de la coloscopie comme outil de dépistage pour le CCR.
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Dogramadzi, Sanja. "Sensors and actuators in computer controlled colonoscopy." Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369813.
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Kale, Ravindra V. "Evaluation of an Active Colonoscopy Training Model." Ohio University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1350759066.
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Malik, Avnish Rajbal. "End of Insertion Detection in Colonoscopy Videos." Thesis, University of North Texas, 2009. https://digital.library.unt.edu/ark:/67531/metadc12159/.
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Colorectal cancer is the second leading cause of cancer-related deaths behind lung cancer in the United States. Colonoscopy is the preferred screening method for detection of diseases like Colorectal Cancer. In the year 2006, American Society for Gastrointestinal Endoscopy (ASGE) and American College of Gastroenterology (ACG) issued guidelines for quality colonoscopy. The guidelines suggest that on average the withdrawal phase during a screening colonoscopy should last a minimum of 6 minutes. My aim is to classify the colonoscopy video into insertion and withdrawal phase. The problem is that currently existing shot detection techniques cannot be applied because colonoscopy is a single camera shot from start to end. An algorithm to detect phase boundary has already been developed by the MIGLAB team. Existing method has acceptable levels of accuracy but the main issue is dependency on MPEG (Moving Pictures Expert Group) 1/2. I implemented exhaustive search for motion estimation to reduce the execution time and improve the accuracy. I took advantages of the C/C++ programming languages with multithreading which helped us get even better performances in terms of execution time. I propose a method for improving the current method of colonoscopy video analysis and also an extension for the same to make it usable for real time videos. The real time version we implemented is capable of handling streams coming directly from the camera in the form of uncompressed bitmap frames. Existing implementation could not be applied to real time scenario because of its dependency on MPEG 1/2. Future direction of this research includes improved motion search and GPU parallel computing techniques.
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Malik, Avnish Rajbal Huan Jung. "End of insertion detection in colonoscopy videos." [Denton, Tex.] : University of North Texas, 2009. http://digital.library.unt.edu/ark:/67531/metadc12159.
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伍望雅 and Morna Ng. "Difference of bowel preparation for colonoscopy between inpatient and outpatient: a matched cohort study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42997628.
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黃蘊蘊 and Wan-wan Wong. "An evidence-based bowel preparation guideline to enhance quality of colonic cleansing for adult patients undergoing colonoscopy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193035.
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Colorectal cancer is one of the most common cancers in Hong Kong and there is an upward trend on the incidence rate. Lots of literatures found that colonoscopy is a relatively effective method for the screening of colorectal cancer. Optimal visualization of entire colonic mucosa is mainly affected by the quality of bowel cleansing. However, poor bowel cleansing is found to be a common problem for patients undergoing colonoscopy. As no evidence-based guideline was found on enhancing the quality of bowel cleansing, this dissertation aims at formulating an evidence-based guideline on it.
In constructing this guideline regarding the enhancement of quality of bowel cleansing, a systemic search of relevant literatures was performed in several databases. Six studies were identified and critically appraised by using quality appraisal tool.
Scottish Intercollegiate Guideline Network (SIGN). After that, the evidences were summarized, synthesized and translated into four recommendations. An evidence-based guideline to enhance the quality of colonic cleansing for adult patients undergoing colonoscopy was developed and its implementation potential was evaluated.
In the phase of implementation, a communication plan was developed to initiate, guide and sustain the change. A pilot test was then established to examine the feasibility of actual implementation. An evaluation plan was made to assess the effectiveness of the proposed guideline on achieving the expected main outcomes, in patient, healthcare provider and system aspects.
It is anticipated that with the use of this guideline, the quality of colonic cleansing for adult patients undergoing colonoscopy will be enhanced. The hospital involved will thus improve the quality of care and contribute to the whole health care system.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Au, Chun-lam Antony, and 歐浚林. "A framework of credentialing and defining scope of practice in healthcare providers for colonoscopy and its applicability in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/207969.
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Introduction: In recent years, the incidence of colorectal cancer in Hong Kong has risen to become the most frequent cancer type whereas its mortality ranks second. As effective screening is demonstrated to improve survival outcomes, the government in response proposed a mass population colorectal cancer screening program for high-risk groups; screening methods include fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Because colonoscopy is a highly operator-dependent and is therefore very prone to human error, processes to ensure it is performed safely include credentialing and defining scope of practice. As this concept is relatively new in Hong Kong, this study aims to investigate its applicability specific to colonoscopy in the city’s medical profession through determining competency indicators in the procedure.
Methods: A systematic review was performed using online databases—PubMed and Google Scholar—to retrieve sources of information. Aside from academic research, guidelines from professional associations from three countries were also incorporated in this paper; they are the Gastroenterological Society of Australia, the Canadian Association of Gastroenterology, and the American Society for Gastrointestinal Endoscopy.
Results: Technical aspects for competency include a mean withdrawal time of over 6 minutes;; first time examination adenoma detection rate of ≥ 25% and ≥ 15% in asymptomatic men and women ages > 50, respectively; ≥ 90% cecal intubation rate in all cases; perforation and post-polypectomy bleeding complication rates at < 1/1,000 and < 1/100 cases respectively;; and annual volume rates between 100 to 150 procedures. Experience is a significant factor in improving technical competency. Cognitive competency include correctly identifying and managing abnormalities, and knowledge of appropriate patient indications and contraindications for screening colonoscopy, risk management, and intervals for the procedure. .
Conclusion: Guidelines recommend annual volume rates to be used as the primary indicator of technical competency, whereas the minimum medical academic qualification is recommended to have residency in endoscopic surgery. As colonoscopy is provided in both the public and private healthcare sector, the credentialing committee should have authority to influence colonoscopy providers in both sectors. A suitable agency is the Hong Kong Academy of Medicine, as they accredit specialists, and colonoscopy overseas is typically performed by endoscopists having received specialty training.published_or_final_version
Public Health
Master
Master of Public Health
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Ng, Morna. "Difference of bowel preparation for colonoscopy between inpatient and outpatient a matched cohort study /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42997628.
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Junior, Manoel Carlos Vieira. "Preparo de cólon para realização de colonoscopia: estudo prospectivo randomizado comparativo entre solução de polietilenoglicol baixo volume mais bisacodil versus solução de manitol mais bisacodil." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5147/tde-02122011-110656/.
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A colonoscopia é atualmente o padrão ouro para investigação da mucosa dos cólons, reto e íleo terminal. Para sua realização, há necessidade de uso de soluções para limpeza do cólon que, em geral, são mal toleradas pelos pacientes. Os objetivos do presente estudo foram comparar duas soluções de preparo intestinal para colonoscopia, quanto à efetividade, tolerabilidade, aceitabilidade e segurança em pacientes que se submeteriam a colonoscopia eletivamente, no Centro de Diagnóstico em Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Trata-se de estudo unicêntrico, prospectivo, com alocação aleatória dos pacientes. Cem pacientes pareados por sexo e idade foram randomizados em dois grupos. O grupo I recebeu bisacodil mais 1 litro de Polietilenoglicol (PEG) na véspera e 1 litro no dia do exame. O grupo II recebeu bisacodil na véspera e 1 litro de manitol 10% no dia do exame. A mesma dieta foi orientada nos dois grupos. A qualidade do preparo foi graduada através das escalas de Boston e Ottawa. A tolerabilidade e aceitabilidade foram aferidas por questionários previamente estudados. Quanto à segurança, foram ava liadas: variação de sinais vitais antes e após o preparo e complicações. Noventa e seis pacientes (96%) completaram o estudo. Não se observou diferença na qualidade do preparo entre os grupos(p = 0,059). Quanto à tolerabilidade, o grupo I (PEG) apresentou frequência significativamente menor de náusea, vômito, dor abdominal e distensão abdominal (p < 0,05). A aceitabilidade foi significativamente melhor com o grupo I (PEG) (p < 0,05). Em relação à segurança, o grupo I (PEG) apresentou-se mais seguro. No presente estudo, podemos concluir que ambos os preparos são semelhantes em eficácia (p > 0,05) e a solução de PEG apresentou melhor tolerabilidade, aceitabilidade e segurança em comparação ao preparo com manitol (p < 0,05).Colonoscopy is currently the gold standard to examine the colon, the rectum, and the terminal ileum. To perform a colonoscopy, is necessary to use solutions to clean the colon that are generally poorly tolerated by the patients. The study aims to compare the effectiveness, tolerability, acceptability and safety of two solutions used for intestinal preparation for elective colonoscopy examination in the Diagnosis Center Of Hospital das Clinicas, Faculty of Medicine, University of São Paulo. It is a Prospective study carried out in a single center, with random allocation of the patients. One hundred patients that were paired based on sex and age were randomized into two groups. Group I received bisacodyl plus 1 liter of polyethylene glycol (PEG) the night before and 1 liter on the day of the exam. Group II received bisacodyl the night before and 1 liter of a 10% mannitol solution on the day of the exam. The patients diet was the same for both groups. The quality of the preparation was graded based on the Boston and Ottawa scales. Tolerability and acceptability were measured using previously validated questionnaires. In terms of safety, variations in vital signs before and after the preparation were recorded, as well as any complications. Ninety-six patients (96%) completed the study. No difference was observed in the quality of the preparation between the two preparation methods (p = 0,059). As for tolerability, group II (the mannitol preparation group) presented a significantly higher frequency of nausea, vomiting, abdominal pain and abdominal distension (p < 0,05). Acceptability was significantly better in group I (p < 0,05). The PEG solution was also shown to be safer than mannitol. Based on the present study, the following conclusions can be made: 1) Both methods of preparation had similar efficiencies (p > 0,05); 2) PEG method showed higher tolerability, acceptability and safety compared to the mannitol method (p < 0,05).
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Litten, Jonathan D. "Development of an Automatically Adjustable Colonoscope." Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1311274094.
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Tafner, Edmar. "A colonoscopia com e sem auxílio de métodos de cromoscopia no diagnóstico das lesões planas, deprimidas e elevadas do cólon e reto." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-15062011-145410/.
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O câncer colorretal (CCR) é uma das maiores causas de óbito no mundo industrializado, com uma incidência anual de 800.000 casos novos, o que significa 8,5% de todos os novos e 12% das mortes relacionadas a essa doença. No Brasil, excluindo-se os cânceres de pele não melanoma, o CCR é o quarto mais freqüente entre os homens e o terceiro entre as mulheres. O risco de desenvolver CCR é de aproximadamente 5% a 6% na população ocidental. Existem evidências epidemiológicas de redução do CCR em 60% -90% quando a colonoscopia com polipectomia é usada preventivamente A colonoscopia ainda é o melhor método para o diagnóstico precoce do CCR e das lesões precursoras. Contudo existem falhas de detecção não desprezíveis. O objetivo deste estudo foi comparar o resultado do exame detalhado da mucosa do cólon e do reto através da colonoscopia convencional, da cromoendoscopia e do NBI, na detecção de lesões elevadas, deprimidas e planas em pacientes submetidos ao exame sem antecedentes pessoais e ou familiares. Entre janeiro de 2007 e outubro de 2009 foram selecionados 181 pacientes divididos aleatoriamente em três grupos: A: 48 pacientes, controle; B: 29 pacientes, NBI; C: 104 pacientes, cromoscopia difusa. Pode-se observar que dos 181 pacientes examinados 38 (21%) não apresentavam lesões. Os 143 pacientes com lesão, apresentaram um número médio de 2,65 lesões, com mínimo de 1 e máximo de 7 lesões. Nos total dos 181 pacientes e no conjunto dos 143 pacientes com lesões não foi observada diferença estatisticamente significante entre os três grupos A, B e C para a idade, o tempo reto-ceco e o tempo ceco-reto, enquanto que para a altura, peso e conseqüente IMC houve variação estatística. O tamanho médio das 379 lesões encontradas nos 143 pacientes, avaliado pelo seu diâmetro foi de 5,45 ± 2,84 mm, sem variação estatística entre os grupos, entre os hemicólons e entre os hemicólons nos grupos. Os tamanhos das lesões foram reunidos em três intervalos distintos: até 5 mm (76,30%), de 6 a 10 mm (19,50%) e de 11 a 20 mm (4,20%). Do total de 379 lesões, 203 (53,6%) mostraram-se neoplásicas e 176 (46,4%) não neoplásicas. O tamanho médio das 203 lesões neoplásicas foi de 5,96 mm, e das 176 não neoplásicas, 4,87 mm. As lesões neoplásicas mostraram-se maiores que as não neoplásicas, com significância estatística. Nos grupos não houve variação significante entre neoplasia e não neoplasia, mas diferença significante entre o tamanho das neoplasias e não neoplasias. Não houve diferença estatística entre os tamanhos das lesões nos dois hemicólons, mas com diferença significante entre os tamanhos das lesões neoplásicas e não neoplásicas. O mesmo se observa quando os segmentos do cólon são analisados individualmente. Os dois segmentos que apresentaram diferença significante, especificamente, quanto ao tamanho das lesões neoplásicas e não neoplásicos foram o sigmóide e o transverso. Nota-se que todas as lesões subpediculadas e as lesões plano-elevadas com depressão central eram neoplásicas. As lesões planas e neoplásicas são proporcionalmente mais visíveis no hemicólon direito nos grupos B (85,7%) e C (67,9%), sem diferença estatística. As hipóteses diagnósticas das lesões feitas durante o exame colonoscópico foram comparadas com os resultados histopatológicos. Pode-se observar que no grupo A sensibilidade de 82,7%, especificidade de 59%, com taxa de concordância de 72,5 %, considerada regular, no grupo B sensibilidade de 92,3%, especificidade de 61,9%, com concordância de 78,7 %, regular e no C sensibilidade de 88,8%, especificidade de 79,3%, taxa de concordância de 84,2%, considerada boa. Proporcionalmente o grupo C tem maior número de pacientes com três ou mais lesões e três ou mais lesões neoplásicas, mas sem valor estatístico. Conclui-se que não houve diferença estatística entre os 181 pacientes examinados e os 143 pacientes com lesões, quanto aos dados gerais, não houve diferenças significativas quanto ao número relativo, ao tipo e ao tamanho das lesões. As lesões neoplásicas apresentam-se maiores quando comparadas às não-neoplásicas, com significância estatística. A concordância entre a hipótese diagnóstica colonoscópica e a histologia é maior no grupo da cromoscopiaColorectal cancer (CRC) is one of the largest causes of death on the industrialized world. Its annual incidence of 800.000 new cases means 8,5% of all the new ones and 12% of deaths related to this disease. In Brazil, excluding the non-melanoma skin-cancers, CRC is the fourth more frequent among men and the third one among women. The risk for developping CRC is approximately of 5 to 6% on the Western population. There are epidemiological evidences for reducing CRC on 60-90% when colonoscopy with polypectomy is used preventively. Colonoscopy is still the best method both for the early dyagnosis of CRC and precursor lesions. However, there are non-contemptible failures on the detection. This paper purpose was comparing the result of colon and rectum mucous membrane detailed test through conventional colonoscopy, chromoendoscopy and NBI, on the detection of augmented, depressed and flat lesions in patients submitted to it without any personal or familiar antecedents. Between January 2007 and October 2009 181 patients were selected randomically and divided into 3 groups: A: 48 control patients; B: 29 patients, NBI; C: 104 patients, diffuse chromoscopy. It is observed that, from the 181 examined patients, 38 (21%) didnt present lesions. The 143 patients with lesion, presented an average number of 2,65 lesions, with a minimum of 1 and a maximum of 7 lesions. On the total of the 181 patients and on the whole of the 143 patients with lesions it was not observed any statistically significant difference among the three groups A, B and C as for Age, the Rectum-Cecum Time and the Cecum-Rectum Time, while there was a statistical variation for Height, Weight and consequent bmi. The average size of the 379 lesions found on the 143 patients, assessed by its diameter was of 5,45 mm (2.14 in.) + 2,84 mm (1,11 in), without any statistical variation among the groups, among the hemicolons and among the hemicolons in the groups. The size of the lesions were gathered into three distinct intervals: up to 5 mm [1.9 in.] (76,30%), from 6 mm [2.3 in.] to 10 mm [3.9 in] (19,50%) and from 11 to 20 mm [4.3 to 7.8 in] (4,20%). From the total of 379 lesions, 203 (53,6%) revealed themselves neoplastic and 176 (46,4%) non-neoplastic. The average size of the 203 neoplastic lesions was of 5,96 mm (2.34 in.), and of the 176 non-neoplastic ones, 4,87 mm [12,36 in]. Neoplastic lesions have shown larger than the non-neoplastic ones, with a stastistical significance. On the groups there is any significant variation between neoplasia and non-neoplasia, but a significant difference between the neoplasias and non-neoplasias size. There was any statistical difference among the lesion size on both hemicolons, however, a significant difference among the sizes of neoplastic and non-neoplastic ones. The same is observed when colon segments were analyzed individually. The two segments that have presented significant lesions, specifically on what concerns the size of neoplastic and non-neoplastic ones were the Sigmoid and the Transverse. It is observed that all the subpediculated lesions and the flat-augmented ones with a central depression were neoplastics. The flat and neoplastic lesions are proportionally more visible on the right hemicolon at groups B (85,7%) and C (67,9%), without any statistical difference. The diagnostic hypotheses of the lesions grown during the colonoscopic test were compared to the histopathological results. On control group (A) it is observed a 82,7% sensibility, a 59% specificity with a concordance rate of 72,5%, considered regular. On group B it is observed a 92,3% sensibility, a 61,9% specificity, with a regular concordance rate of 78,7%. On group C it is observed a 88,8% sensibility, a 79,3% specificity, a 84,2% concordance rate, considered good. Proportionally group C has a larger number of patients with 3 or more lesions and or more neoplastic lesions, but with no statistical value. On what concerns general data, it is concluded that there wasnt any statistical difference among the 181 patients examined and the 143 ones presenting lesions as for the relative number, the type and size of the lesions. Neoplastic lesions appear to be larger when compared to non-neoplastic ones, with a statistical significance. The concordance between the colonoscopic diagnostic hypothesis and the histology is larger on chromoscopy group
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Poon, Andrew. "Real time simulation of colonoscopy using dynamic models." Thesis, Imperial College London, 1991. http://hdl.handle.net/10044/1/8177.
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Brooker, James Christopher. "Advances in adenoma detection and polypectomy at colonoscopy." Thesis, Imperial College London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407913.
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Chang, Hung-Jou. "Bowel preparation for colonoscopy: is diet restriction necessary?" Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33728.
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Background: Bowel preparation is essential for quality colonoscopy. Although most bowel preparation regimens recommend dietary restriction for 24 to 48 hours before the procedure, the evidence for this is poor. Objectives: To establish whether dietary restriction during bowel preparation improves the quality of bowel preparation. Methods: A prospective single blind, randomised controlled pilot study. The dietary restriction (DR) group was instructed not to ingest high fibre foods for 48 hours prior to the use of a polyethylene glycol (PEG) bowel preparation. The non-dietary restriction (NDR) group was not given any dietary modification, but received instructions for the use of the PEG-based preparation solution. On the day of colonoscopy, the quality of the bowel effluent was assessed, and additional preparation given as necessary. The primary endpoint was quality of bowel cleansing using the Harefield Cleansing Scale during colonoscopy. The secondary endpoint was the need for additional bowel preparation and quantity of additional bowel preparation given prior to endoscopy. Data were analysed on an intention to treat basis. Results: Twenty-three participants were randomised to the intervention group and thirty-four to the control group. Patient demographics were similar in both groups. Dietary restriction did not influence the success rate of bowel preparation: 97% successful bowel preparation in the DR group, vs 91% successful bowel preparation in the NDR group (p=0.559). Additional bowel preparation requirement were similar in both groups: 35% in DR group vs 39% in NDR group (p=0.768). Mean amount of additional bowel preparation required was similar: 560 ml in the DR group vs 460 ml in the NDR group (p=0.633). Conclusion: The quality of bowel preparation was comparable in patients with and without dietary restrictions prior to colonoscopy. Non-restrictive diets prior to bowel preparation should be considered to increase compliance. The sample size of this pilot study prohibited definite statistical conclusions but demonstrated this to be a reasonable methodology for a larger study.
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Cao, Yu. "AVIDENSE Advanced Video Analysis System for Colonoscopy Semantics /." [Ames, Iowa : Iowa State University], 2007.
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Calderwood, Audrey Hong. "Predictors of adherence to post-polypectomy surveillance colonoscopy." Thesis, Boston University, 2014. https://hdl.handle.net/2144/21128.
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Thesis (M.S.H.P.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.BACKGROUND: Effective colorectal cancer prevention programs should ensure that patients with adenomas receive timely surveillance colonoscopy consistent with guidelines. The aim of our study was to identify patient-, provider-, and system-level predictors of adherence with surveillance colonoscopy in an ethnically diverse safety-net population. METHODS: We performed a retrospective analysis of average-risk patients age 50-75 with adenomas diagnosed at screening colonoscopy at Boston Medical Center and its affiliated community health centers from 1/1/2005 to 12/31/2007. The primary outcome was on-time follow-up defined as attendance at surveillance colonoscopy within 5.5 years of the screening colonoscopy. We compared frequencies of on-time follow-up and performed multivariable analysis, including ethnicity/language and any variable with P value <0.20 in unadjusted analysis. RESULTS: We identified 891 patients, of which 38% were English-speaking Non-Hispanic blacks, 24% Non-Hispanic white, and 10% Spanish-speaking Hispanics. Overall, 38.2% attended on-time surveillance colonoscopy. In unadjusted analyses, having ≥3 PCP visits in year 3-5 after baseline colonoscopy (OR 3.6 [2.6-5.1]), having “adenoma” on the electronic medical record problem list (OR 2.2 [1.6-2.9]), age (OR 0.98 [0.96-1.0]), and Charlson Index ≥1 (OR 1.3 [1.0-1.8]) were positively associated with adherence. In multivariate analysis, having “adenoma” on the problem list remained significant (adjusted OR (aOR) 1.8 [1.3-2.5]). Significant interactions were observed for ethnicity/language and PCP visits (P=0.008). CONCLUSION: A substantial proportion of adenoma-bearing patients fail to attend surveillance colonoscopy even in a safety net setting. Adding “adenomas” to the EMR problem list improved attendance, suggesting that system-level interventions may increase adherence to surveillance colonoscopy.
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Shah, Syed Ghafoor. "Magnetic imaging colonoscopy effects on performance and clinical outcomes." Thesis, Imperial College London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.415562.
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Norton, Joseph Christopher. "The design and development of a mobile colonoscopy robot." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/16399/.
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The conventional colonoscopy is a common procedure used to access the colon. Despite it being considered the Gold Standard procedure for colorectal cancer diagnosis and treatment, it has a number of major drawbacks, including high patient discomfort, infrequent but serious complications and high skill required to perform the procedure. There are a number of potential alternatives to the conventional colonoscopy, from augmenting the colonoscope to using Computed Tomography Colonography (CTC) - a completely non-invasive method. However, a truly effective, all-round alternative has yet to be found. This thesis explores the design and development of a novel solution: a fully mobile colonoscopy robot called “RollerBall”. Unlike current passive diagnostic capsules, such as PillCam, this device uses wheels at the end of adjustable arms to provide locomotion through the colon, while providing a stable platform for the use of diagnostic and therapeutic tools. The work begins by reviewing relevant literature to better understand the problem and potential solutions. RollerBall is then introduced and its design described in detail. A robust prototype was then successfully fabricated using a 3D printing technique and its performance assessed in a series of benchtop experiments. These showed that the mechanisms functioned as intended and encouraged the further development of the concept. Next, the fundamental requirement of gaining traction on the colon was shown to be possible using hexagonal shaped, macro-scale tread patterns. A friction coefficient ranging between 0.29 and 0.55 was achieved with little trauma to the tissue substrate. The electronics hardware and control were then developed and evaluated in a series of tests in silicone tubes. An open-loop strategy was first used to establish the control algorithm to map the user inputs to motor outputs (wheel speeds). These tests showed the efficacy of the locomotion technique and the control algorithm used, but they highlighted the need for autonomy. To address this, feedback was included to automate the adjusting of the arm angle and amount of force applied by the device; a forward facing camera was also used to automate the orientation control by tracking a user-defined target. Force and orientation control were then combined to show that semi-autonomous control was possible and as a result, it was concluded that clinical use may be feasible in future developments.
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Ignjatovic, Ana. "Recognition of colonic dysplasia at colonoscopy using advanced technology." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/17760.
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Colonoscopy remains the gold standard for detection of dysplasia in the colon. Resection of dysplasia at colonoscopy has been shown to reduce the subsequent risk of colorectal cancer. With the recent advent of National Bowel Cancer Screening Programme the number of colonoscopies performed in the United Kingdom has increased significantly. In addition, the recent drive for quality improvement has resulted in increased number of dysplastic lesions detected, resected and sent for histopathology. This has led to substantial increases in the cost associated with the procedure. This thesis investigates how advanced technology can improve detection and characterisation of dysplasia at colonoscopy, potentially contributing to time and cost savings. The introduction reviews the literature on dysplasia detection at colonoscopy, both in terms of basic withdrawal technique and how advanced technology can help reduce miss rates. The significance of small colorectal polyps is reviewed and the accuracy of recent colonoscopic technologies in polyp characterization considered. Three studies examined detection of dysplasia: a small randomized control trial showed that magnetic endoscope imager did not improve caecal intubation or dysplasia detection rates in selected patients when used by experienced colonoscopists. Two studies, one of which was in patients with long standing colitis, did not demonstrate the benefit of narrow band imaging for detection of dysplasia. A cohort study revealed that in vivo characterization of dysplasia can be done accurately and is feasible in routine clinical practice although the inter-observer agreement is moderate at best as assessed by a retrospective study. A computer algorithm was devised to attempt to reduce the inter-observer variability and has shown promising results in a pilot study. A training module on the use of narrow band imaging in characterization was developed and validated leading to improved accuracy and reduced variability amongst the participants. Finally, a quality assurance study confirmed that the still photographs of polyps are adequate record of optical diagnosis.
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Ussui, Vivian Mayumi. "Estudo dos parâmetros de tolerância relacionados à colonoscopia." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5147/tde-24052011-123302/.
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Os exames endoscópicos são considerados procedimentos invasivos, desconfortáveis e estressantes. A colonoscopia, em virtude da necessidade de laxantes para o preparo do cólon, de sua complexidade técnica e do constrangimento devido à maior exposição, causa ansiedade, preocupação e preconceito. No entanto, a colonoscopia é, atualmente, o procedimento de escolha para investigação de enfermidades do intestino grosso de elevada acurácia e possibilidade de realização de procedimentos terapêuticos, mas requer elevada colaboração e tolerância dos pacientes. A tolerância pode ser interpretada de várias maneiras, como aceitação, nível de satisfação e conforto durante o exame, ou disposição para repetir o procedimento. Foi realizado no Centro de Diagnóstico do Serviço de Gastroenterologia Clínica do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, um estudo observacional prospectivo, longitudinal, com o objetivo de avaliar o nível de tolerância do paciente submetido à colonoscopia e os fatores intervenientes na tolerância. No período de março a dezembro de 2008, foram avaliados 373 pacientes adultos consecutivos, submetidos à colonoscopia eletiva. Foram incluídos pacientes submetidos a exames eletivos, com idade acima de 18 anos, com compreensão e aceitação da entrevista e do procedimento, e que assinaram o termo de consentimento livre e esclarecido. Um inquérito foi aplicado antes, durante e após o exame, a partir de dois questionários: formulário do paciente, preenchido pelo médico pesquisador; e ficha de avaliação médica, preenchido pelos médicos pesquisador e executante. No presente estudo considerou-se tolerância como a disposição do paciente para repetir o exame. Esse questionamento foi aplicado imediatamente na pré-alta, com o indivíduo desperto e orientado, no mínimo duas horas após o procedimento. Os fatores avaliados no pré-exame, durante o exame e no pós-exame foram comparados entre o grupo de pacientes tolerantes e os não tolerantes. Noventa e um por cento dos pacientes avaliados mostraram-se tolerantes à colonoscopia. Maiores níveis de tolerância foram observados em pacientes do sexo masculino (p=0,005; OR=14,8), com idade entre 41 anos e 60 anos (p=0,003; OR=56,92), colaborativos durante o exame (p=0,013; OR=6,15) e que não apresentaram cólica durante o preparo intestinal (p=0,013; OR=5) ou dor abdominal após o procedimento (p=0,032; OR=3,25). Um dos fatores limitantes do presente estudo foi o desconhecimento da razão pela qual o paciente não faria novamente o exame. A diferente graduação dos médicos colonoscopistas, a inclusão de pacientes ambulatoriais e internados submetidos à cirurgia colorretal tornaram a amostra heterogênea, porém mais representativa da prática clínica. Nessa amostra, a dor abdominal associada à colonoscopia foi o elemento mais significativo na caracterização da tolerânciaEndoscopic assessments are considered invasive, uncomfortable and stressful procedures. The colonoscopy, due to the need for laxative use for colon preparation, its technical complexity and the embarrassment caused by privacy exposure, results in anxiety, concern and prejudice. However, the colonoscopy is currently the procedure of choice to investigate large bowel disorders, due to its high accuracy and the possibility of performing therapeutic procedures during the examination, but it requires a high degree of collaboration and compliance on the part of the patient. Tolerance can be interpreted in different ways, such as acceptance, level of satisfaction, and comfort during the examination, or willingness to have the procedure repeated. A prospective observational study was carried out at the Diagnostic Center of the Service of Clinical Gastroenterology of Instituto Central of Hospital das Clínicas of the School of Medicine of the University of São Paulo (HCFMUSP), aiming at evaluating the level of tolerance of patients submitted to colonoscopy and the factors that interfere with this tolerance. A total of 373 consecutive adult patients submitted to elective colonoscopy were studied from March to December 2008. The inclusion criteria consisted of patients submitted to elective examinations, aged 18 and older, which understood and agreed with the interview and the procedure and signed the Free and Informed Consent Form. A survey was applied before, during and after the examination, based on two questionnaires: the patients questionnaire, filled out by the medical researcher and the medical assessment file, filled out by the medical researcher and the attending physician. The present study considered the patients tolerance as the willingness to have the procedure repeated. This survey was applied immediately at the pre-hospital discharge, when the patient was conscious and oriented, at least two hours after the procedure. The factors assessed before, during and after the examination were compared between the groups of compliant and non-compliant patients. A total of 91% of the assessed patients showed to be compliant with the colonoscopy. Higher levels of tolerance were observed in male patients (p=0.005; OR=14.8), aged 41 to 60 years (p=0.003; OR=56.92), who collaborated during the examination (p=0.013; OR=6.15) and did not have colic during the intestinal preparation (p=0.013; OR=5) or abdominal pain after the procedure (p=0.032; OR=3.25). One limitation of the present study was the lack of information on why the patient would not have the procedure repeated. The varied degrees of skill presented by colonoscopists, the inclusion of outpatients and inpatients submitted to colorectal surgery made the sample a more heterogeneous one, albeit more representative of clinical practice. In this sample, abdominal pain associated with the colonoscopy was the most significant element in the characterization of tolerance
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Ahmed, Abdi Samed. "Comparison between two different colon cleansing methods prior to colonoscopy." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52501.
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Shen, Yuan. "Feature Extraction and Feasibility Study on CT Image Guided Colonoscopy." Thesis, Virginia Tech, 2010. http://hdl.handle.net/10919/32275.
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Computed tomographic colonography(CTC), also called virtual colonoscopy, uses CT scanning and computer post-processing to create two dimensional images and three dimensional virtual views inside of the colon. Computer-aided polyp detection(CAPD) automatically detects colonic polyps and presents them to the user in either a first or second reader paradigm, with a goal reducing examination time while increasing the detection sensitivity. During colonoscopy, the endoscopists use the colonoscope inside of a patient's colon to target potential polyps and validate CAPD found ones. However, there is no direct information linking between CT images and the real-time optical colonoscopy(OC) video provided during the operation, thus endoscopists need to rely largely on their past experience to locate and remove polyps. The goal of this research project is to study the feasibility of developing an image guided colonoscopy(IGC) system that combines CTC images, real-time colonoscope position measurements, and video stream to validate and guide the removal of polyps found in CAPD. System would ease polyp level validation of CTC and improve the accuracy and efficiency of guiding the endoscopist to the target polyps. In this research project, a centerline based matching algorithm has been designed to estimate, in real time, the relative location of the colonoscope in the virtual colonoscopy environment. Furthermore, the feasibility of applying online simultaneous localization and mapping(SLAM) into CT image guided colonoscopy has been evaluated to further improve the performance of localizing and removing the pre-defined target polyps. A colon phantom is used to provide a testing setup to assess the performance of the proposed algorithms.Master of Science
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Salz, Talya Weinberger Morris. "Underuse and overuse of colonoscopy among survivors of colorectal cancer." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,2151.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Feb. 17, 2009). "... in partial fulfillment of the requirements for the degree of Doctorate of Philosophy in the Department of Health Policy and Management." Discipline: Health Policy and Management; Department/School: Public Health.
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Sheen, Andrew Scott William. "Implicit emotional memory and the effects of positive suggestion during colonoscopy." Thesis, University of Leicester, 2011. http://hdl.handle.net/2381/9889.
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Introduction - This research aimed to investigate implicit emotional memory and the effects of positive suggestion during colonoscopy with conscious sedation. Evidence of emotional arousal in response to a word stimulus, without conscious recall, was investigated Method - During colonoscopy, under midazolam sedation and fentanyl analgesia, participants (N=25) heard either positive suggestion or nursery rhyme titles. Measures of mood, intra-operative distress, post-traumatic stress traits and sleep disturbance of the two groups, were compared throughout three time periods. Sedative effect on emotional memory formation was examined pre and post-procedurally, using the Skin Conductance Response (SCR) technique to compare participants' physiological reactions to nonsense-words, two emotive and one neutral. Procedural-based questionnaires and mood measures were completed one hour and two days after colonoscopy. Results - There was a significant difference between distress levels in suggestion-groups with the positive suggestion group demonstrating less intra-operative distress. There was no significant effect of what participants heard under sedation on mood-disturbance scores across time. Neither depression nor anxiety was affected by type of audio stimuli. Neither group showed any significant difference in levels of intrusive post-procedural memories or levels of dissociation. No participants demonstrated changes in dissociation post endoscopic examination. SCR differences showed physiological effects of priming with emotive words. Participants demonstrating implicit memory had significantly higher sleep disturbance scores than those with explicit memory for intra-procedural events. Conclusion –Hearing positive suggestion whilst under conscious sedation reduced intra-procedural distress and implicit memory for colonoscopy increased sleep disturbance in the days following the procedure. Evidence was found for midazolam sedation between 2-3mg impairing explicit memory whilst leaving implicit memory intact. Due to the low number of willing participants findings were tentative and difficult to generalise to a wider population.
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Switzer, Jennifer Margaret. "Recovery times and adverse events between propofol and midazolam during colonoscopy." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/45308.
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Sedation and analgesia are integral to successful colonoscopy completion and controversy surrounds the optimal pharmacokinetic agent that will target and maintain a moderate sedation level, offer operational efficiency with reduced recovery time, and minimize risk for cardiopulmonary complications. Current practice is imprecise; manual administration of procedural sedation using a combination of benzodiazepine and opioids puts patients at risk for descending into deeper levels of sedation, which can lead to risk for cardiorespiratory depression, and an increase in recovery times for up to two hours.
Studies have reported that propofol, a sedative agent with a short half life, can result in a shorter recovery, however there is limited research that has used consistent measurement to evaluate the procedural sedation recovery process or the influence of predictors such as age, sex, medication history, medical history, procedure time and body mass index (BMI), on recovery time and cardiopulmonary risk.
Therefore, a non-experimental descriptive retrospective study was undertaken with two groups of 100 subjects who had either midazolam administered manually or propofol administered using the Sedasys® System for colonoscopy to explore the differences in procedure length and recovery time between these groups.
Participants in the propofol group were somewhat younger and healthier than those in the midazolam group; average age 50.1 years versus 58.9 years, took fewer cardiac medications, had a lower BMI, and a lower incidence of cardiac or respiratory disease.
Multiple regression analyses were conducted to assess the contribution of independent clinical predictors (age, sex, BMI, medical history and medication history) for duration of recovery from procedural sedation and analgesia and the incidence of sedation-related
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adverse events. Propofol provided the largest contribution to the variance in recovery time after controlling for other significant predictors (R-squared = 0.22). Based on the MOAA/S score, participants who received propofol were discharged home sooner than those who received midazolam. There were no adverse events in either group.
The results of this study suggest that propofol for procedural sedation during colonoscopy may improve efficiencies and throughput in the endoscopy suite and may provide a safe means that can assist in meeting the rising demand for colonoscopy.
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Ngu, Wee Sing. "The impact of Endocuff Vision on adenoma detection rates in colonoscopy." Thesis, Durham University, 2018. http://etheses.dur.ac.uk/12516/.
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Background: One of the problems with colonoscopy is its imperfection due to variation in operator dependent adenoma detection rates. Low adenoma detection rates are linked to increased interval colorectal cancer rates and reduced cancer survival. Devices to enhance mucosal visualisation and improve adenoma detection rates such as Endocuff Vision have been developed. The primary aim of this study was to compare adenoma detection rates between Endocuff Vision-assisted colonoscopy and standard colonoscopy. Methods: A multicentre, randomised controlled trial in seven hospitals in the United Kingdom was undertaken. Patients aged 18 and above referred for colonoscopy due to symptoms, colonoscopy surveillance, or as part of the Bowel Cancer Screening Programme following a positive screening faecal occult blood test were invited to the study. Patients with a suspicion of bowel obstruction, known colon cancer, polyposis syndromes, known strictures, active colitis, on anticoagulant therapy during the procedure, pregnant, attending for a therapeutic procedure or assessment of a known lesion were excluded. Findings: One thousand, seven hundred and seventy-two patients (57% male, mean age 62) were recruited from November 2014 until February 2016. Patient characteristics were comparable between trial arms. Endocuff Vision increased adenoma detection rates by 4.7% (p=0.02). This was largely driven by an increase in adenoma detection rates in screening patients from 50.9% to 61.7% (p < 0.001). Endocuff Vision-assisted colonoscopy also detected more mean adenomas per procedure, left sided adenomas, sessile serrated adenomas, diminutive adenomas, small adenomas and cancers. Cuff removal rate was 4.1%. Median intubation time was one minute quicker with Endocuff Vision-assisted colonoscopy (p=0.001). Anal intubation was rated as more uncomfortable with Endocuff Vision-assisted colonoscopy. There were no significant cuff-related adverse events. Endocuff Vision-assisted colonoscopy was non-inferior to SC in other markers of comfort and procedure time. Conclusion Endocuff Vision significantly improved ADR driven by an improvement in the faecal occult blood test positive screening population. Endocuff Vision-assisted colonoscopy was non-inferior in all aspects other than discomfort on anal intubation.
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Bruce, Michael P. "Detection of Endoscopic Looping During Colonoscopy Procedure Using Embedded Bending Sensors." Ohio University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1429796708.
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Chen, Gang. "Design, modeling and control of a micro-robotic tip for colonoscopy." Lyon, INSA, 2005. http://theses.insa-lyon.fr/publication/2005ISAL0107/these.pdf.
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Robotics is increasingly accepted as a viable solution to many application in surgery, particularly in the field of Minimally Invasive Surgery (MIS). Medical robotics has tremendous potential for improving the precision and capabilities to help physicians perform surgical procedures. This dissertation aims to design and control a new class of robot (continuum robot) for the purpose of improving the procedure of colonoscopy. Based on the detailed analysis of specific problems of traditional colonoscopy and one surgeon's suggestion, an automatic bendable micro-robotic manipulator was designed to guide the advancement of colonoscope during its insertion into the colon. This micro-robotic manipulator, called EDORA II (Distal Extremity with Automatic ORientation), was built by using silicone rubber. Three servovalves were utilized to control the pressure of each chambre to get the deflected shape of the EDORA II. Experiments showed that EDORA II could incline 120° with a pressure of 2 bar. To facilitate the representation of the motion of EDORA II, a new kinematic model for EDORA II was formulated based on the concept of arc length and validated experimentally. Experimental dynamics specific to the tubular inspection was also studied and model parameters were determined through system identification. Three optical fiber sensors were chosen and their integration into EDORA II allowed the measurement of the distance between EDORA II and the wall of the tube. The test in the colon-like tube justified that the feasibility of the design of EDORA II and its capability to improve the procedure of colonoscopyLa robotique médicale permet à la fois à la chirurgie moderne d'être moins invasive et au chirurgien d'être plus performant. Cette thèse porte sur la conception et la commande d'un nouveau type de robot " continuum " afin d'améliorer le procédé de coloscopie. Ce manipulateur robotisé, appelé EDORA II (Extrémité Distale à ORientation Automatique), a été construit en employant du silicone et utilise un actionnement pneumatique. Trois servovalves ont été utilisées pour commander la pression de trois chambres afin d'obtenir la forme désirée de l'EDORA II. Un nouveau modèle géométrique pour EDORA II a été élaboré en s'appuyant sur la déformation géométrique de l'actionneur. Les résultats comparatifs ont démontré que le modèle géométrique direct proposé reproduit de manière fidèle leur comportement statique. Un modèle dynamique de comportement reposant sur une analyse des parties mécanique et pneumatique est ensuite présenté. Le système est décomposé en trois sous systèmes indépendants, un pour chaque chambre, chaque sous-système contant deux parties : une partie electro-pneumatique et une partie mécanique. Pour déterminer les paramètres intervenant dans le modèle dynamique, la méthode du modèle est choisie. Une analyse fréquentielle et une étude de robustesse nous ont permis de valider ce modèle. Trois capteurs à fibres optiques ont été intégrés sur l'actionneur EDORA II afin de mesurer son éloignement de la paroi du colon. Une validation expérimentale est effectuée dans un tube afin d'évaluer les performances de ce nouveau actionneur
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Kumara, Muthukudage Jayantha. "Automated Real-time Objects Detection in Colonoscopy Videos for Quality Measurements." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc283843/.
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The effectiveness of colonoscopy depends on the quality of the inspection of the colon. There was no automated measurement method to evaluate the quality of the inspection. This thesis addresses this issue by investigating an automated post-procedure quality measurement technique and proposing a novel approach automatically deciding a percentage of stool areas in images of digitized colonoscopy video files. It involves the classification of image pixels based on their color features using a new method of planes on RGB (red, green and blue) color space. The limitation of post-procedure quality measurement is that quality measurements are available long after the procedure was done and the patient was released. A better approach is to inform any sub-optimal inspection immediately so that the endoscopist can improve the quality in real-time during the procedure. This thesis also proposes an extension to post-procedure method to detect stool, bite-block, and blood regions in real-time using color features in HSV color space. These three objects play a major role in quality measurements in colonoscopy. The proposed method partitions very large positive examples of each of these objects into a number of groups. These groups are formed by taking intersection of positive examples with a hyper plane. This hyper plane is named as 'positive plane'. 'Convex hulls' are used to model positive planes. Comparisons with traditional classifiers such as K-nearest neighbor (K-NN) and support vector machines (SVM) proves the soundness of the proposed method in terms of accuracy and speed that are critical in the targeted real-time quality measurement system.
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Stanek, Sean. "A soft real-time system for automatic capture of colonoscopy video." [Ames, Iowa : Iowa State University], 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1472090.
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Chen, Gang Redarce Tanneguy. "Design, modeling and control of a micro-robotic tip for colonoscopy." Villeurbanne : Doc'INSA, 2006. http://docinsa.insa-lyon.fr/these/pont.php?id=chen.
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Tumlinson, Alexandre Rex. "Ultrahigh-Resolution Endoscopic Optical Coherence Tomography for In Vivo Mouse Colonoscopy." Diss., The University of Arizona, 2007. http://hdl.handle.net/10150/194990.
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In vivo monitoring of mouse models of colon cancer promises to reduce the cost of research by improving sacrifice timing and allowing serial studies that observe the progression of disease and drug efficacy in a relatively small set of animals. Optical coherence tomography (OCT) is an optical analog of ultrasound imaging, capable of minimally-invasive mapping of light scatter intensity up to 2 mm deep in tissue. In this work, factors limiting resolution in OCT were examined and devices were created and applied to mouse colon imaging that extended the state-of-the-art in endoscopic ultrahigh-resolution OCT. First, axial chromatic aberration of the objective optics acts as a spectral filter in the sample arm limiting the effective bandwidth of the system. An achromatized endoscope design was demonstrated that achieved axial resolution of 2.3 mum in tissue and 4.4 mum lateral spot diameter with 101 dB sensitivity when interfaced with a time domain OCT system utilizing a 10-femtosecond laser (bandwidth=150 nm FWHM, center wavelength=800 nm). Second, dispersion matching between the sample and reference arms presents the practical resolution limit to endoscopic implementations including a separate, fiber-based reference arm. A second endoscope incorporated the reference arm into the tip of the endoscope using a novel custom beamsplitter prism and achieved 2.4 mum axial resolution in tissue without adjustments for pathlength or dispersion matching when interfaced with a spectrometer-based frequency domain OCT system and a similar laser. Third, non-linear dispersion of the sample media with respect to wavelength causes distortion and broadening of the axial point spread function when data are sampled uniformly in optical frequency. An experiment was performed on high dispersion glass to demonstrate that dispersion artifact free imaging can be achieved without post process corrections if the samples are acquired at equal intervals of media index of refraction divided by vacuum wavelength. Finally, other microscopic modalities that depend on tissue scatter intensity are used to find the origins of scatter in the mouse colonic mucosa. These observations are used to explain unexpected features found in ultrahigh-resolution tomograms collected with the two endoscopes presented.
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Neves, José Francisco Nunes Pereira das. "Sedação para colonoscopia: ensaio clínico comparando propofol e fentanil associado ou não ao midazolam." Universidade Federal de Juiz de Fora (UFJF), 2012. https://repositorio.ufjf.br/jspui/handle/ufjf/8069.
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A Colonoscopia é um dos procedimentos mais realizados. Sedação e analgesia são fundamentais, pois diminuem ansiedade e o desconforto, minimizando riscos de complicações e proporcionando melhores condições para o exame. Em razão disso, os pacientes preferem que o exame seja realizado sob sedação e analgesia, embora não tenha sido determinada, a combinação de fármacos que possibilite condições ideais de exame com mínimo prejuízo cognitivo pós-procedimento. A combinação de benzodiazepínicos com opióides vem sendo utilizada em procedimentos de colonoscopia para aliviar a dor e o desconforto do paciente. Mais recentemente, o propofol assumiu posição de destaque. Este estudo apresenta-se como o único na literatura médica que especificamente comparou, de forma prospectiva, o uso do propofol e fentanil associado ou não ao midazolam na sedação para colonoscopia realizada por anestesiologista. Os objetivos do estudo foram avaliar os efeitos colaterais da sedação, as condições de alta da sala de recuperação pós-anestésica e a qualidade da sedação nas opiniões do endoscopista e do paciente. Além disso, buscou-se avaliar o consumo de propofol durante a colonoscopia, com ou sem o midazolam como pré-anestésico. Trata-se de um estudo prospectivo, randomizado, duplo cego, que envolveu 140 pacientes submetidos à colonoscopia, no Hospital Universitário – CAS da Universidade Federal de Juiz de Fora. Foram incluídos no projeto os pacientes com idade entre 18 e 60 anos, ASA I e II e que assinaram o Termo de Consentimento Livre e Esclarecido. Foram excluídos os pacientes que não obedeciam aos critérios de inclusão ou que faziam uso de medicações com atuação no sistema nervoso central. Os pacientes foram divididos em dois grupos. O Grupo I recebeu, por via endovenosa, midazolam (0,05 mg.Kg-1) como pré-anestésico, cinco minutos antes da sedação, seguido do fentanil (1 μg.Kg-1) e propofol (1 mg. Kg-1). O Grupo II recebeu, por via endovenosa, anestesia com fentanil (1 μg. Kg-1) e propofol (1 mg. Kg-1). Os pacientes do Grupo II apresentaram maior incidência de reação (motora ou verbal) à introdução do colonoscópio, bradicardia (P < 0,04), hipotensão arterial (P = 0,121) e maior consumo total de propofol (P < 0,001). A satisfação dos pacientes foi maior no Grupo I (P = 0,006). De acordo com a metodologia empregada, a associação de midazolam ao propofol e fentanil para sedação em colonoscopia reduz o consumo total de propofol e cursa com maior satisfação do paciente.
Colonoscopy is one of the most performed procedures. Sedation and analgesia are fundamental, since decrease anxiety and discomfort, minimizing risks of complications and providing better conditions for the exam. As a result, patients prefer the exam to be performed under sedation and analgesia. Although, the combination of drugs that provides ideal conditions for the examination with minimal post-procedure cognitive impairment has not yet been defined. The combination of benzodiazepines with opioids has been used in colonoscopy procedures to relieve the pain and discomfort of the patient. More recently, the propofol took a prominent position. Our study is unique in the literature, specifically comparing, prospectively, the use of propofol and fentanyl associated or not to midazolam on sedation for colonoscopy, performed by anesthesiologist. The objectives of the study were to evaluate the side effects of sedation, discharge conditions from the recovery room and quality of sedation in the opinion of the endoscopist and the patient. Evaluate the consumption of propofol during colonoscopy with or without the midazolam as pre anesthetic. The study was prospective, randomised, double blind and involved 140 patients submitted to colonoscopies procedures at University Hospital – CAS at the Federal University of Juiz de Fora. All the included patients in the project were between 18 and 60 years old, ASA I and II and they signed an informed consent. Some other patients were excluded because they did not attend to the criteria of inclusion or have been using medication that acts on the central nervous system. The patients were divided in two groups. The Group I received midazolam (0.05 mg.Kg-1) intravenously as preanesthetic five minutes before the sedation, followed by the fentanyl (1 μg Kg-1) and propofol (1 mg/Kg-1) (EV). The Group II received anesthesia with fentanyl (1 μg Kg-1) and propofol (1 mg/Kg-1) intravenously. The patients from Group II showed a higher incidence of reaction (motor or verbal) to the introduction of the colonoscope, bradycardia (P < 0.04), hypotension (P = 0.121) and a higher consumption of propofol (P < 0.001). Patient satisfaction was higher in Group I (P = 0.006). In accordance with the methodology, the association of midazolam to propofol and fentanyl for sedation in colonoscopy reduces the total consumption of propofol and ensure a higher patient satisfaction.
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Antonietti, Camila Cristine. "Percepção de estresse e estilo de coping dos pacientes no período pré-procedimento colonoscópico." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-16032013-132310/.
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Introdução: A colonoscopia é um dos métodos mais completos de investigação das doenças colorretais, com vantagens por proporcionar a observação da mucosa intestinal, em tempo único e de forma direta e também por ser a técnica de maior acurácia para o diagnóstico de lesões estruturais. Salienta-se que o paciente, ao se deparar com a indicação da colonoscopia, interpreta-a como sendo um exame que provoca desconforto e desencadeia sentimentos de vulnerabilidade, vergonha, medo e ansiedade. Perante estas emoções, o procedimento poderá ser percebido como um fator estresse importante ao paciente e que requer a utilização de estratégias para o enfrentamento da situação de desafio. Objetivo: analisar a percepção de estresse e os estilos de coping em pacientes no período que antecede o procedimento colonoscópico, conforme as variáveis biossociais e clínicas. Material e método: tratase de um estudo descritivo, transversal, exploratório e de campo, com abordagem quantitativa, desenvolvido no Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo (HU-USP). Foram entrevistados 100 pacientes em período de complementação de preparo, adultos, com solicitação formal para a realização do procedimento colonoscópico. Para esta análise, foram utilizados os instrumentos Escala de Estresse Percebido (PSS 10), o Inventário de Estratégias de Enfrentamento de Folkman e Lazarus (1985) e um roteiro de entrevista semiestruturada para caracterização da população do estudo. Resultados: o perfil biossocial da amostra foi, predominantemente, de mulheres (73%), idade superior a 65 anos (50%), casados ou com companheiros (90%), com pelo menos um filho (38%), com escolaridade superior a oito anos de estudos (33%), que pertenciam as religiões evangélica e católica (48% e 45%, respectivamente), em sua maioria aposentados (48%), com antecedentes clínicos de hipertensão arterial sistêmica (90%) e familiar de câncer de colón (68%); 59% dos pacientes em período de preparo revelaram um nível médio de estresse percebido e os estilos de coping com maiores médias foram o Suporte Social (6,43±1,54), Aceitação da Responsabilidade (5,70±2,41) e Reavaliação Positiva (5,64±1,41). As variáveis sexo, idade, estado civil, escolaridade, tipo de preparo e número de exames realizados previamente foram determinadas, como fatores preditores de estresse nessa população. As correlações estatisticamente significativas deste estudo compreenderam a associação entre o PSS-10 e as estratégias de enfrentamento Confronto, Afastamento, Suporte Social, Aceitação da Responsabilidade e Reavaliação Positiva. Entre estes preditores, houve associação do sexo feminino, da idade superior a 65 anos, dos casados ou com namorado, dos não letrados ou daqueles com 2° grau completo/incompleto, do tipo de preparo ambulatorial e dos pacientes com pelo menos um exame realizado com o PSS-10 e os domínios selecionados. Conclusão: a análise da colonoscopia como fator de estresse é pouco estudada em nosso meio, assim como a associação dos processos de enfrentamento. A percepção de estresse foi maior entre os indivíduos da população da pesquisa quando comparados com a população do estudo de tradução e validação do instrumento. Quanto aos estilos de coping foram observados predomínios dos domínios com foco na emoção. Os resultados desta pesquisa permitiram o desenvolvimento de intervenções voltadas para a diminuição do estresse desses pacientes e que os estilos de enfrentamento encontrados nesta análise sejam utilizados para a melhoria da prática assistencial.Introduction: Colonoscopy is one of the most complete methods of investigation for colorectal diseases, with several advantages. One is that it makes possible the observation of bowel mucus, directly and in a single session. Another is that it is one of the most accurate ways of diagnosing structural lesions in bowel. It is important to understand that patients who face this procedure interpret the exam as one that provokes discomfort, which leads to feelings of vulnerability, shame, fear and anxiety. In light of the emotional factors involved, the procedure may be viewed as a source of stress for the patient, and so, requires the implementation of strategies for approaching such a challenging situation. Objective: To analyze the perception of stress, according to bio-social and clinical variables, and coping styles of patients during the period preceding a colonoscopy procedure. Methods: This is a descriptive, transversal, field study with a quantitative approach developed by the Endoscopy Service of São Paulo Hospital University (HU-USP). One hundred patients in the preparatory stages were interviewed, of whom 100% were adults who had received a formal referral for the colonoscopy procedure. For the analysis, the following were employed: the Perceived Stress Scale (PSS-10), the Ways of Coping Questionare of Folkman and Lazarus (1985), as well as a semi-structured interview guide whose aim was to characterize the study population. Results: The bio-social profile of the sample population was predominantly female (73%), 65 years or older (50%), married or with a partner (90%) with at least one child (38%). The sample population also consisted of individuals with an eighth-grade or above level of education (33%), who professed a Faith of either Catholic or Evangelical (48% and 45%, respectively), for the most part retired (48%), with a history of hypertension (90%) and a family member with colon cancer (68%); 59% of the patients undergoing preparations revealed a medium level of perceived stress and the coping styles most utilized by these patients were the Social Support style (6,43±1,54), Acceptance of Responsibility Style (5,70±2,41) and Positive Reappraisal style (5,64±1,41). The variables of gender, age, marital status, schooling, type of preparation, and number of exams previously realized proved to be predictive factors of stress among this population. The statistically significant correlations within this study revealed themselves to be an association between PSS-10 and the coping strategies of Confrontive Coping, Distancing, Seeking Social Support, Acceptance of Responsibility and Positive Reappraisal. Among these predictors, an association of female, 65 years, married or with a partner, secondary schooling either complete or incomplete, with a outpatients preparation and patients with at least one procedure conducted style of PSS-10. Conclusion: The analysis of stress in the realization of colonoscopy exams is a little studied area in our field, as is the association of coping processes. The perception of stress was greater among the participants of the study, when compared with the instrument validation population. In terms of coping mechanisms, it was observed that those that focus on emotion were prevalent. The results of this study allow for a development of interventions that focus on diminishing stress in these patients. The results also permit that the coping mechanisms encountered in this analysis be utilized to better the work of care practitioners.
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Hilsden, Robert J. "Utilization and outcomes of surveillance colonoscopy following curative surgery for colorectal cancer." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq64813.pdf.
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Goto, Hidemi, Naoki Ohmiya, Ryoji Miyahara, Masanao Nakamura, Kohei Funasaka, Masanobu Matsushita, Kazuhiro Morise, et al. "HEPATIC PORTAL VENOUS GAS FOLLOWING COLONOSCOPY IN A PATIENT WITH CROHN’S DISEASE." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18477.
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Beckett, Joanne. "An investigation into implicit emotional memory with concurrent midazolam amnesia following colonoscopy." Thesis, University of Hull, 2003. http://hydra.hull.ac.uk/resources/hull:13773.
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The aim of this study was to investigate whether implicit emotional memory could be demonstrated in patients undergoing a colonoscopy with midazolam sedation. It was hypothesised that the distress associated with a noxious non-surgical procedure would facilitate the conditioning of neologisms designed to readily associate with the negative experience of colonoscopy. It was further hypothesised that mood (in particular high levels of anxiety), personality (specifically introverted and neurotic patients) and objectively rated peri-operative behavioural distress (especially high ratings of distress) may increase the likelihood of implicit emotional memory formation. The study design was a prospective randomised pre and post repeated measures double blind trial including comparison between three groups. Measurement took place at three different time points both pre- and post-surgical procedure (i.e. immediately before and after the colonoscopy and up to one week post procedure). Also the group that participants were allocated to was randomised and unknown to both the researcher and the participant. The measures used were the Hospital Anxiety and Depression Scale, the Eysenck Personality Inventory, the Behavioural Distress Scale, free recall as a measure of explicit memory for intra-operative events and skin conductance response change as a measure of implicit emotional memory for intra-operatively presented neologisms. The investigation failed to find any statistically significant evidence for implicit memory of neologisms presented during colonoscopy, as detected by skin conductance response, or any differences between those participants presented with 'emotive' and 'neutral' neologisms. There was also no significant effect of mood. personality or behavioural distress on this hypothesised interaction. A potentially unrepresentative and relatively small sample. plus some limitations of methodology. implementation and interpretation are discussed with reference to other research and literature related to the field of interest. Finally. some suggestions are made concerning the direction of future research.
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Tenga, Ryan Richard. "Development of an Endoscope Propulsion System to Aid in the Colonoscopy Procedure." Thesis, Virginia Tech, 2007. http://hdl.handle.net/10919/30848.
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Colorectal cancer is the third most common form of cancer, and is the number two cancer-related death in the United States. Receiving regular colonoscopies can reduce the average personâ s risk of dying from colon cancer by 90%. However, only 54% if adults over the age of 50 get regular colonoscopies. This low percentage can be attributed to the examâ s poor availability, severe discomfort, high cost, and the risk of procedural complications. The Endoscope Propulsion System, or EPS, will assist in the colonoscopy procedure. This device will enable a lesser skilled physician to effectively perform the colonoscopy, thus increasing the procedureâ s availability. In addition to requiring less skill, the assistive nature of the EPS will also decrease the chance of complications due to colon perforation. The EPS will greatly reduce the discomfort cause by the colonoscope, which will eliminate the need for anesthesia and recovery, therefore greatly reducing the cost of the procedure. The Endoscope Propulsion System design described in this paper is an update to the device outlined in Dr. M. Jonathan Bernâ s patent application (20060270901). The criteria and requirements of the design are discussed along with the final design and analysis. Finally, a prototype was built to ensure the validity of the proposed invention.Master of Science
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Karri, Venkata Praveen. "Effective and Accelerated Informative Frame Filtering in Colonoscopy Videos Using Graphic Processing Units." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc31536/.
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Colonoscopy is an endoscopic technique that allows a physician to inspect the mucosa of the human colon. Previous methods and software solutions to detect informative frames in a colonoscopy video (a process called informative frame filtering or IFF) have been hugely ineffective in (1) covering the proper definition of an informative frame in the broadest sense and (2) striking an optimal balance between accuracy and speed of classification in both real-time and non real-time medical procedures. In my thesis, I propose a more effective method and faster software solutions for IFF which is more effective due to the introduction of a heuristic algorithm (derived from experimental analysis of typical colon features) for classification. It contributed to a 5-10% boost in various performance metrics for IFF. The software modules are faster due to the incorporation of sophisticated parallel-processing oriented coding techniques on modern microprocessors. Two IFF modules were created, one for post-procedure and the other for real-time. Code optimizations through NVIDIA CUDA for GPU processing and/or CPU multi-threading concepts embedded in two significant microprocessor design philosophies (multi-core design and many-core design) resulted a 5-fold acceleration for the post-procedure module and a 40-fold acceleration for the real-time module. Some innovative software modules, which are still in testing phase, have been recently created to exploit the power of multiple GPUs together.
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Lundmark, Katrin, and Eva Greus. "Faktorer som påverkar patientens situation vid koloskopiundersökning - en litteraturstudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-95916.
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Bakgrund: Koloskopi utförs i diagnostiskt syfte, vid uppföljningar av olika tarmsjukdomar och i behandlande syfte. I och med ökad livslängd, fler cancerfall och utökad screeningsverksamhet kommer antalet koloskopiundersökningar att öka. Syfte: Syftet med denna litteraturstudie var att belysa faktorer som påverkar patientens situation vid koloskopiundersökning. Metod: I denna litteraturstudie har nio kvantitativa och en två-fas studie granskats och analyserats. Sökningarna av artiklarna genomfördes i databaserna CINAHL och PubMed. Även manuell sökning genomfördes. Resultat: Analysen resulterade i tre kategorier och fyra underliggande subkategorier. Fysiska och psykiska faktorer; Smärta och obehag, Oro. Psykologiska faktorer; Skam och genans. Sociala faktorer; Bemötande och samspel mellan patient och vårdpersonal. Resultatet visade att ovanstående faktorer påverkar patienten negativt inför och under koloskopiundersökningen. Resultatet visade även att det fanns könsskillnader som påverkar situationen vid koloskopiundersökningen. Konklusion: Behov finns att lyfta fram och belysa de faktorer som påverkar patientens situation vid koloskopiundersökning. För sjuksköterskan är det viktigt att ha kunskap om dessa faktorer för att kunna bemöta och ha ett samspel med patienten och få en djupare förståelse av vad det innebär för patienten att genomgå en koloskopiundersökning. Nyckelord: colonoscopy, experience, anxiety, attitudes, patient
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Parker, Margaret. "Psychosocial costs and benefits of screening for colorectal cancer." Thesis, University of Nottingham, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320536.
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Woloshynowych, Maria. "Psychological preparation for gastrointestinal endoscopy." Thesis, University College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287454.
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