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7 protocols using cf hq290

1

Comprehensive Colonoscopy Protocol with Advanced Imaging

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Patients underwent colonoscopy with an Elite CF290 endoscopy system (CV-290 and CLV-290, Olympus, Japan) with a 290 series colonoscope (CF-HQ290Z, CF-HQ290, or PCF-H290Z, Olympus, Japan) or a 260 series colonoscope (PCF-PQ260 or CF-H260) and a carbon dioxide (CO
2) insufflator (UCR CO
2regulation unit, Olympus, Japan). NBI was available for all the scopes. A flushing pump (OFP-2, Olympus, Japan) was used for the 290 series colonoscope. PCF-H290Z and PCF-PQ260 were used for patients aged 80 years or older, patients aged 70 years or older who had undergone a previous abdominal surgery, and patients likely to experience a difficult insertion due to a colon adhesion found during a previous colonoscopy
9 (link)
. We used an image filing system (T-File System; STS Medic, Japan).
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2

Endoscopic Resection Protocol

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Endoscope: CF-HQ290 (Olympus Co., Tokyo, Japan)

Snare: M00562321 (Boston Scientific Co., Tokyo, Japan)

Clip: EZ CLIP (HX-610-135, Olympus Co., Tokyo, Japan) (Cost per clip: \975, US $9.56, €7.01)

Injection needle: (NM-4U, Olympus Co., Tokyo, Japan)

Local injection solution: Saline solution

Incisional generator device: ERBE VIO300D (Elektromedizin, Tübingen, Germany; setting: Swift mode 45w, effect 4)

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3

Endoscopic Submucosal Dissection Procedure

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ESD was performed under conscious sedation (6 patients) or general anesthesia (4 patients) using a colonoscope (CF-Q260 or CF-HQ290, Olympus) with an attached transparent cap. Carbon dioxide was used for insufflation. Other equipment and accessories used during the procedure included a high-frequency generator (VIO 200D; ERBE), an argon plasma coagulation unit (APC300; ERBE), various dissecting knives (hybrid knife, dual knife, and insulation-tip knife), an injection needle (NM-4L-1; Olympus), and hemostatic clips (HX-600-90; Olympus).
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4

Endoscopic Submucosal Dissection for Colorectal Lesions

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Colon pretreatment was performed using 0.15-L magnesium citrate on the night before the ESD and using 1.2 to 2-L low-volume polyethylene glycol solution (Moviprep, EA Pharma Co. Tokyo, Japan) on the day of ESD. When the stool became clear, colon preparation was considered complete. If the stools were not clear after taking 2 L of low-volume polyethylene glycol solution, 120-mL glycerine enema or isotonic magnesium citrate solution was used.
ESD was performed using a colonoscope with a waterjet instrument (PCF-H290, CF-HQ290 or PCF-H290T; Olympus, Tokyo, Japan) and an attachment (D-201-12704; Olympus) fitted to the tip. Incision and dissection were performed with a FlushKnife BTS (DK2620 J -B15S-; Fujifilm) or a DualKnifeJ (KD-655Q; Olympus, Tokyo, Japan). Precut-coagulation of vessel or hemostasis was performed with Coagrasper (FD-411QR; Olympus, Tokyo, Japan). In addition, hyaluronic acid (MucoUp; Boston scientific Tokyo, Japan) with a small volume of epinephrine and indigo carmine was injected.
High-frequency power supply (VIO300D; Erbe, Tübingen, Germany) was used. The endocut I mode (effect 3, duration 2, interval 2) was used for mucosal incision and submucosal dissection. The forced coagulation mode 45 W (effect 2) was used for submucosal dissection, and the soft coagulation mode 80 W (effect 5) was used for precut-coagulation and hemostatic treatment.
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5

Colonoscopic Polypectomy Techniques

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Colonoscopic polypectomy was performed using a normal electric video endoscope (PCF-H290ZI, PCF-Q260AZI, CF-HQ290; Olympus, Tokyo, Japan), with carbon dioxide insufflation. All patients received 2 L of polyethylene glycol solution or 1.8–2.4 L of magnesium citrate solution in the morning on the day of the procedure. CSP was performed for small polyps (≤10 mm in maximum diameter) using Captivator II (Boston Scientific Japan, Tokyo, Japan). Cold forceps polypectomy (CFP) was performed for small polyps (≤4 mm in maximum diameter) using Radial Jaw4 Jumbo cold polypectomy forceps (Boston Scientific Japan, Tokyo, Japan). The same endoscopists that performed CSP used a B-wave (Xemex, Tokyo, Japan), Captivator II (Boston Scientific Japan, Tokyo, Japan), or SnareMaster (Boston Scientific Japan, Tokyo, Japan) to perform hot snare polypectomy (HSP). For endoscopic mucosal resection (EMR), normal saline was injected into the submucosa before excision. VIO 300D (ERBE Elektromedizin, Tubingen, Germany) was used as a power source, and all participant endoscopists used the same setting. Decisions on procedures for polyps 3–45 mm in size (i.e., application of HSP, EMR, CSP or CFP) and decisions regarding clip placement for prophylaxis of PPB were made by the endoscopists in charge.
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6

Endoscopic Channel Cleaning with EZ Jet Ball

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The novel BB (EZ Jet Clean Ball; Silverex, Incheon, Korea) is made to fit the endoscopic channel, and balls of various sizes (2.2, 2.8, 3.2, 3.7, and 4.2 mm) are used according to the diameter of the lumen. It is made of a silicon ball wrapped in microfibers that are 0.5–1.0 mm larger than the inner diameter of the endoscopic channel. Upon contact with water, the ball swells slightly from its original size (approximately 0.1 mm) (Supplementary Fig. 1). It is subsequently sucked in using the tip of the endoscope. Its design allows it to scrub the interior as it passes through the lumen of the channel (Fig. 1). The upper gastrointestinal endoscopes used for the examination were GIF-Q260 and GIF-H260 (Olympus, Tokyo, Japan; channel diameter, 2.8 mm; universal code diameter, 3.7 mm). CF-Q260AL, CF-H260AL, and CF-HQ290 (Olympus) were used as the lower gastrointestinal endoscopes (channel diameter, 3.2, 3.7, and 3.7 mm, respectively; universal code diameter, 3.7 mm for all).
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7

Endoscopic Resection Equipment and Techniques

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Endoscope: CF-HQ290 (Olympus Co., Tokyo, Japan).

Incisional knife: IT knife 2 (KD-611L, Olympus Co., Tokyo, Japan).

Hemostatic forceps: Coagrasper (FD-410LR, Olympus Co., Tokyo, Japan).

Injection needle: NM-4U (Olympus Co., Tokyo, Japan).

Local injection solution: hyaluronic acid (MucoUp®, Johnson & Johnson K.K., Tokyo, Japan) and 10% glycerin (mixing ratio 1:1).

Incisional generator device: ERBE VIO300D (Elektromedizin, Tübingen, Germany).

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