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17 protocols using cf h260

1

Colonoscopy Practices in Diagnostic Setting

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This cross-sectional study was conducted on consecutive patients who underwent diagnostic colonoscopies at Dongguk University Ilsan Hospital between May 2016 and August 2016. The exclusion criteria were insufficient information about the bowel cleansing quality, therapeutic colonoscopy for alleged colorectal neoplasms, and previous history of colorectal resection. This study was approved by the Institutional Review Board (DUIH 2017-11-013-003).
All patients were examined by experienced endoscopists using a video colonoscope (Olympus CF-H260 or CF-Q260; Olympus Optical Co., Ltd., Tokyo, Japan). Intravenous midazolam was administered to the patients who wanted sedative endoscopies. The dose was determined according to a unified protocol based on the subject’s age and weight. Meperidine was applied routinely as an analgesic.
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2

Colonoscopy Performance Evaluation Across Experts and Trainees

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All participants were examined using a video colonoscope (Olympus CF-H260 or CF-Q260, Olympus Optical Co., Ltd, Tokyo, Japan) by six expert colonoscopists or five training fellows. All the experts had performed at least 1000 colonoscopic examinations. All of the training fellows had less than one year of endoscopic training and less than 300 colonoscopy experiences. Trainees performed colonoscopy independently or sometimes under minor supervision.
All the subjects received 2L doses of a polyethylene glycol and electrolyte solution (CoolPrep powder, Taejoon Pharm, Seoul, Korea) before the examinations for bowel cleansing. The degree of bowel preparation was assessed using Aronchick scale (excellent, good, fair, poor, or inadequate).[14 (link)] Subjects with inadequate preparation were excluded from this study due to incomplete examination. Intravenous midazolam was administered to those who sought sedative endoscopy. The dose was determined according to a unified protocol based on a subject's age and weight. Meperidine was routinely applied as analgesia. CIT was defined as the time interval from the start of an examination until the cecum was reached. The examination was defined as difficult colonoscopy when the CIT was longer than 15 minutes. Abnormal colonoscopic findings such as diverticulosis, and colorectal neoplasms were recorded.
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3

Colorectal Disease Diagnosis Protocol

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An electronic high-resolution video endoscope (model CFH260; Olympus Optical, Tokyo, Japan) with full preparation was used for diagnosis of colorectal diseases. Endoscopy was performed by well-trained staff who were blinded to the questionnaire results. When abnormalities were detected by colonoscopy, biopsy, polypectomy, or endoscopic mucosal resection was performed. All removed specimens were evaluated by expert pathologists, and final diagnoses of colorectal diseases were made.
Colorectal diseases included early and advanced colorectal cancer, other colorectal tumor, inflammatory bowel disease, ischemic colitis, and other colitis, as reported previously.[20 (link)] During the same period (within 1 week of colonoscopy), upper endoscopy was performed for 110 patients, none of whom were found to have cancerous or ulcerous lesions or severe gastritis.
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4

Comprehensive Colorectal Examination

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An electronic high-resolution video endoscope (model CFH260; Olympus Optical, Tokyo) with full colonic preparation was used for diagnosis of colorectal disease. Well-trained staff performed colonoscopy while blinded to the questionnaire results. The location of all lesions was recorded in the electronic endoscopic database (Olympus Medical Systems; Solemio Endo). Anorectal cancer and other HPV diseases were screened for in all patients and biopsy or endoscopic mucosal resection were performed when necessary (Figure 2a-c). The biopsy or resected sample was histopathologically assessed by experienced pathologists (Figure 2d-f). 29
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5

Colonoscopy-Assessed Melanosis Coli Grading

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Colonoscopy was performed either by experienced endoscopists who had each performed more than 500 colonoscopies before the study began, or by junior endoscopists under the supervision of experienced physicians. Either CF Q260 / CF H260 (Olympus, Japan) or Fu (Fuji, Japan) colonoscopes were used. Melanosis coli was diagnosed and defined as brownish or blackish pigmentation of the colonic mucosa during colonoscopy confirmed by histology of tissue biopsy, showing pigment-laden macrophages in the lamina propria.
Melanosis coli was categorized as three grades depending on the extent of pigmentation due to accumulation of pigmented phagosomes in macrophages in the lamina propria [17 ]: Grade I, light brown colonic mucosa with no apparent boundary with normal mucosa (Fig 1A and 1B); Grade II, brown colonic mucosa, with clear linear or non-continuous boundary with normal mucosa (Fig 1C and 1D); Grade III, dark black colonic mucosa with linear or spotted boundary with normal mucosa (Fig 1E and 1F).
The distribution of melanosis coli was defined according to the predominant region of the colon involved: Type 1, right colonic: cecum, ascending colon, and transverse colon mainly involved; Type 2, left colonic: descending colon, sigmoid colon, and rectum mainly involved; Type 3, total colonic: total colon involved.
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6

Colonoscopic Polyp Removal Protocol

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A standard colonoscope (CF-H260; Olympus, Tokyo, Japan) was used for the procedure. The colon was cleansed with a 4-L polyethylene glycol electrolyte solution. Midazolam (Dormicum®) for conscious sedation and meperidine (Demerol®) for pain control were selectively given to patients. Polypectomy was performed in a standard fashion by one endoscopist and one assistant. The polyp was removed by oval-shaped snares (Olympus) after saline injection mixed with indigo carmine and epinephrine. There was no additional routine procedure after the polypectomy. However, if it was suspected macroscopically that the polyp had not been removed completely, we performed additional polypectomy by using a snare, biopsy forceps, and/or argon plasma coagulation (APC). If there was a possibility of postpolypectomy hemorrhage, we used hemoclipping, administered an epinephrine injection, and/or APC. The size of the polyp was estimated by the endoscopist during the endoscopy.
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7

Endoscopic Classification of Laterally Spreading Tumors

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All patients were examined using video colonoscopies (Olympus CF-240I or CF-H260; Olympus, Tokyo, Japan). LSTs were subclassified using the endoscopic Kudo classification [10 (link)] into LST-Gs and LST-NGs. LST-Gs were further divided into LST-G-H and LST-G-M lesions, and LST-NGs were divided into LST-NG-FE and LST-NG-PD lesions. The locations of LSTs were categorized into the ileocecal valve, ascending colon, hepatic flexure, right transverse colon, left transverse colon, splenic flexure, descending colon, sigmoid colon, and rectum. The right-side colon includes the cecum, ascending colon, hepatic flexure, and two-thirds of the transverse colon. The left-side colon includes the other one-third of the transverse colon, splenic flexure, descending colon, and sigmoid colon.
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8

Two-person Colonoscopy with ESD

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In our center, we use a two-person approach to colonoscopy. ESD was performed using a conventional endoscope (CF-H260, Olympus, Tokyo, Japan). A mixture of glycerin and fructose, normal saline, adrenaline, and methylene blue was injected into the submucosal plane with a submucosal injection needle (Alton) to create a visible submucosal cushion for elevation of the lesion. Mucosal incision and submucosal dissection were performed using the needle knife or insulated tip knife (Olympus Endoscopy Medical System, Tokyo, Japan) depending on the individual endoscopists’ preference. All procedures were performed without anesthesia. The patients undergoing ESD did not receive any kind of IV sedation.
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9

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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10

Endoscopic Submucosal Dissection Technique

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All procedures were performed using a colonoscope (CF-H260; Olympus, Japan) with a transparent cap (D-201-13404; Olympus, Japan) and a gastroscope (GIF-H260J; Olympus, Japan) with a distal attachment (ND-201-11804; Olympus, Japan). A Dual knife (KD-650Q; Olympus, Japan) was used during all ESD procedures. A high-frequency electrosurgical generator (VIO 200S; ERBE, Germany) was set up. An injection needle (NM-200L-0423; Olympus, Japan) was used to lift up the lesion. Hot biopsy forceps (FD-1U-1; Olympus, Japan) or endoscopic metal clips (HX-610-090L; Olympus, Japan) were used to stop bleeding. A mixture of 100 ml of 10% glycerol solution containing 2 ml of methylthioninium chloride and 1 mg of 0.002% epinephrine was used as the injection solution [14 (link)].
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