Biopsy forceps

  • 文章类型: Case Reports
    炎症性支气管息肉(IEP)很少见,良性支气管肿瘤的诊断和治疗的挑战,由于有限的数据。一个55岁的男人,接受过敏性支气管肺曲霉病的治疗,有一周的发热和脓痰病史。确诊为肺炎,他接受了抗菌治疗。然而,因为持续的症状,在计算机断层扫描中怀疑支气管内肿瘤。通过柔性支气管镜和镊子活检证实IEP,息肉切除改善了症状,肺功能,和成像。
    Inflammatory endobronchial polyps (IEPs) are rare, benign bronchial tumors posing diagnostic and therapeutic challenges owing to limited data. A 55-year-old man, receiving treatment for allergic bronchopulmonary aspergillosis, presented with a one-week history of fever and purulent sputum. Diagnosed with pneumonia, he received antimicrobial treatment. However, because of persistent symptoms, an endobronchial tumor was suspected on computed tomography. IEP was confirmed through flexible bronchoscopy with forceps biopsy, and polyp removal improved symptoms, lung function, and imaging.
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  • 文章类型: Journal Article
    柔性支气管镜检查是从气道中提取异物的侵入性较小的程序。然而,关于头巾别针提取的研究仍然非常有限,无法确定使用带活检钳的柔性支气管镜提取头巾别针的有效性和安全性。
    这项回顾性研究是在Persahabatan医院进行的,雅加达,印度尼西亚,2013年1月至2023年2月期间在该医院接受头巾别针拔除治疗的患者。在全身麻醉下进行纤维支气管镜检查。使用径向爪4mm单次使用肺活检钳移除销。首先释放了受撞击的尖头,使用活检钳夹住针体的近端部分。一旦固定住尖头或销钉的近端,支气管镜和镊子均在直视下缓慢退出。
    32例头巾针抽吸术通过纤维支气管镜检查进行处理。共有12名患者(37.5%)没有任何呼吸道疾病;但是,同样数量的咳嗽和6例咯血(18.7%)。发现所有在气道中可见的销钉的情况都是圆头朝下,尖锐的尖端在气道中向上定向并在粘膜中受到冲击。纤维支气管镜摘出成功31例(96.8%)。只有一例被转换为手术。无重大并发症。
    在全身麻醉下进行活检钳的纤维支气管镜检查对于去除头巾针抽吸是安全有效的。
    UNASSIGNED: Flexible bronchoscopy is a less invasive procedure for extracting foreign bodies from the airways. However, studies on the extraction of headscarf pins are still very limited to determine the efficacy and safety of headscarf pin extraction using flexible bronchoscopy with biopsy forceps.
    UNASSIGNED: This retrospective study was conducted at Persahabatan Hospital, Jakarta, Indonesia, on patients who had been treated in this hospital for headscarf pin extraction between January 2013 and February 2023. Fibreoptic bronchoscopy was performed under general anaesthesia. The pin was removed using Radial Jaw 4 mm single-use pulmonary biopsy forceps. The impacted sharp tip of the pin was freed first, and the proximal part of the pin body was gripped using biopsy forceps. Once a firm hold of the sharp end or the proximal part of the pin was secured, the bronchoscope and forceps were both slowly withdrawn under direct vision.
    UNASSIGNED: Thirty-two cases with headscarf pin aspiration were managed by fibreoptic bronchoscopy. A total of 12 patients (37.5%) came without any respiratory complaints; however, an equal number complained of cough and 6 cases (18.7%) of haemoptysis. All the cases in which the pins were visible in the airway were found with the round head down and the sharp tip oriented superiorly in the airway and impacted in the mucosa. Fibreoptic bronchoscopy extraction succeeded in 31 cases (96.8%). Only one case was converted to surgery. There were no major complications.
    UNASSIGNED: Fibreoptic bronchoscopy with biopsy forceps under general anaesthesia is safe and effective for the removal of headscarf pin aspiration.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    传入环路阻塞(ALO)可作为BillrothII或Roux-en-Y重建胃切除术的并发症发生。传统上,大多数病例都进行了紧急手术,虽然最近有报道对择期病例进行内窥镜检查。我们报告了由植物牛黄引起的ALO的独特病例,该病例已通过内窥镜手术成功治疗。
    方法:一名76岁女性患者在晚餐后出现上腹痛数小时。该患者在62岁时有远端胃切除术和Roux-Y重建胃癌的病史。计算机断层扫描(CT)显示十二指肠和胆总管明显扩张,并在空肠空肠吻合部位检测到牛黄,表明ALO是由牛黄诱导的。上内窥镜检查显示吻合部位的未消化食物形成,并且通过使用活检钳的内镜碎片成功地将其移位。手术后,腹部症状消退,患者在第四天出院。
    牛黄诱导的ALO很少见。在这种情况下,CT有助于诊断牛黄引起的ALO。最近,ALO的内窥镜干预措施有所增加,并且有一些报道称牛黄引起的小肠梗阻正在通过内窥镜治疗。因此,随后进行了内窥镜检查,在这种情况下,确认存在植物石,并导致侵入性较小的内窥镜碎片治疗。
    结论:这是一个独特的病例报告,通过内窥镜对未消化的食物进行破碎处理,提供有益的治疗选择。
    UNASSIGNED: Afferent loop obstruction (ALO) can occur as a complication of gastrectomy with Billroth II or Roux-en-Y reconstruction. Conventionally, emergent surgery was performed for most cases, while endoscopic procedures for elective cases have been reported more recently. We report a unique case of ALO caused by a phytobezoar that was successfully treated by endoscopic procedures.
    METHODS: A 76-year-old female patient presented with epigastric pain for several hours after dinner. The patient had a history of distal gastrectomy with Roux-Y reconstruction for gastric cancer at age 62. Computed tomography (CT) demonstrated evident dilation of the duodenum and common bile duct, and detected a bezoar at the jejunojujunal anastomosis site, indicating that the ALO was induced by the bezoar. Upper endoscopy visualized undigested food formation stuck at the anastomosis site, and it was successfully dislodged by endoscopic fragmentation using biopsy forceps. After the procedure, the abdominal symptoms subsided, and the patient was discharged on the fourth day.
    UNASSIGNED: Bezoar-induced ALO is rare. In this case, CT helped diagnose the ALO induced by the bezoar. In recent times, there has been a rise in endoscopic interventions for ALO, and there are some reports of bezoar-induced small bowel obstruction being treated endoscopically. Therefore, a subsequent endoscopic examination was performed, confirming the presence of a phytobezoar and leading to a less invasive endoscopic fragmentation treatment in this case.
    CONCLUSIONS: This is a unique case report of phytobezoar-induced ALO treated by endoscopic fragmentation of undigested food, providing a beneficial treatment option.
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  • 文章类型: Journal Article
    背景:由于与冷镊子息肉切除术(CFP)相比,不完全切除率较低,并且与热圈套息肉切除术(HSP)相比,冷圈套息肉切除术(CSP)是小(6-9mm)息肉的首选切除技术。
    目的:描述小(6-9mm)息肉的切除技术,并确定与次优技术相关的因素。
    方法:这是2012年至2019年由胃肠和外科内镜医师进行的结肠镜检查的回顾性队列研究,其中至少切除了一个6-9毫米息肉。病人,提供者,并收集了程序特征。进行单变量和多变量回归分析以确定与次优技术相关的因素。
    结果:总计,包括773个结肠镜检查,其中由21个内窥镜医师切除了1,360个6-9毫米息肉。CSP用于1,122(82.5%),CFP为61(4.5%),和HSP为177(13.0%)。外科医生专业与CFP使用相关(aOR7.81;95%CI3.02-20.16)。左结肠息肉位置(aOR1.65;95%CI1.17-2.33)和带蒂形态(aOR12.76;95%CI7.24-22.50)与HSP相关。CSP的总体使用量从2012年的30.4%大幅增加到2019年的96.8%。
    结论:从2012年至2019年取出的所有6-9毫米息肉中,有82.5%是使用冷圈套器取出的,从2012年至2019年CSP显着增加。随着时间的推移,基于专业如何采用最佳技术的差异凸显了对标准化实践指南和质量监控的需求。
    Cold snare polypectomy (CSP) is the preferred resection technique for small (6-9 mm) polyps due to lower rate of incomplete resection compared to cold forceps polypectomy (CFP) and improved safety profile over hot snare polypectomy (HSP).
    To describe resection techniques for small (6-9 mm) polyps and determine factors associated with sub-optimal technique.
    This was retrospective cohort study of colonoscopies performed by gastroenterological and surgical endoscopists from 2012 to 2019 where at least one 6-9 mm polyp was removed. Patient, provider, and procedure characteristics were collected. Univariate and multivariate regression analyses were performed to determine factors associated with sub-optimal technique.
    In total, 773 colonoscopies where 1,360 6-9 mm polyps removed by 21 endoscopists were included. CSP was used for 1,122 (82.5%), CFP for 61 (4.5%), and HSP for 177 (13.0%). Surgeon specialty was associated with CFP use (aOR 7.81; 95% CI 3.02-20.16). Polyp location in left colon (aOR 1.65; 95% CI 1.17-2.33) and pedunculated morphology (aOR 12.76; 95% CI 7.24-22.50) were associated with HSP. There was a significant increase in overall CSP use from 30.4% in 2012 to 96.8% in 2019.
    82.5% of all 6-9 mm polyps removed from 2012 to 2019 were removed using a cold snare with significant increase in CSP from 2012 to 2019. Differences in how optimal technique was adopted over time based on specialty highlight the need for standardized practice guidelines and quality monitoring.
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  • 文章类型: Journal Article
    慢性胃肠病,包括面筋敏感性和马莫塞特消瘦综合征,经常发生在普通and猴(Callithrixjacchus)的圈养菌落中。受影响的动物的早期识别和诊断是期望的。本文描述了马猴结肠的内窥镜检查,但是小肠可以有明显的粘膜病变,不代表结肠。由于患者体积较小,目前评估小肠需要进行侵入性手术活检,有严重并发症的风险。
    在全身麻醉下,在10只小鼠中显示了十二指肠/近端空肠的内窥镜插管和多部位活检。
    食管胃十二指肠镜检查与结肠镜检查有效地帮助检查胃肠道,并获得具有慢性胃肠道体征的猴的死前组织学诊断。
    这种微创技术在猿猴中是可行的。未来对慢性胃肠病发病机制的研究将受益于这些数据,导致改善动物福利和更好的个人和群体健康管理。
    Chronic gastroenteropathies, including gluten sensitivity and marmoset wasting syndrome, frequently occur in captive colonies of common marmosets (Callithrix jacchus). Early identification and diagnosis of affected animals are desirable. Endoscopic examination of the colon in marmosets is described, but the small intestine can harbor significant mucosal lesions not representing those in the colon. Evaluating the small intestine currently requires invasive surgical biopsies due to the small patient size, carrying a risk of severe complications.
    Endoscopic intubation and multisite biopsy of the duodenum/proximal jejunum are demonstrated in 10 marmosets under general anesthesia.
    Esophagogastroduodenoscopy with colonoscopy efficiently aid in examining the gastrointestinal tract and obtaining an antemortem histologic diagnosis in marmosets with chronic gastrointestinal signs.
    This minimally invasive technique is feasible in marmosets. Future investigations into the pathogenesis of chronic gastroenteropathies will benefit from these data, leading to improved animal welfare and better individual and colony health management.
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  • 文章类型: Journal Article
    UNASSIGNED:带有嵌入钩的严重倾斜是成功回收下腔静脉(IVC)过滤器的常见障碍。
    UNASSIGNED:使用处置活检钳对中心位置的过滤器钩进行重塑,以将嵌入的钩从腔壁上释放。
    UNASSIGNED:活检钳辅助的环形圈套器技术已成功用于取回带有嵌入IVC壁中的钩子的过滤器。
    UNASSIGNED:我们在这里介绍的活检钳辅助环圈套器技术为IVC过滤器的复杂检索提供了一种新的解决方案。在过滤器检索的标准技术失败的情况下,该技术可以证明是有用的。
    UNASSIGNED: Severe tilt with embedded hooks is a common obstacle to successful inferior vena cava (IVC) filter retrieval.
    UNASSIGNED: Disposal biopsy forceps were used to remodel the filter hook in the center position to release the embedded hook from the caval wall.
    UNASSIGNED: The biopsy forceps-assisted loop snare technique was successfully used to retrieve filters with hooks embedded in the IVC wall.
    UNASSIGNED: The biopsy forceps-assisted loop snare technique we present here offers a new solution for the complex retrieval of IVC filters. This technique may prove useful in cases where standard techniques at filter retrieval fail.
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  • 文章类型: Case Reports
    一名76岁的女性,她有左股浅动脉血管内治疗(EVT)的病史,血管内支架移植物[VIABAHN(W.L.Gore&Associates,Inc.,DE,美国)]突然经历了她左腿的间歇性跛行。血管造影显示先前的支架移植物完全闭塞,穿过导丝后使用血栓抽吸导管.由于使用血栓抽吸导管的逆行血管造影显示,即使在几次血栓抽吸后,在前一个支架的远端边缘仍有大量残留血栓。用于肠内窥镜的活检钳[径向颚(波士顿科学,MA,美国)]被成功用于去除血栓。在远端保护下球囊充气后,血管造影显示,她的左股总动脉有大量残余血栓,股深动脉血流受限。再一次,活检钳被成功地用于去除血栓。在这个系列中,我们报告了总共11例使用肠内窥镜活检钳进行EVT的病例[桡骨颌骨(波士顿科学,MA,美国)]。在11个案例中,八人使用活检钳进行EVT以去除血栓,两名患者在严重钙化病变中接受了钙化切除,其中一个接受了分离的导丝的移除。除了一名患者在EVT后接受大截肢外,没有发生重大不良肢体事件(MALEs)。一个男性独立于活检钳的使用发生,因为活检钳只用于移除分离的电线。用于肠内窥镜的活检钳在临床上对EVT有用且安全。
    A 76-year-old female who had a history of endovascular treatment (EVT) for her left superficial femoral artery with endovascular stent grafts [VIABAHN (W. L. Gore & Associates, Inc., DE, USA)] suddenly experienced intermittent claudication of her left leg. Angiography revealed total occlusion of previous stent grafts, and a thrombus aspiration catheter was used after crossing the guidewire. Since retrograde angiography using a thrombus aspiration catheter revealed a large residual thrombus at the distal edge of the previous stent even after several thrombus aspirations, biopsy forceps for intestinal endoscopes [Radial Jaw (Boston Scientific, MA, USA)] were successfully used to remove that thrombus. After balloon inflation under distal protection, angiography revealed a large residual thrombus at her left common femoral artery with a flow limiting of her deep femoral artery. Again, biopsy forceps were successfully used to remove that thrombus. In this case series, we reported a total of 11 cases which underwent EVT using biopsy forceps for intestinal endoscopes [Radial Jaw (Boston Scientific, MA, USA)]. Of the 11 cases, eight underwent EVT using biopsy forceps for thrombus removal, two underwent calcification removal in severely calcified lesions, and one underwent removal of a detached guidewire. There were no major adverse limb events (MALEs) except for one patient who underwent major amputation after EVT. One MALE occurred independently of biopsy forceps use because biopsy forceps were used only to remove the detached wire. Biopsy forceps for intestinal endoscopes were clinically useful and safe for EVT.
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  • 文章类型: Journal Article
    BACKGROUND: The present study aimed to compare the clinical results and pathological diagnostic quality of percutaneous transhepatic cholangiobiopsy for biliary obstruction using biopsy forceps (BFs) of varying diameter.
    METHODS: A total of 57 patients with obstructive jaundice who underwent percutaneous transhepatic cholangiobiopsy and drainage with 1 of 2 BFs diameters (6.0-mm BFs, n=30; 4.5-mm BFs, n=27) between February 2018 and May 2019 were retrospectively assessed. BFs were compared in terms of their sample quality, diagnostic accuracy, sensitivity, specificity, number of passes, and complication rate.
    RESULTS: All 57 patients underwent the procedure successfully and the technical success rate was 100%. The 6.0- and 4.5-mm BFs demonstrated a diagnostic accuracy of 80% (24/30) and 85% (23/27), respectively (P=0.733), and a sensitivity of 78% (22/28) and 86% (22/26), respectively (P=0.729). The specificity of both the 6.0- and 4.5-mm BFs was 100%. The complication rate was 10% (3/30) with the 6.0-mm BFs and 19% (5/27) with the 4.5-mm BFs (P=0.456). The mean number of biopsies was 2.9±0.6 with the 6.0-mm BFs compared with 3.6±1.0 with the 4.5-mm BFs (P<0.001). The 6.0-mm BFs provided a larger biopsy size and a less crushed specimen compared with the 4.5-mm BFs. The overall tissue scores were 5.2±0.8 with 6.0-mm BFs and 4.5±1.0 with 4.5-mm BFs (P=0.012).
    CONCLUSIONS: There was no statistically significant difference in the clinical results between the 2 BFs in the context of percutaneous transhepatic cholangiobiopsy. Superior samples were obtained using the 6.0-mm BFs, with a fewer number of passes. The complication rate did not increase compared with the 4.5-mm BFs.
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  • 文章类型: Journal Article
    Although the importance of the retrieval of an optional inferior vena cava filter (o-IVCF) has gained attention because of the awareness of a high complication rate with long indwelling time, the o-IVCF retrieval rate remains low. The advanced retrieval technique of o-IVCF may increase the retrieval rate, which in turn diminishes future adverse events. Through two cases, we describe how to perform the novel approach \"bidirectional sling technique with biopsy forceps.\" This technique will improve the retrieval rate in patients following the failure by conventional retrieval technique.
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