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RISS 인기검색어
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- 저자 : Munish Ashat (검색결과 2 건)
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Munish Ashat,Kaartik Soota,Jagpal S. Klair,Sarika Gupta,Chris Jensen,Arvind R. Murali,Randhir Jesudoss,Rami El Abiad,Henning Gerke 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4
Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration is very effective for providing specimens forcytological evaluation. However, the ability to provide sufficient tissue for histological evaluation has been challenging due to thetechnical limitations of dedicated core biopsy needles. Recently, a modified EUS needle has been introduced to obtain tissue coresamples for histological analysis. We aimed to determine (1) its ability to obtain specimens for histological assessment and (2) thediagnostic accuracy of EUS-guided fine-needle biopsy (EUS-FNB) using this needle. Methods: We retrospectively analyzed consecutive cases of FNB using modified EUS needles for 342 lesions in 303 patients. Thecytology and histological specimens were analyzed. Diagnostic accuracy was calculated. Results: Adequate cytological and histological assessment was possible in 293/342 (86%) and 264/342 (77%) lesions, respectively. Diagnostic accuracy of the cytological specimen was 294/342 (86%) versus 254/342 (74%) for the histological specimen (p<0.01). Diagnostic accuracy of the combined cytological and histological assessment was 323/342 (94.4%), which was significantly higher thanthat of both histology alone (p<0.001) and cytology alone (p=0.001). Conclusions: EUS-FNB with the modified EUS needle provided histologic tissue cores in the majority of cases and achieved excellentdiagnostic accuracy with few needle passes.
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Shivanand Bomman,Munish Ashat,Navroop Nagra,Mahendran Jayaraj,Shruti Chandra,Richard A Kozarek,Andrew Ross,Rajesh Krishnamoorthi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminatedduodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhancedsurveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethyleneoxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review andmeta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inceptionuntil January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates ofpost-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRTduodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]:2.3%–10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%–2.7%,I2=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoingefforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design toimprove safety are warranted.
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