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OBJECTIVES To determine whether a second observer during colonoscopy increases adenoma detection. METHODS Consecutive patients undergoing screening colonoscopy were prospectively randomized to routine colonoscopy or physician and nurse observation during withdrawal. RESULTS Of 502 patients, 249 were randomized to routine colonoscopy, and 253 to(More)
BACKGROUND Pancreatic cysts are common, however, their diagnosis and classification remains a challenge despite advances in cross-sectional imaging and endoscopic ultrasound with fine needle aspiration (EUS-FNA). OBJECTIVE To determine the incremental yield of cytologic examination of material obtained from targeted fine needle aspiration ("puncture") of(More)
BACKGROUND & AIMS The ability to observe cellular and subcellular detail during routine endoscopy is a major goal in the development of new endoscopic imaging techniques. Multiphoton microscopy, which relies on nonlinear infrared optical processes, has the potential to identify cellular details by excitation of endogenous fluorescent molecules. We examined(More)
BACKGROUND There is no widely adopted, easily applied method for distinguishing between adenomatous and nonadenomatous polyps during real-time colonoscopy. OBJECTIVE To compare white light (WL) with narrow-band imaging (NBI) for the differentiation of colorectal polyps in vivo and to assess for a learning curve. DESIGN A prospective polyp series. (More)
BACKGROUND There is little data on the prevalence of residual neoplastic tissue or the rate of endoscopically detected recurrence in patients with prior surgical or endoscopic resection of advanced neoplasia. AIMS To compare standard white light with NBI for both the detection, as well as the differentiation, of residual or recurrent neoplastic tissue(More)
BACKGROUND Adenoma detection rate (ADR) is increasingly used as a quality indicator for screening/surveillance colonoscopy. Recent investigations to identify factors that affect ADR have focused on the technical aspects of the procedure or the equipment. OBJECTIVE To assess whether gastroenterology (GI) fellow participation during colonoscopy affects ADR.(More)
BACKGROUND Characterization of pancreatic cysts by using EUS-FNA includes chemical and cytologic analysis. OBJECTIVE To evaluate whether material obtained from FNA of the cyst wall increases diagnostic yield. DESIGN Prospective series. SETTING Tertiary referral center. PATIENTS Consecutive patients with pancreatic cysts referred for EUS-FNA between(More)
GOALS To describe a multicenter experience using an endoscopic suturing device for management of gastrointestinal (GI) defects and stent anchorage. BACKGROUND Endoscopic closure of GI defects including perforations, fistulas, and anastomotic leaks as well as stent anchorage has improved with technological advances. An endoscopic suturing device(More)