Effect of Comprehensive Nursing Intervention on Intestinal Preparation Quality of Hospitalized Patients undergoing Colonoscopy

Objective: To explore the impact of comprehensive nursing intervention on the quality of intestinal preparation in the process of intestinal preparation for hospitalized patients undergoing colonoscopy. Methods: A total of 320 patients underwent colonoscopy in our department from January to June 2021. They were grouped by random number table. There were 160 cases in the control group and 160 cases in the observation group. The adverse reactions of intestinal preparation and the cleanliness of intestinal preparation were analyzed. Results: Through comprehensive nursing intervention, it can be found that the incidence of adverse reactions in the preparation of colonoscopy in the control group was 24.38%, and that in the observation group was 13.48%. The results showed that the incidence of adverse reactions in the preparation of colonoscopy was significantly lower than that in the control group (P < 0.05), which indicates that the difference was statistically significant. In the control group, 105 people qualified in intestinal cleanliness score (> 5 points) during enteroscopy preparation, and the cleanliness qualification rate was 65.63%. In the observation group, 139 people qualified in intestinal cleanliness score (> 5 points) during enteroscopy preparation, and the cleanliness qualification rate was 86.88%. The cleanliness qualification rate of enteroscopy preparation was significantly higher than that of the control group, and P < 0.05, which indicates that the difference was statistically significant. Conclusion: Comprehensive nursing intervention can promote the quality of preparation of patients for colonoscopy, improve the compliance of patients and improve the accuracy of examination effect.

GCaMP6F Fluorescence in Ex Vivo Intestinal Preparation v1

Protocol for GCaMP6F imaging in ex vivo intestinal tissue used in Yoo et al 2021

Are preoperative oral antibiotics effective in reducing the incidence of anastomotic leakage after Colorectal cancer surgery: Study protocol for a prospective, multicentre, randomized controlled study

Introduction The optimal preoperative preparation for elective colorectal cancer surgery has been debated in academic circles for decades. Previously, many expert teams have conducted studies on whether preoperative mechanical bowel preparation and preoperative oral antibiotics can effectively reduce the incidence of postoperative complications, such as surgical site infections and anastomotic leakage. Most of the results of these studies have suggested that preoperative mechanical bowel preparation for elective colon surgery has no significant effect on the occurrence of surgical site infections and anastomotic leakage. Methods/design This study will examine whether oral antibiotic bowel preparation (OABP) influences the incidence of anastomotic leakage after surgery in a prospective, multicentre, randomized controlled trial that will enrol 1500 patients who need colon surgery. The primary endpoint, incidence of anastomotic leakage, is based on 2.3% in the OABP ± mechanical bowel preparation (MBP) group in the study by Morris et al. The patients will be randomized (1:1) into two groups: the test group will be given antibiotics (both neomycin 1 g and metronidazole 1 g) the day before surgery, and the control group will not have any special intestinal preparation before surgery, including oral antibiotics or mechanical intestinal preparation. All study-related clinical data, such as general patient information, past medical history, laboratory examination, imaging results, and surgery details, will be recorded before surgery and during the time of hospitalization. The occurrence of postoperative fistulas, including anastomotic leakage, will be recorded as the main severe postoperative adverse event and will represent the primary endpoint. Ethics and dissemination Ethics and dissemination Ethics approval has been obtained from the Ethics Committee at the Chinese Ethics Committee of Registering Clinical Trials(ChiECRCT20200173). The results of this study will be disseminated at several research conferences and as published articles in peer-reviewed journals. Trial registration: ChiCTR2000035550. Registered on 13 Aug 2020.

Nursing Value Analysis and Risk Evaluation of Acute Gastroenterology Diseases

In the Department of Gastroenterology, poor compliance, psychological anxiety, fear, and other reasons result in a high rate of breach of appointment. The failure rate of colonoscopy was 6.68. This paper proposes mastering the psychological characteristics of patients and implement humanistic care services to alleviate patients’ psychological anxiety. The study found that telephone follow-up 2 days before diagnosis and treatment can let us know whether patients can come for examination and reduce the rate of nonappointment. Second, preoperative education can significantly reduce the degree of anxiety and improve the anxiety of patients. Third, the cleanliness of intestinal preparation before colonoscopy directly affects the results of colonoscopy. The incidence of missing flat adenomas due to inadequate intestinal preparation can be as high as 27%. In this paper, 7250 patients were analyzed, of which 4% failed to complete the examination, of which 32.7% were caused by unqualified intestinal preparation. The combination of telephone and network communication should be taken before colonoscopy to give education and guidance to patients, which is expected to improve intestinal preparation. To sum up, digestive endoscopic treatment technology is widely used to guide the nursing of patients after endoscopic treatment. The three effective schemes proposed in this paper can achieve higher patient satisfaction and improve the quality of nursing at the same time.

Use of Artificial Intelligence to Improve the Quality Control of Gastrointestinal Endoscopy

With the rapid development of science and technology, artificial intelligence (AI) systems are becoming ubiquitous, and their utility in gastroenteroscopy is beginning to be recognized. Digestive endoscopy is a conventional and reliable method of examining and diagnosing digestive tract diseases. However, with the increase in the number and types of endoscopy, problems such as a lack of skilled endoscopists and difference in the professional skill of doctors with different degrees of experience have become increasingly apparent. Most studies thus far have focused on using computers to detect and diagnose lesions, but improving the quality of endoscopic examination process itself is the basis for improving the detection rate and correctly diagnosing diseases. In the present study, we mainly reviewed the role of AI in monitoring systems, mainly through the endoscopic examination time, reducing the blind spot rate, improving the success rate for detecting high-risk lesions, evaluating intestinal preparation, increasing the detection rate of polyps, automatically collecting maps and writing reports. AI can even perform quality control evaluations for endoscopists, improve the detection rate of endoscopic lesions and reduce the burden on endoscopists.

Modern and promising ways of bowel preparation for instrumental research

A review is presented to summarize data on intestinal preparation approaches and methods for research. The historical background and main stages in the development of the intestinal lavage method are highlighted, and traditional and modern methods of evaluating its effectiveness are characterized. Dietary recommendations and information about the basic drugs used nowadays in preparation of the intestine for instrumental research are adduced. Clinical aspects of different types of osmotic action of drugs are considered. The composition of laxatives for salt and electrolyte components in terms of potential benefit and risk in patients is analyzed. The main positions of the current recommendations of domestic, European and American expert communities concerning the discussed topic are taken into account. Demonstrated “no less efficacy” of sulfate solution compared with macrogol in adult patients. Clinical case is presented: patient A., 22 years old, admitted to the clinic with complaints of recurrent pain in the left abdomen, frequent stools, sometimes with blood, loss of hair, flaky spots on the skin of the upper extremities. The patient was prepared for the examination – colon cleansing with a sulfate drug, endoscopic examination of the colon - colonoscopy was performed. Diagnosis: nonspecific ulcerative colitis. The treatment scheme is presented, clinical remission of the disease is achieved.

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

Objective. To analyze the correlation of intestinal cleanliness in each segment of the Boston Intestinal Preparation Scale. Methods. From February 2017 to October 2019, the data of patients who underwent colonoscopy in the Department of Gastroenterology, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, were collected. Statistical analysis was performed according to the Boston Intestinal Preparation Scale score, and the correlation of intestinal cleanliness in each region was obtained. Results. A total of 1739 patients were included. The overall score of BBPS was 6.77±1.88. The scores of each region were 2.04±0.84 (right lateral colon), 2.25±0.68 (transverse colon), and 2.48±0.64 (left colon). The difference between the regions was statistically significant (P<0.05). The bowel cleanliness showed a gradual deterioration trend, and there was a positive correlation between colon cleanliness in each region. The accuracy of the transverse colon in predicting the right colon (AUC=0.809) is higher than that of the left colon (AUC=0.735), and the accuracy of predicting the cleanliness of the right colon intestinal tract by the cleanliness of the left colon intestinal tract is relatively low. Conclusion. Intestinal cleanliness gradually deteriorates from the direction of the insert. It is not reliable to predict the right side of poor cleanliness by using the left colon intestinal cleanliness (BBPS 0-1 score). It should continue to further endoscopy. When the cleanliness of the transverse colon is poor, then stopping further endoscopy is considered.