Komazawa Yoshinori, Yuki Mika, Fukuba Nobuhiko, Kobayashi Yoshiya, Ishitobi Hitomi, Nakashima Sayaka, Nagaoka Makoto, Takahashi Yoshiko, Shizuku Toshihiro
Department of Gastroenterology, Izumo Tokushukai Hospital, Izumo, Japan.
Division of Internal Medicine, Izumo City General Medical Center, Izumo, Japan.
Clin Endosc. 2021 Mar;54(2):236-241. doi: 10.5946/ce.2020.062. Epub 2021 Jan 19.
BACKGROUND/AIMS: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens.
Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined.
Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001).
For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.
背景/目的:非镇静状态下的经鼻食管胃十二指肠镜检查(EGD)会受到内镜镜头清洁功能不佳的影响。我们之前报道过乌龙茶清洗液虽效果有限但也有不错的表现;在此,我们评估了一种5%的镜头清洁液对EGD镜头清洁的有效性。
制备5%镜头清洁液(C组)、5%二甲硅油溶液(D组)和蒸馏水(W组)。研究I:用猪油弄脏镜头,用每种清洗液清洗,然后判断其图像质量。研究II:计划进行经鼻EGD的患者(n = 996)被随机分配到C组或W组。确定镜头清洁程度、使用的清洗液体积以及因镜头污染导致的内镜医师压力。
研究I:用(C组)清洗的镜头图像质量明显更优。(D组)因喷嘴堵塞在临床上不适用。研究II:C组的镜头清洁效果明显更优(p < 0.0001),所需的清洗液体积显著减少(p < 0.0001),同时内镜医师的压力也更低(p < 0.0001)。
对于经鼻小口径EGD,目前的5%镜头清洁液提供了良好的视野。它具有高去污能力,并且易于配制用于治疗性内镜应用,如内镜黏膜下剥离术。