Novi tip kolonoskopije i gastroskopije u "Hirurgiji dr Drašković" - Kolonoskopija sa ugljen dioksidom
Prednosti ove metode:
- Koristi se ugljen dioksid umesto vazduha
- Svaki pacijent dobija sterilisan I dezinfikovan gastroskop ( kolonoskop)
OPIS METODE
Korišćenje CO2 (ugljen dioksida) za izvođenje gastroskopije i kolonoskopije, u analgosedaciji potpuno je bezbedna i preporuka je da se rutinski primenjuje u praksi, a u svetu je standard.
Medicinske studije su pokazale da korišćenje CO2 umesto vazduha smanjuje bol i nadutost trbuha, jer se CO2 resorbuje preko sluzokože creva, za razliku od vazuha, koji se mora izbaciti preko čmara. ( Vidi opširnije, spisak referenci).
Reference:
- Bretthauer M, Lynge AB, Thiis-Evensen E, Hoff G, Fausa O, Aabakken L. Carbon dioxide insufflation in colonoscopy: safe and effective in sedated patients. Endoscopy. 2005 Aug;37(8):706-9. doi: 10.1055/s-2005-870154. PMID: 16032487.
- Seo EH, Kim TO, Park MJ, Kim HJ, Shin BC, Woo JG, Heo NY, Park J, Park SH, Yang SY, Moon YS. The efficacy and safety of carbon dioxide insufflation during colonoscopy with consecutive esophagogastroduodenoscopy in moderately sedated outpatients: a randomized, double-blind, controlled trial. J Clin Gastroenterol. 2013 May-Jun;47(5):e45-9. doi: 10.1097/MCG.0b013e31825c023a. PMID: 22858513.
- Memon MA, Memon B, Yunus RM, Khan S. Carbon Dioxide Versus Air Insufflation for Elective Colonoscopy: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. Surg Laparosc Endosc Percutan Tech. 2016 Apr;26(2):102-16. doi: 10.1097/SLE.0000000000000243. PMID: 26841319.
- Sajid MS, Caswell J, Bhatti MI, Sains P, Baig MK, Miles WF. Carbon dioxide insufflation vs conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials. Colorectal Dis. 2015 Feb;17(2):111-23. doi: 10.1111/codi.12837. PMID: 25393051.
- Falt P, Šmajstrla V, Fojtík P, Hill M, Urban O. Carbon dioxide insufflation during colonoscopy in inflammatory bowel disease patients: a double-blind, randomized, single-center trial. Eur J Gastroenterol Hepatol. 2017 Mar;29(3):355-359. doi: 10.1097/MEG.0000000000000791. PMID: 27845950.
- Chen SW, Hui CK, Chang JJ, Lee TS, Chan SC, Chien CH, Hu CC, Lin CL, Chen LW, Liu CJ, Yen CL, Hsieh PJ, Liu CK, Su CS, Yu CY, Chien RN. Carbon dioxide insufflation during colonoscopy can significantly decrease post-interventional abdominal discomfort in deeply sedated patients: A prospective, randomized, double-blinded, controlled trial. J Gastroenterol Hepatol. 2016 Apr;31(4):808-13. doi: 10.1111/jgh.13181. PMID: 26421801.
- Riss S, Akan B, Mikola B, Rieder E, Karner-Hanusch J, Dirlea D, Mittlböck M, Weiser FA. CO2 insufflation during colonoscopy decreases post-interventional pain in deeply sedated patients: a randomized controlled trial. Wien Klin Wochenschr. 2009;121(13-14):464-8. doi: 10.1007/s00508-009-1202-y. PMID: 19657610.
- Rogers AC, Van De Hoef D, Sahebally SM, Winter DC. A meta-analysis of carbon dioxide versus room air insufflation on patient comfort and key performance indicators at colonoscopy. Int J Colorectal Dis. 2020 Mar;35(3):455-464. doi: 10.1007/s00384-019-03470-4. Epub 2020 Jan 3. PMID: 31900583.
- Singh R, Neo EN, Nordeen N, Shanmuganathan G, Ashby A, Drummond S, Nind G, Murphy E, Luck A, Tucker G, Tam W. Carbon dioxide insufflation during colonoscopy in deeply sedated patients. World J Gastroenterol. 2012 Jul 7;18(25):3250-3. doi: 10.3748/wjg.v18.i25.3250. PMID: 22783048; PMCID: PMC3391761.
Efekat je još izraženiji ukoliko se obe endoskopske procedure izvode istovremeno.
Bolesnici sa uplanim bolestima creva (Ulcerozni kolitis i Kronova bolest) posebno su osetljivi na bol tokom ovih procedura, jer vazduh izaziva širenje creva. Primenom CO2, pored smanjivanja subjektivnih tegoba, smanjuje se I mogućnost komplikacija koje mogu nastupiti zbog povećanja pritiska u crevu.
Pored kvalitetnog pregleda, izuzetno je važan i komfor pacijenta tokom I posle procedura,, tako da smo pre godinu dana uveli CO2 endoskopiju.
Po učinjenom pregledu, mašinski se aparat opere, dezinfikuje I steriliše, a potom se odlaže u specijalnu komoru gde se neprekidno suši i sterilize UV zracima.
Za svakog pacijenta koristi se sterilisani gastroskop ( kolonoskop), koji je prošao procedure sterilizacije I dezinfekcije u trajanju od 45 minuta.
Na ovaj način se preveniraju sve infekcije, pre svega infekcija Clostridijom, koja nekada može biti fatalna.
