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Best Practice & Research. Clinical Gastroenterology

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https://www.readbyqxmd.com/read/27938792/surveillance-in-cholangiocellular-carcinoma
#1
REVIEW
Thomas C Wirth, Arndt Vogel
Cholangiocellular carcinoma is the most frequent malignant neoplasm originating from the epithelium of intra- or extrahepatic bile ducts. In the past decades, the incidence of cholangiocarcinoma has been shown to increase while overall mortality has remained high with an approximate 5-year overall survival below 20%. Surgery remains the only curative option while systemic treatment is limited to palliative chemotherapy. Therefore, surveillance strategies for patients at risk of developing cholangiocarcinoma are urgently needed, particularly in patients with primary sclerosing cholangitis and patients infected with liver flukes...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938791/surveillance-for-neoplasia-in-the-pancreas
#2
REVIEW
Kasper A Overbeek, Djuna L Cahen, Marcia Irene Canto, Marco J Bruno
Despite its low incidence in the general population, pancreatic cancer is one of the leading causes of cancer-related mortality. Survival greatly depends on operability, but most patients present with unresectable disease. Therefore, there is great interest in the early detection of pancreatic cancer and its precursor lesions by surveillance. Worldwide, several programs have been initiated for individuals at high risk for pancreatic cancer. Their first results suggest that surveillance in high-risk individuals is feasible, but their effectiveness in decreasing mortality remains to be proven...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938790/surveillance-after-endoscopic-and-surgical-resection-of-colorectal-cancer
#3
REVIEW
Masau Sekiguchi, Takahisa Matsuda, Yutaka Saito
With the increase in colorectal cancer burden, surveillance following endoscopic and surgical resection is an essential issue. The aim of surveillance programs is improvement of patient survival by early detection of residual tumor tissue or local recurrence, metachronous colorectal tumors, and metastases. Appropriate surveillance should be determined according to this risk of factors. In current guidelines, only surveillance colonoscopy is recommended after endoscopic resection of polyps with high-grade dysplasia, whereas intensive, multimodality surveillance using colonoscopy, radiological imaging and tumor marker measurements is recommended following surgical resection of invasive colorectal cancer...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938789/surveillance-of-patients-with-inflammatory-bowel-disease
#4
REVIEW
Jessica X Yu, James E East, Tonya Kaltenbach
Patients with inflammatory bowel disease involving the colon are at increased risk for developing colorectal cancer. Colonoscopy surveillance is important to identify and treat IBD associated dysplasia. The SCENIC consensus provides evidence-based recommendations for optimal surveillance and management of dysplasia in IBD. Chromoendoscopy, with the surface application of dyes to enhance mucosal visualization, is the superior endoscopic surveillance strategy to detect dysplasia. Most dysplasia is visible, and can be endoscopically resected...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938788/surveillance-after-colorectal-polyp-removal
#5
REVIEW
Rodrigo Jover, Evelien Dekker
Surveillance colonoscopy is aimed to reduce CRC incidence and mortality by removing adenomas and detecting CRC in early stage. However, colonoscopy is an invasive and expensive procedure and surveillance colonoscopy should be targeted at those who are most likely to benefit at the minimum frequency required to protect for cancer. Surveillance recommendations are based on guidelines, but the recommendations in those guidelines are based on moderate to low quality evidence and adherence to these guidelines is poor...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938787/surveillance-of-patients-with-hereditary-gastrointestinal-cancer-syndromes
#6
REVIEW
Leticia Moreira, Antoni Castells
Gastrointestinal cancers are among the most frequent tumors. Although most cases are sporadic, up to 5-6% develops in the context of gastrointestinal hereditary syndromes. These entities have specific characteristics and often a germline mutation identified, thus allowing performing genetic counseling. This review summarizes the most common gastrointestinal hereditary syndromes, focusing on the surveillance recommendations.
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938786/surveillance-of-patients-with-gastric-precancerous-conditions
#7
REVIEW
Jorge Lage, Noriya Uedo, Mário Dinis-Ribeiro, Kenshi Yao
Intestinal-type gastric adenocarcinoma arises from a multistep process starting with Helicobacter pylori infection followed by gastric atrophy, gastric intestinal metaplasia and dysplasia. Indeed, patients with gastric precancerous conditions or lesions (GPC) are at increased risk to develop gastric cancer even in regions with low incidence. Thus, the identification and surveillance of a high risk subgroup could lead to the diagnosis of cancer at early stage and improve survival. However, both endoscopic and histological accuracy and interobserver agreement in the diagnosis of GPC are still far from optimal...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938785/review-surveillance-of-patients-with-barrett-oesophagus
#8
REVIEW
Sielte Maes, Prateek Sharma, Raf Bisschops
There has been a rapid increase in the incidence of oesophageal adenocarcinoma in most Western countries over the past thirty years. Barrett's oesophagus (BE) is a common premalignant lesion of oesophageal adenocarcinoma, although the risk of developing cancer in BE remains low. Therefore, screening is not recommended in the general population. Surveillance of BE is recommended to detect high grade dysplasia or carcinoma in an early stage, although there is no clear evidence that surveillance leads to a reduced mortality...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938784/surveillance-of-patients-at-high-risk-of-squamous-cell-esophageal-cancer
#9
REVIEW
A Chaber-Ciopinska, D Kiprian, A Kawecki, M F Kaminski
Currently curative treatment for esophageal squamous cell cancer (ESCC) is possible only in patients with early-stage, usually asymptomatic disease. In Western countries, where the incidence of ESCC is relatively low, a screening of asymptomatic, average-risk population is untenable. In order to detect early-stage ESCC or its precursor lesions it is important to identify high-risk patients and consider endoscopic surveillance in these groups. These high-risk groups include patients after curative treatment for head and neck cancer, previous endoscopic resection of ESCC, caustic injury, and patients with tylosis or achalasia...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938783/cost-effectiveness-of-surveillance-for-gi-cancers
#10
REVIEW
Amir-Houshang Omidvari, Reinier G S Meester, Iris Lansdorp-Vogelaar
Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938782/methodological-considerations-for-surveillance-in-gi-practice
#11
REVIEW
Øyvind Holme, Magnus Løberg
Surveillance is recommended for various GI cancers, and substantial resources are invested. However, little is known about the effect of surveillance, neither for good, nor for bad. Most evidence stems from observational studies, but observational studies of surveillance can be subject to various biases that may severely influence the results. In this chapter we discuss challenges related to various research questions, study designs, choice of endpoints, and how to deal with different forms of bias. We hope this chapter will be helpful for researchers when performing high-quality studies of surveillance, and to enable physicians and policy-makers to understand the possibilities and limitations of current evidence...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938781/organization-of-surveillance-in-gi-practice
#12
REVIEW
Carlo Senore, Cristina Bellisario, Cesare Hassan
BACKGROUND: Several reports documented an inefficient utilisation of available resources, as well as a suboptimal compliance with surveillance recommendations. Although, evidence suggests that organisational issues can influence the quality of care delivered, surveillance protocols are usually based on non-organized approaches. METHODS: We conducted a literature search (publication date: 01/2000-06/2016) on PubMed and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Cochrane Central Register of Controlled Trials for guidelines, or consensus statements, for surveys of practice, reporting information about patients, or providers attitudes and behaviours, for intervention studies to enhance compliance with guidelines...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938780/cancer-surveillance-in-gastroenterology-practice
#13
EDITORIAL
Michal F Kaminski, Michael Bretthauer
No abstract text is available yet for this article.
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938779/surveillance-for-hepatocellular-carcinoma
#14
REVIEW
Álvaro Díaz-González, Alejandro Forner
Hepatocellular carcinoma (HCC) appears mainly in patients with underlying liver disease and it is recognized as one of the most important causes of death in this population. Early detection by surveillance has been suggested as an effective tool for reducing cancer-specific mortality and the most accepted strategy is semiannual abdominal ultrasound in those patients at risk of HCC development. The benefit of HCC surveillance is proven by a randomized-controlled study, several prospective or retrospective analyses, and multiple modeling studies and according to the current scientific evidence, surveillance of HCC should be recommended and widely implemented...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#15
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931639/complications-in-pediatric-endoscopy
#16
REVIEW
Andrea Tringali, Valerio Balassone, Paola De Angelis, Rosario Landi
The experience of the "endoscopic community" in pediatric patients is limited, but during recent years increased skills of the endoscopists and technological improvements lead to a standardization of pediatric endoscopy and the development of specialized pediatric endoscopy unit. Adverse events related to diagnostic and therapeutic endoscopy in children are usually rare. Diagnosis, prevention and treatment of complications in pediatric endoscopy is crucial when dealing with benign diseases in children. The complication rate of diagnostic EGD and colonoscopy in children are extremely low...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#17
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931637/complications-of-ercp
#18
REVIEW
Rupjyoti Talukdar
Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931636/complications-of-submucosal-endoscopy
#19
REVIEW
Jean-Michel Gonzalez, Alban Benezech, Marc Barthet
Submucosal endoscopy essentially regroups peroral endoscopic esophageal myotomy (POEM) and, more recently, pyloromyotomy and tunnel tumor resections. The complication rate of POEM is between 5% and 10%. Complications include gas-related complications, mucosal tears, and bleeding, and are usually managed conservatively or with non-surgical procedures. Only one case of death has been reported. The most commonly identified risk factors for complicated procedures in POEM are short experience with the technique and sigmoid-type esophagus...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#20
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
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