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Colorectal polypectomy

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https://www.readbyqxmd.com/read/28042387/colorectal-cancer-screening-opportunities-to-improve-uptake-outcomes-and-disparities
#1
REVIEW
Neal Shahidi, Winson Y Cheung
Colorectal cancer screening has become a standard of care in industrialized nations for those 50 to 75 years of age, along with selected high-risk populations. While colorectal cancer screening has been shown to reduce both the incidence and mortality of colorectal cancer, it is a complex multi-disciplinary process with a number of important steps that require optimization before tangible improvements in outcomes are possible. For both opportunistic and programmatic colorectal cancer screening, poor participant uptake remains an ongoing concern...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28035253/colon-adenoma-features-and-their-impact-on-risk-of-future-advanced-adenomas-and-colorectal-cancer
#2
Audrey H Calderwood, Karen E Lasser, Hemant K Roy
AIM: To review the evidence on the association between specific colon adenoma features and the risk of future colonic neoplasia [adenomas and colorectal cancer (CRC)]. METHODS: We performed a literature search using the National Library of Medicine through PubMed from 1/1/2003 to 5/30/2015. Specific Medical Subject Headings terms (colon, colon polyps, adenomatous polyps, epidemiology, natural history, growth, cancer screening, colonoscopy, CRC) were used in conjunction with subject headings/key words (surveillance, adenoma surveillance, polypectomy surveillance, and serrated adenoma)...
December 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28024986/the-natural-history-of-diminutive-and-small-colorectal-polyps-a-systematic-literature-review
#3
REVIEW
Jasper L A Vleugels, Yark Hazewinkel, Paul Fockens, Evelien Dekker
BACKGROUND: Diminutive (1-5 mm) and small (6-9 mm) polyps comprise 90% of detected lesions during colonoscopy and rarely contain advanced histology or colorectal cancer (CRC). Routine removal of these lesions results in a significant burden to colonoscopy programs. At the same time, the risk for progression of these polyps to CRC is unclear. We performed a systematic review to explore the natural history of diminutive and small colorectal polyps. METHODS: We searched MEDLINE and EMBASE for studies investigating the natural history of colorectal polyps...
December 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28005009/computer-aided-classification-of-gastrointestinal-lesions-in-regular-colonoscopy
#4
Pablo Mesejo, Daniel Pizarro, Armand Abergel, Olivier Rouquette, Sylvain Beorchia, Laurent Poincloux, Adrien Bartoli
We have developed a technique to study how good computers can be at diagnosing gastrointestinal lesions from regular (white light and narrow banded) colonoscopic videos compared to two levels of clinical knowledge (expert and beginner). Our technique includes a novel tissue classification approach which may save clinician's time by avoiding chromoendoscopy, a time-consuming staining procedure using indigo carmine. Our technique also discriminates the severity of individual lesions in patients with many polyps, so that the gastroenterologist can directly focus on those requiring polypectomy...
September 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/27988288/prospective-multicenter-randomized-controlled-trial-comparing-adenoma-detection-rate-in-colonoscopy-using-water-exchange-water-immersion-and-air-insufflation
#5
Yu-Hsi Hsieh, Chih-Wei Tseng, Chi-Tan Hu, Malcolm Koo, Felix W Leung
BACKGROUND AND AIMS: Adenoma detection rate (ADR) is a quality indicator. We tested the hypothesis that water exchange (WE) improves whereas water immersion (WI) has no adverse effect on ADR compared with air insufflation (AI). METHODS: A prospective study (NCT01894191) was conducted at the Dalin Tzu Chi Hospital in southern Taiwan and the Hualien Tzu Chi Hospital in eastern Taiwan on patients randomly assigned to WE, WI, or AI with stratification by the 3 study colonoscopists...
December 14, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27987015/insulated-tip-knife-endoscopic-polypectomy-for-difficult-pedunculated-colorectal-polyps-a-prospective-pilot-study
#6
Lianjun Ma, Yaqi Zhai, Ningli Chai, Huikai Li, Li Yan, Zhenjuan Li, Xiaobin Zhang, Xiuxue Feng, Enqiang Linghu
BACKGROUND: Endoscopic polypectomy is widely used for colorectal polyps. However, for giant pedunculated colorectal polyps (≥3 cm), conventional techniques are so difficult with en bloc resection that patients had to be transferred to surgery. We had firstly reported our first experience with an insulated-tip knife to successfully remove a giant pedunculated polyp in the sigmoid colon. In this study, our aim was to explore safety and feasible of insulated-tip knife endoscopic polypectomy (IT-EP) for difficult pedunculated colorectal polyps...
December 16, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27888868/novel-findings-in-colorectal-polyp-surveillance
#7
Sabela Carballal
Colorectal adenomas and serrated polyps are the best characterised premalignant lesions involved in the development of colorectal cancer (CRC). Therefore, the identification and removal of these lesions, as well as post-polypectomy surveillance of affected patients, are key goals in the field of CRC prevention. Current post-polypectomy surveillance strategies differ among the various scientific societies and have several limitations that hamper their application in clinical practice. First, current surveillance intervals are based only on polyp characteristics, excluding other potential clinical conditions, such as diabetes or metabolic syndrome...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27881836/relationship-between-lesions-in-adenomatous-polyp-dysplasia-colorectal-cancer-sequence-and-neutrophil-to-lymphocyte-ratio
#8
Feyzullah Uçmak, Elif Tuğba Tuncel
BACKGROUND The aim of our study was to evaluate all lesions in the adenoma-dysplasia-cancer sequence of the colon and to examine whether the neutrophil-to-lymphocyte ratio (NLR) can distinguish polyps indicating dysplasia and cancer. MATERIAL AND METHODS A total of 397 patients who had colonoscopic polypectomy between January 2010 and December 2014 were included in our retrospective study. The patients were divided into four groups: patients with hyperplastic polyps, patients with adenomatous polyps, patients with dysplasia, and patients with cancer...
November 24, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27830330/risk-factors-of-nonadherence-to-colonoscopy-surveillance-after-polypectomy-and-its-impact-on-clinical-outcomes-a-kasid-multicenter-study
#9
Chung Hyun Tae, Chang Mo Moon, Seong-Eun Kim, Sung-Ae Jung, Chang Soo Eun, Jae Jun Park, Geom Seog Seo, Jae Myung Cha, Sung Chul Park, Jaeyoung Chun, Hyun Jung Lee, Yunho Jung, Jin Oh Kim, Young-Eun Joo, Dong Il Park
BACKGROUND: An optimal surveillance program is important to prevent advanced colorectal neoplasm. In this context, we have evaluated the cumulative risk of high-risk adenoma (HRA) or colorectal cancer (CRC) according to surveillance interval time after polypectomy. In addition, we assessed risk factors for late surveillance to determine whether late surveillance can impact the risk of subsequent advanced colorectal neoplasm. METHODS: This was a multicenter retrospective cohort study involving 3562 subjects who had undergone removal of at least one adenoma at the index colonoscopy and who subsequently underwent a surveillance colonoscopy...
November 9, 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27809553/endoscopic-resection-of-colorectal-polyps-in-patients-on-antiplatelet-therapy-an-evidence-based-guidance-for-clinicians
#10
Gema Plumé Gimeno, Marco Bustamante-Balén, Carla Satorres Paniagua, Francia Carolina Díaz Jaime, Maria José Cejalvo Andújar
Due to the rising prevalence of coronary heart disease, endoscopists are more frequently performing a polypectomy in patients on antiplatelet therapy (APT) and dual antiplatelet therapy (DATP). Despite the availability of several guidelines with regard to the management of antiplatelet drugs during the periprocedure period, there is still variability in the current clinical practice. This may be influenced by the low quality of the evidence supporting recommendations, because most of the studies dealing with APT and polypectomy are observational and retrospective, and include mainly small (< 10 mm) polyps...
November 4, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27780941/clinical-outcomes-of-endoscopic-removal-in-patients-with-colorectal-polypoid-leiomyomas
#11
Hyun Ho Choi, Young Seok Cho, Soo Kyoung Choi, Hyung Keun Kim, Sung Soo Kim, Hiun Suk Chae, Ok Ran Shin
Background/Aims: Although polypoid leiomyomas in the colon and rectum are rare, they are increasingly detected during colonoscopy. The aim of this study was to evaluate the efficacy and clinical outcomes of endoscopic removal for colorectal polypoid leiomyoma. Methods: Data were retrospectively collected from 22 patients with polypoid leiomyoma arising from the muscularis mucosae in the colon and rectum who underwent endoscopic removal at single referral gastrointestinal endoscopy unit...
October 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27732635/long-term-prediction-of-the-demand-of-colonoscopies-generated-by-a-population-based-colorectal-cancer-screening-program
#12
Mercè Comas, Joan Mendivil, Montserrat Andreu, Cristina Hernández, Xavier Castells
OBJECTIVE: To estimate the long-term need for colonoscopies after a positive fecal immunochemical test (FIT) and post-polypectomy surveillance in the context of a population-based colorectal cancer (CRC) screening program. METHODS: A discrete-event simulation model was built to reproduce the process of CRC screening and post-polypectomy surveillance following European guidelines in a population of 100,000 men and women aged 50-69 years over a 20-year period. Screening consisted of biennial FIT and colonoscopy in participants with positive results...
2016: PloS One
https://www.readbyqxmd.com/read/27683963/the-effect-of-right-colon-retroflexion-on-adenoma-detection-a-systematic-review-and-meta-analysis
#13
Jonah Cohen, Douglas Grunwald, Laurie B Grossberg, Mandeep S Sawhney
BACKGROUND: Although colonoscopy with polypectomy can prevent up to 80% of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Previous studies addressing right colon retroflexion have revealed discordant evidence regarding the benefit of this maneuver on adenoma detection with concomitant concerns about safety and rates of maneuver success. In this meta-analysis, we sought to determine the effect of right colon retroflexion on improving adenoma detection compared with conventional colonoscopy without retroflexion, as well as determine the rates of retroflexion maneuver success and adverse events...
September 28, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27669818/a-minor-but-deadly-surgery-of-colonic-polypectomy-in-an-elderly-and-fragile-patient-a-case-report-and-the-review-of-literature
#14
Xiaoming Yuan, Guangrong Zhou, Yan He, Aiwen Feng
BACKGROUND: Epithelial dysplasia and adenomatous polyps of colorectum are precancerous lesions. Surgical removal is still one of the important treatment approaches for colorectal polyps. CASE PRESENTATION: A male patient over 78 years was admitted due to bloody stool and abdominal pain. Colonoscopic biopsy showed a high-grade epithelial dysplasia in an adenomatous polyp of sigmoid colon. Anemia, COPD, ischemic heart disease (IHD), arrhythmias, and hypoproteinemia were comorbidities...
September 26, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27628421/influence-of-genetic-polymorphisms-in-prostaglandin-e2-pathway-cox-2-hpgd-slco2a1-abcc4-on-the-risk-for-colorectal-adenoma-development-and-recurrence-after-polypectomy
#15
Carina Pereira, Sara Queirós, Ana Galaghar, Hugo Sousa, Ricardo Marcos-Pinto, Pedro Pimentel-Nunes, Catarina Brandão, Rui Medeiros, Mário Dinis-Ribeiro
OBJECTIVES: Deregulation of prostaglandin E2 (PGE2) levels reported in colorectal carcinogenesis contributes to key steps of cancer development. Our aim was to evaluate the influence of the genetic variability in COX-2/HPGD/SLCO2A1/ABCC4 PGE2 pathway genes on the development and recurrence of colorectal adenomas. METHODS: A case-control study was conducted gathering 480 unscreened individuals and 195 patients with personal history of adenomas. A total of 43 tagSNPs were characterized using the Sequenom platform or real-time PCR...
September 15, 2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27597424/maintaining-low-non-neoplastic-polypectomy-rates-in-high-quality-screening-colonoscopy
#16
Joshua Melson, Daniel Berger, Michael Greenspan, Mohamed Bayoumi, Shriram Jakate
BACKGROUND AND AIMS: Non-neoplastic polypectomies (NNP) add pathology and procedural costs but do not reduce cancer risk and should be minimized. We sought to define the minimal non-neoplastic polypectomy rate for those colonoscopists achieving high-quality colorectal cancer screening based on adenoma detection rates. METHODS: Non-neoplastic polypectomy rates (NNPR) for colonoscopists achieving high-quality adenoma detection rates (ADR) were reported to determine minimal NNPR goals...
September 2, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27517467/a-prognostic-model-for-advanced-colorectal-neoplasia-recurrence
#17
Lin Liu, Karen Messer, John A Baron, David A Lieberman, Elizabeth T Jacobs, Amanda J Cross, Gwen Murphy, Maria Elena Martinez, Samir Gupta
PURPOSE: Following colonoscopic polypectomy, US Multisociety Task Force (USMSTF) guidelines stratify patients based on risk of subsequent advanced neoplasia (AN) using number, size, and histology of resected polyps, but have only moderate sensitivity and specificity. We hypothesized that a state-of-the-art statistical prediction model might improve identification of patients at high risk of future AN and address these challenges. METHODS: Data were pooled from seven prospective studies which had follow-up ascertainment of metachronous AN within 3-5 years of baseline polypectomy (combined n = 8,228)...
October 2016: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/27513877/should-prophylactic-measures-to-prevent-postpolypectomy-bleeding-after-resection-of-large-colorectal-polyps-be-used
#18
Estanislao J Gómez, Ariel Izcovich
Post-polypectomy bleeding after colonoscopy with resection of large colorectal polyps can cause significant morbidity (readmission for monitoring, transfusion, repeat endoscopy and therapy) and a significant cost to hospitals and insurers. Nevertheless prophylactic endoscopic measures could reduce risk of post-polypectomy bleeding. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 10 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach...
August 3, 2016: Medwave
https://www.readbyqxmd.com/read/27501728/a-novel-methodology-for-in-vivo-endoscopic-phenotyping-of-colorectal-cancer-based-on-real-time-analysis-of-the-mucosal-lipidome-a-prospective-observational-study-of-the-iknife
#19
James Alexander, Louise Gildea, Julia Balog, Abigail Speller, James McKenzie, Laura Muirhead, Alasdair Scott, Christos Kontovounisios, Shanawaz Rasheed, Julian Teare, Jonathan Hoare, Kirill Veselkov, Robert Goldin, Paris Tekkis, Ara Darzi, Jeremy Nicholson, James Kinross, Zoltan Takats
BACKGROUND: This pilot study assessed the diagnostic accuracy of rapid evaporative ionization mass spectrometry (REIMS) in colorectal cancer (CRC) and colonic adenomas. METHODS: Patients undergoing elective surgical resection for CRC were recruited at St. Mary's Hospital London and The Royal Marsden Hospital, UK. Ex vivo analysis was performed using a standard electrosurgery handpiece with aspiration of the electrosurgical aerosol to a Xevo G2-S iKnife QTof mass spectrometer (Waters Corporation)...
August 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27494455/impact-of-an-automated-system-for-endocytoscopic-diagnosis-of-small-colorectal-lesions-an-international-web-based-study
#20
Yuichi Mori, Shin-Ei Kudo, Philip Wai Yan Chiu, Rajvinder Singh, Masashi Misawa, Kunihiko Wakamura, Toyoki Kudo, Takemasa Hayashi, Atsushi Katagiri, Hideyuki Miyachi, Fumio Ishida, Yasuharu Maeda, Haruhiro Inoue, Yukitaka Nimura, Masahiro Oda, Kensaku Mori
Background and study aims: Optical diagnosis of colorectal polyps is expected to improve the cost-effectiveness of colonoscopy, but achieving a high accuracy is difficult for trainees. Computer-aided diagnosis (CAD) is therefore receiving attention as an attractive tool. This study aimed to validate the efficacy of the latest CAD model for endocytoscopy (380-fold ultra-magnifying endoscopy). Patients and methods: This international web-based trial was conducted between August and November 2015. A web-based test comprising one white-light and one endocytoscopic image of 205 small colorectal polyps (≤ 10 mm) from 123 patients was undertaken by both CAD and by endoscopists (three experts and ten non-experts from three countries)...
December 2016: Endoscopy
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