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Colorectal polypectomy

Minwoo Cho, Jee Hyun Kim, Hyoun Joong Kong, Kyoung Sup Hong, Sungwan Kim
PURPOSE: The colonoscopy adenoma detection rate depends largely on physician experience and skill, and overlooked colorectal adenomas could develop into cancer. This study assessed a system that detects polyps and summarizes meaningful information from colonoscopy videos. METHODS: One hundred thirteen consecutive patients had colonoscopy videos prospectively recorded at the Seoul National University Hospital. Informative video frames were extracted using a MATLAB support vector machine (SVM) model and classified as bleeding, polypectomy, tool, residue, thin wrinkle, folded wrinkle, or common...
March 8, 2018: International Journal of Colorectal Disease
Akihiro Ito, Tomoaki Suga, Hiroyoshi Ota, Nobuyuki Tateiwa, Akihiro Matsumoto, Eiji Tanaka
BACKGROUND: Cold snare polypectomy (CSP) has not undergone sufficient histopathological evaluation. This study aimed to clarify the histopathological features of CSP specimens, including resection depth and layer, as compared with endoscopic mucosal resection (EMR). METHODS: Polyps were recruited retrospectively. Sessile, semi-pedunculated, and 0-IIa polyps of ≤ 9 mm were selected by propensity score matching and classified as either a complete resection or one with an unevaluable/positive (X/+) margin...
March 7, 2018: Journal of Gastroenterology
Andreas W Berger, Katja Raedler, Cord Langner, Leopold Ludwig, Nektarios Dikopoulos, Karl F Becker, Julia Slotta-Huspenina, Michael Quante, Daniel Schwerdel, Lukas Perkhofer, Alexander Kleger, Eugen Zizer, Franz Oswald, Thomas Seufferlein, Alexander Meining
Background and objective: Current surveillance strategies for colorectal cancer following polypectomy are determined by endoscopic and histopathological factors. Such a distinction has been challenged. The present study was designed to identify molecular parameters in colonic polyps potentially defining new sub-groups at risk. Methods: One hundred patients were enrolled in this multicentre study. Polyps biopsies underwent formalin-free processing (PAXgene, PreAnalytiX) and targeted next generation sequencing (38 genes (QIAGEN), NextSeq 500 platform (Illumina))...
March 2018: United European Gastroenterology Journal
John F Sullivan, John A Dumot
Colonoscopy is a proven screening test for colorectal cancer; maximizing its effectiveness is the best way to decrease interval colorectal cancer. The adenoma detection rate can be improved by monitoring physician detection rates. Assistive devices and innovative endoscopic equipment may also decrease adenoma miss rates. Complete polypectomy of adenomatous lesions and recommending the proper date for the next examination are important considerations. Advanced polypectomy techniques including endoscopic mucosal resection and endoscopic mucosal dissection have a clear role in the nonsurgical management of large laterally spreading adenomatous polyps that previously would have required surgical resection...
April 2018: Surgical Oncology Clinics of North America
Mohamad A Mouchli, Lidia Ouk, Marianne R Scheitel, Alisha P Chaudhry, Donna Felmlee-Devine, Diane E Grill, Shahrooz Rashtak, Panwen Wang, Junwen Wang, Rajeev Chaudhry, Thomas C Smyrk, Ann L Oberg, Brooke R Druliner, Lisa A Boardman
AIM: To determine the frequency and risk factors for colorectal cancer (CRC) development among individuals with resected advanced adenoma (AA)/traditional serrated adenoma (TSA)/advanced sessile serrated adenoma (ASSA). METHODS: Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study...
February 28, 2018: World Journal of Gastroenterology: WJG
Jian Dong, Minman Wu, Jiarong Miao, Tao Zhi, Tianmei Zhang, Gang Yang, Yarong Chen, Lei Zhang, Qiong Nan
The role of surveillance colonoscopy has long been established: it reduces both the incidence and the mortality of colorectal cancer. We aimed to assess the optimal colonoscopy surveillance interval period for the adenoma patients who underwent an adequate polypectomy at baseline colonoscopy to avoid overuse or underuse of colonoscopy. A retrospective study was carried out on the baseline adenoma patients who had had at least two completed colonoscopy examinations during the years 2000-2013 in the Digestive Endoscopy Center of the First Affiliated Hospital of Kunming Medical University...
February 23, 2018: European Journal of Cancer Prevention
Flavia Merigo, Alessandro Brandolese, Sonia Facchin, Silvia Missaggia, Paolo Bernardi, Federico Boschi, Renata D'Incà, Edoardo Vincenzo Savarino, Andrea Sbarbati, Giacomo Carlo Sturniolo
AIM: To investigate by immunostaining glucose transporter expression in human colorectal mucosa in controls and patients with inflammatory bowel disease (IBD). METHODS: Colorectal samples were obtained from patients undergoing lower endoscopic colonoscopy or recto-sigmoidoscopy. Patients diagnosed with ulcerative colitis ( n = 18) or Crohn's disease ( n = 10) and scheduled for diagnostic colonoscopy were enrolled. Patients who underwent colonoscopy for prevention screening of colorectal cancer or were followed-up after polypectomy or had a history of lower gastrointestinal symptoms were designated as the control group (CTRL, n = 16)...
February 21, 2018: World Journal of Gastroenterology: WJG
Elizabeth T Jacobs, Samir Gupta, John A Baron, Amanda J Cross, David A Lieberman, Gwen Murphy, María Elena Martínez
OBJECTIVES: Little is known about the relationship between having a first-degree relative (FDR) with colorectal cancer (CRC) and risk for metachronous colorectal adenoma (CRA) following polypectomy. METHODS: We pooled data from seven prospective studies of 7697 patients with previously resected CRAs to quantify the relationship between having a FDR with CRC and risk for metachronous adenoma. RESULTS: Compared with having no family history of CRC, a positive family history in any FDR was significantly associated with increased odds of developing any metachronous CRA (OR = 1...
February 20, 2018: American Journal of Gastroenterology
Alexandra Leonard, Lezah P McCarthy, Danielle M Pastor
Schwannomas, peripheral nerve sheath tumours arising from Schwann cells, are often associated with inherited disorders such as neurofibromatosis. Gastrointestinal schwannomas, while rare, have been reported in those without personal or family history of neurofibromatosis. Diagnoses of these lesions, however, typically follow evaluations prompted by symptomatic presentations associated with abdominal pain, rectal bleeding, change in bowel habits or positive results on faecal occult blood tests performed for colorectal cancer screening...
February 17, 2018: BMJ Case Reports
Claire Fan, Adam Younis, Christine E Bookhout, Seth D Crockett
PURPOSE OF REVIEW: The purpose of this review is to summarize the management of serrated colorectal polyps (SPs), with a particular focus on the most common premalignant SP, sessile serrated adenoma or polyp (SSA/P). These lesions present a challenge for endoscopists with respect to detection and resection, and are also susceptible to pathologic misdiagnosis. RECENT FINDINGS: Patients with SSA/Ps are at an increased risk of future colorectal neoplasia, including advanced polyps and cancer...
February 14, 2018: Current Treatment Options in Gastroenterology
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Background/Aims: People around the world are increasingly choosing to undergo colorectal cancer screening via colonoscopy. As a result, guideline adherence to postpolypectomy colonoscopy surveillance has drawn increasing attention. The present study was performed to assess recognition and adherence to guidelines among primary care physicians and gastroenterologists and to identify characteristics associated with compliance. Methods: A nationwide sample of primary care physicians employed at cancer screening facilities and registered members of the Korean Society of Gastrointestinal Endoscopy were recruited...
February 13, 2018: Gut and Liver
Yasuhiro Abe, Haruaki Nabeta, Ryota Koyanagi, Taro Nakamichi, Hayato Hirashima, Alan Kawarai Lefor, Satoshi Shinozaki
Background and study aims:  Despite widespread use of cold snare polypectomy (CSP), the R0 resection rate is not well documented. We perform extended CSP, resecting polyps with a > 1 mm circumferential margin. The aim of this study is to compare the R0 resection rate of extended CSP with conventional CSP and to assess safety. Patients and methods : From April 2014 to September 2016, 712 non-pedunculated colorectal polyps, < 10 mm in size, resected using CSP from 316 patients were retrospectively analyzed...
February 2018: Endoscopy International Open
Daisuke Maruoka, Makoto Arai, Naoki Akizue, Kentaro Ishikawa, Shingo Kasamatsu, Takashi Taida, Hideaki Ishigami, Kenichiro Okimoto, Keiko Saito, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Naoya Kato
BACKGROUND: Endoscopic resection of all colonic adenomas prevents the occurrence of colon cancer and death. The European Society of Gastrointestinal Endoscopy Clinical Guideline recommends resection of all polyps predicted to be adenomas and cold snare polypectomy (CSP) for removal of adenomas ≤ 9 mm on the basis of safety; however, it also states that this recommendation lacks adequate evidence of efficacy. The residual adenoma rate after resection is an important indicator of efficacy, but there have been no reports showing this prospectively...
February 7, 2018: Endoscopy
Hyun-Soo Kim, Ho Yeon Jung, Hong Jun Park, Hee Man Kim, Jae Ho Seong, Yong Seok Kang, Mee Yon Cho, Min Heui Yu, Dae Ryong Kang
BACKGROUND: /Aim: The criterion standard polypectomy technique for the complete removal of small colorectal polyps has not yet been established. This study aimed to compare the complete resection rate of hot snare polypectomy (HSP) with that of endoscopic mucosal resection (EMR) for small, sessile, or flat polyps. METHODS: Patients with 5-9-mm non-pedunculated colorectal polyps were prospectively randomized to the HSP or EMR group. The presence of residual polyps was assessed by performing histological assessment of 4-quadrant forceps biopsies taken from the edges of the polypectomy site...
February 1, 2018: Gastrointestinal Endoscopy
Sam A O'Connor, Trevor N Brooklyn, Paul D Dunckley, Roland M Valori, Ruth Carr, Chris Foy, Thusitha Somarathna, Lukasz A Adamczyk, Neil A Shepherd, John T Anderson
Background and study aims:  The majority of polyps removed at colonoscopy are diminutive (≤ 5 mm) to small (< 10 mm) and there are few guidelines for the best way for these polyps to be removed. We aimed to assess the feasibility and effectiveness of cold biopsy forceps polypectomy with pre-lift (CBPP) for polyps ≤ 7 mm. Our aims were to assess completeness of histological resection of this technique, to identify factors contributing to this and assess secondary considerations such as timing, retrieval and complication rates...
February 2018: Endoscopy International Open
Mio Matsumoto, Shinji Yoshii, Taku Shigesawa, Masayoshi Dazai, Manabu Onodera, Mototsugu Kato, Naoya Sakamoto
BACKGROUND: The cold polypectomy (CP) technique has been increasingly used in recent years. However, there have been few studies about post-polypectomy bleeding (PPB) in patients who underwent CP and who were on antithrombotic drugs. The objective of this study was to determine the safety of CP in patients on antithrombotic medication. METHODS: The subjects were patients who underwent CP in our hospital between April 2014 and March 2016. PPB rates were examined in relation to the use of antithrombotic medication...
February 1, 2018: Digestion
Tingxi Wen, David Medveczky, Jackie Wu, Jianhuang Wu
BACKGROUND: Colonoscopy plays an important role in the clinical screening and management of colorectal cancer. The traditional 'see one, do one, teach one' training style for such invasive procedure is resource intensive and ineffective. Given that colonoscopy is difficult, and time-consuming to master, the use of virtual reality simulators to train gastroenterologists in colonoscopy operations offers a promising alternative. METHODS: In this paper, a realistic and real-time interactive simulator for training colonoscopy procedure is presented, which can even include polypectomy simulation...
January 25, 2018: Biomedical Engineering Online
Maysoon Gamaleldin, Cigdem Benlice, Conor P Delaney, Scott Steele, Emre Gorgun
BACKGROUND: Colonoscopy is the gold standard for colorectal screening and surveillance. Advanced endoscopic polypectomy techniques such as endoscopic submucosal dissection (ESD) have been introduced to remove large colorectal polyps. Our aim was to compare the outcomes of patients who underwent ESD with those of who underwent laparoscopic colectomy for benign colorectal polyps. METHODS: Patients with a preoperative diagnosis of benign colorectal polyp who underwent ESD or colectomy between 2011 and 2016 were case matched for age, sex, body mass index, American Society of Anesthesiologists status, polyp size, and location...
January 17, 2018: Surgery
Soo-Kyung Park, Jeong Yeon Seo, Min-Gu Lee, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jung, Ho-Kyung Chun, Dong Il Park
BACKGROUNDS/AIMS: Although post-polypectomy bleeding is the most frequent complication after colonoscopic polypectomy, only few studies have investigated the incidence of bleeding prospectively. The aim of this study was to investigate the incidence of delayed post-polypectomy bleeding and its associated risk factors prospectively. METHODS: Patients who underwent colonoscopic polypectomy at Kangbuk Samsung Hospital from January 2013 to December 2014 were prospectively enrolled in this study...
January 17, 2018: Surgical Endoscopy
Carlijn Hermans, Dennis van der Zee, Lennard Gilissen
BACKGROUND/AIMS: Because of the national screening program for colorectal carcinoma in The Netherlands, the number of colonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-balloon colonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previously unexplored part of the colon, complication rate of DBc, and CTC results after incomplete colonoscopy. METHODS: Retrospective observational study in a tertiary referral hospital regarding DBc and CTC reports from cases with incomplete colonoscopy...
January 2018: Clinical Endoscopy
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