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Colorectal polypectomy

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
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
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
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
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
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
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...
2016: Medwave
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
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)...
August 5, 2016: Endoscopy
Tae Oh Kim
The detection and removal of adenomatous polyps and postpolypectomy surveillance are considered important for the control of colorectal cancer (CRC). Surveillance using colonoscopy is an effective tool for preventing CRC after colorectal polypectomy, especially if compliance is good. In current practice, the intervals between colonoscopies after polypectomy are variable. Different recommendations for recognizing at risk groups and defining surveillance intervals after an initial finding of colorectal adenomas have been published...
July 2016: Clinical Endoscopy
Antonio Facciorusso, Marianna Di Maso, Gaetano Serviddio, Gianluigi Vendemiale, Nicola Muscatiello
AIM: To develop and validate a risk score for advanced colorectal adenoma (ACA) recurrence after endoscopic polypectomy. METHODS: Out of 3360 patients who underwent colon polypectomy at University of Foggia between 2004 and 2008, data of 843 patients with 1155 ACAs was retrospectively reviewed. Surveillance intervals were scheduled by guidelines at 3 years and primary endpoint was considered 3-year ACA recurrence. Baseline clinical parameters and the main features of ACAs were entered into a Cox regression analysis and variables with P < 0...
July 14, 2016: World Journal of Gastroenterology: WJG
Prasanna L Ponugoti, Douglas K Rex
BACKGROUND AND AIMS: Prophylactic endoscopic clipping may be effective in preventing delayed post-polypectomy hemorrhage after EMR of large colorectal lesions. The rate of retention of hemoclips on EMR sites has not been fully described. The aim of this study was to evaluate the adherence rates of hemoclips placed after EMR of large colorectal lesions. METHODS: This was a retrospective review of a prospectively maintained database of large colorectal polyps (≥20 mm) referred to Indiana University Hospital between June 2006 and August 2015...
July 25, 2016: Gastrointestinal Endoscopy
Jun Lee
Colorectal polyps are classified as neoplastic or non-neoplastic on the basis of malignant potential. All neoplastic polyps should be completely removed because both the incidence of colorectal cancer and the mortality of colorectal cancer patients have been found to be strongly correlated with incomplete polypectomy. The majority of colorectal polyps discovered on diagnostic colonoscopy are diminutive and small polyps; therefore, complete resection of these polyps is very important. However, there is no consensus on a method to remove diminutive and small polyps, and various techniques have been adopted based on physician preference...
July 2016: Clinical Endoscopy
Chan Hyuk Park, Yoon Suk Jung, Eunwoo Nam, Chang Soo Eun, Dong Il Park, Dong Soo Han
OBJECTIVES: Although various endoscopic therapies have been suggested for preventing bleeding after colorectal polypectomy, the optimal therapy has yet to be fully clarified. We assessed the comparative efficacy of prophylactic therapies for postpolypectomy bleeding through a network meta-analysis combining direct and indirect comparisons. METHODS: We searched for all relevant randomized controlled trials published up until January 2016 examining the effects of prophylactic therapy for bleeding after colorectal polypectomy...
September 2016: American Journal of Gastroenterology
Hong Jun Park
Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characteristics of endoscopic instruments for colorectal polypectomy and their appropriate use, as well as the basic principles and settings of the ESU...
July 2016: Clinical Endoscopy
N Falco, T Fontana, R Tutino, C Raspanti, A Mascolino, I Melfa, G Scerrino, G Salamone, G Gulotta
AIM: Laparoscopy is considered a good approach in treatment of colorectal neoplastic diseases; the endoscopic tattooing is then recommended (Evidence Level III and grade of recommendation A) to mark a lesion or a polypectomy site for intraoperative identification. We describe the case of perforation after tattoing treated conservatively. CASE REPORT: 63 years old woman, underwent colonoscopy for lipoma tattooing with India ink SPOT® solution kit and saline test...
March 2016: Il Giornale di Chirurgia
Harindra Jayasekara, Jeanette C Reece, Daniel D Buchanan, Dennis J Ahnen, Susan Parry, Mark A Jenkins, Aung Ko Win
BACKGROUND AND AIM: We conducted a systematic review and meta-analysis to identify personal, lifestyle and tumor-related risk factors for metachronous colorectal cancer (CRC) and polyp. METHODS: Relevant studies were identified by searching MEDLINE, Web of Science and Cochrane Central Register through 15 May 2016. Estimates for associations were summarized using random effects models. RESULTS: Fifty-five studies were included in the review...
June 29, 2016: Journal of Gastroenterology and Hepatology
Michael Malandra, Sunpreet Kaur, Ashish Chogle
INTRODUCTION: Benign juvenile hamartomatous polyps are common in pediatric gastrointestinal practice. We hypothesize that in the absence of gross mucosal abnormalities, the likelihood of histologic abnormalities from routine random colonic biopsies is low. METHODS: We performed a retrospective chart review identifying patients aged 1 to 18 years who underwent complete colonoscopy and polypectomy for suspected colorectal polyps from January 1, 2004 to July 1, 2014...
June 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
Naoki Asayama, Shiro Oka, Shinji Tanaka, Daiki Hirano, Kyoku Sumimoto, Yuki Ninomiya, Yuzuru Tamaru, Kenjiro Shigita, Nana Hayashi, Fumio Shimamoto, Koji Arihiro, Kazuaki Chayama
We present a rare case of colorectal T1 carcinoma with metastasis of previous lung carcinoma found at the deepest invasive portion. A 61-year-old man presented with cervical lymphadenopathy 18 years after undergoing surgery for right lung carcinoma [poorly differentiated adenocarcinoma stage IIb (T3N0M0)]. Contrast-enhanced computed tomography showed enlarged lymph nodes (LNs) in the neck and mediastinal regions. Combined hybrid-F-fluorodeoxyglucose positron emission-computerized tomography showed increased radionuclide uptake in multiple cervical LNs and mediastinal LNs...
August 2016: Clinical Journal of Gastroenterology
Michael Bretthauer, Michal F Kaminski, Magnus Løberg, Ann G Zauber, Jaroslaw Regula, Ernst J Kuipers, Miguel A Hernán, Eleanor McFadden, Annike Sunde, Mette Kalager, Evelien Dekker, Iris Lansdorp-Vogelaar, Kjetil Garborg, Maciej Rupinski, Manon C W Spaander, Marek Bugajski, Ole Høie, Tryggvi Stefansson, Geir Hoff, Hans-Olov Adami
IMPORTANCE: Although some countries have implemented widespread colonoscopy screening, most European countries have not introduced it because of uncertainty regarding participation rates, procedure-related pain and discomfort, endoscopist performance, and effectiveness. To our knowledge, no randomized trials on colonoscopy screening currently exist. OBJECTIVE: To investigate participation rate, adenoma yield, performance, and adverse events of population-based colonoscopy screening in several European countries...
July 1, 2016: JAMA Internal Medicine
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