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Colorectal polypectomy

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https://www.readbyqxmd.com/read/29122600/width-and-depth-of-resection-for-small-colorectal-polyps-hot-versus-cold-snare-polypectomy
#1
Sho Suzuki, Takuji Gotoda, Chika Kusano, Hisatomo Ikehara, Akihiro Sugita, Misa Yamauchi, Mitsuhiko Moriyama
BACKGROUND AND AIMS: Curability is associated with resection width and depth in polypectomy. We evaluated the resection width and depth achieved with hot snare polypectomy (HSP) and cold snare polypectomy (CSP) for small colorectal polyps. METHODS: In this single-center, prospective, randomized controlled study, patients with rectal or rectosigmoid polyps ≤10 mm in diameter were treated with HSP or CSP. Resection width was evaluated as mucosal defect size, measured immediately postprocedure and 1 day later...
November 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29105290/endoscopic-resection-of-large-colorectal-adenomas-clinical-experience-of-a-tertiary-referral-center
#2
Liat Mlynarsky, Shira Zelber-Sagi, Eliaz Miller, Revital Kariv
BACKGROUND: Colorectal cancer is a leading cause for cancer-related mortality. Adenomatous polyps are typically resected endoscopically to prevent cancer while giant and complex polyps are managed surgically. No criteria clearly define the indications for surgical versus endoscopic resection. AIM: To evaluate factors associated with short-term efficacy and safety of endoscopic resection of large (≥20mm) and giant (≥40mm) adenomas. METHODS: Consecutive cases with colonic adenomas larger than 20mm, resected endoscopically were included...
November 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29104470/critical-role-of-p53-and-k-ras-in-the-diagnosis-of-early-colorectal-cancer-a-one-year-single-center-analysis
#3
Hui-Ying Lu, Ri-Tian Lin, Guang-Xi Zhou, Tian-Ming Yu, Zhan-Ju Liu
Background: Colorectal cancer (CRC) is strongly associated with colorectal polyps, which has become the third most common cancer in China. In the present study, we revealed the susceptible population and risk factors of colorectal polyps, and analyzed the expression of Ki-67, p53 and K-ras in the intestinal mucosa of patients with colorectal polyps in order to explore their significance in the detection and prognosis of CRC at an early stage. Materials and Methods: Total 801 cases of colorectal polyps were collected during endoscopic resection including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29103541/problematic-colorectal-polyps-is-it-cancer-and-what-do-i-need-to-do-about-it
#4
REVIEW
Maurice B Loughrey, Neil A Shepherd
Two issues commonly arise for pathologists reporting adenomatous polyps of the colorectum. Particularly problematic within large sigmoid colonic adenomas is the distinction between benign misplacement of epithelium into the submucosa and invasive malignancy. This distinction requires careful morphologic evaluation of key discriminatory features, assisted only rarely by the application of selected adjunctive immunohistochemistry. Following a diagnosis of adenocarcinoma within a polypectomy or other local excision specimen, systematic assessment is required of features that may indicate the risk of residual local and/or nodal neoplastic disease and inform management decision-making regarding the need for further endoscopic or surgical intervention...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29089272/post-polypectomy-bleeding-after-colonoscopy-on-uninterrupted-aspirin-non-steroideal-antiflammatory-drugs-systematic-review-and-meta-analysis
#5
REVIEW
Flavia Pigò, Helga Bertani, Giuseppe Grande, Abate Federica, Sara Vavassori, Rita Luisa Conigliaro
BACKGROUND AND AIM: The aim of this systematic review and meta-analysis was to assess the risk of post-polypectomy bleeding (PPB) in patients that underwent colorectal polypectomy and exposed to ASA/NSAIDs. METHODS: Relevant publications were identified in MEDLINE/EMBASE for the period 1950-2016. Studies with specified ASA/NSAIDs exposure and bleeding rate were included. Study quality was ascertained according to Newcastle-Ottawa Scale. Forest plot was based on fixed or random effect models in relation to the heterogeneity...
October 18, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29082224/repeat-colonoscopy-within-6-months-after-initial-outpatient-colonoscopy-in-ontario-a-population-based-cross-sectional-study
#6
Lawrence Paszat, Rinku Sutradhar, Nancy N Baxter, Jill Tinmouth, Linda Rabeneck
BACKGROUND: The goal of this study is to examine utilization of early repeat colonoscopy ≤ 6 months after an index procedure. METHODS: We identified persons having repeat colonoscopy ≤ 6 months following outpatient colonoscopy without prior colonoscopy ≤ 5 years or prior diagnosis of colorectal cancer (CRC). We modeled repeat colonoscopy using a generalized estimating equation with an exchangeable correlation structure to account for clustering of patients by endoscopist...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29074726/outcomes-following-polypectomy-for-malignant-colorectal-polyps-are-similar-to-those-following-surgery-in-the-general-population
#7
Anthony Lopez, Anne-Marie Bouvier, Valérie Jooste, Vanessa Cottet, Gaëlle Romain, Jean Faivre, Sylvain Manfredi, Come Lepage
OBJECTIVE: Population-based studies on colorectal malignant polyps (MPs) are scarce. The aim of this study was to describe time trends in the incidence of colorectal MPs before and after the introduction of a colorectal mass-screening programmein 2003 and to assess outcomes (survival and recurrence) after endoscopic or surgical resection in patients with MPs. DESIGN: We included 411 patients with MPs diagnosed between 1982 and 2011 in a well-defined population. Age-standardised incidence rates were calculated...
October 26, 2017: Gut
https://www.readbyqxmd.com/read/29072082/chemoprevention-of-polyp-recurrence-with-curcumin-followed-by-silibinin-in-a-case-of-multiple-colorectal-adenomas
#8
Vicente Alfonso-Moreno, Antonio López-Serrano, Eduardo Moreno-Osset
Chemoprevention is a practical approach to reduce the risk of various cancers including colorectal cancer (CRC). The goal is to reduce the incidence of pre-neoplastic adenomatous polyps and prevent its progression to CRC. Curcumin and silibinin prevent intestinal polyp formation in mice. Curcumin sensitizes silymarin to exert synergistic anticancer activity in colon cancer cells. Patients presenting with multiple colorectal adenomatous polyps (MCRA) have a high lifetime risk for CRC. We present a 57-year-old man with MCRA, without deleterious germline APC or MYH mutations...
October 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29046738/colorectal-cancer-incidence-in-path_mlh1-carriers-subjected-to-different-follow-up-protocols-a-prospective-lynch-syndrome-database-report
#9
Toni Seppälä, Kirsi Pylvänäinen, Dafydd Gareth Evans, Heikki Järvinen, Laura Renkonen-Sinisalo, Inge Bernstein, Elke Holinski-Feder, Paola Sala, Annika Lindblom, Finlay Macrae, Ignacio Blanco, Rolf Sijmons, Jacqueline Jeffries, Hans Vasen, John Burn, Sigve Nakken, Eivind Hovig, Einar Andreas Rødland, Kukatharmini Tharmaratnam, Wouter H de Vos Tot Nederveen Cappel, James Hill, Juul Wijnen, Mark Jenkins, Maurizio Genuardi, Kate Green, Fiona Lalloo, Lone Sunde, Miriam Mints, Lucio Bertario, Marta Pineda, Matilde Navarro, Monika Morak, Ian M Frayling, John-Paul Plazzer, Julian R Sampson, Gabriel Capella, Gabriela Möslein, Jukka-Pekka Mecklin, Pål Møller
BACKGROUND: We have previously reported a high incidence of colorectal cancer (CRC) in carriers of pathogenic MLH1 variants (path_MLH1) despite follow-up with colonoscopy including polypectomy. METHODS: The cohort included Finnish carriers enrolled in 3-yearly colonoscopy (n = 505; 4625 observation years) and carriers from other countries enrolled in colonoscopy 2-yearly or more frequently (n = 439; 3299 observation years). We examined whether the longer interval between colonoscopies in Finland could explain the high incidence of CRC and whether disease expression correlated with differences in population CRC incidence...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/29042789/linked-color-imaging-combined-with-the-nice-classification-system-for-optical-diagnosis-of-colon-polyps-new-image-enhanced-endoscopic-technology-for-pathological-prediction
#10
Chi-Huan Wu, Tsung-Hsing Chen, Chen-Ming Hsu, Ming-Yao Su, Cheng-Tang Chiu, Ren-Chin Wu, Cheng-Chou Lai
INTRODUCTION: Linked-color imaging (LCI) is a recently developed system used in endoscopy. It creates clear and bright endoscopic images using short-wavelength, narrow-band laser light combined with white laser light. The illuminating light and signal processing emphasize slight color differences in abnormal regions that approximate the normal color of the mucosa. As a result, regions initially appearing red become a deeper shade of red, while regions originally appearing white become brighter, yet with natural tones...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28994567/underwater-endoscopic-mucosal-resection-uemr-an-alternative-for-removal-of-large-sessile-colorectal-polyps
#11
Dalbir S Sandhu, Ye J Lee, Henning Gerke
BACKGROUND AND AIMS: Large sessile/flat colonic polyps are traditionally removed by lift polypectomy. Underwater endoscopic mucosal resection (UEMR) is a novel technique where air is suctioned out and replaced by water to decompress the colon so that the flat lesions assumes a more polypoid shape facilitating its removal with the standard snare resection. We report the feasibility and safety in our series of patients utilizing this technique. PATIENTS AND METHODS: A retrospective, observational study of all patients who underwent removal of large colonic polyps (>10 mm) over a period of 3 years (January 2012 - January 2015) at a tertiary care center by UEMR were included in the study...
October 9, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28991080/prospective-trial-evaluating-the-surgical-anastomosis-at-one-year-colorectal-cancer-surveillance-ct-colonography-versus-optical-colonoscopy-and-implications-for-patient-care
#12
MULTICENTER STUDY
Perry J Pickhardt, Kristin Edwards, David H Bruining, Marc Gollub, Sonja Kupfer, Sam J Lubner, David H Kim, Eric Ross, Eileen Keenan, David S Weinberg
OBJECTIVE: The aim of this study was to compare the accuracy of CT colonography versus optical colonoscopy for neoplastic involvement at the surgical anastomosis 1 year after curative-intent colorectal cancer resection. DESIGN, SETTING, PATIENTS, AND INTERVENTIONS: Two hundred one patients (mean age, 58.6 years; 117 men, 84 women) underwent same-day contrast-enhanced CT colonography and colonoscopy approximately 1 year (mean, 12.1 months; median, 11.9 months) after colorectal cancer resection as part of a prospective, multicenter trial...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28986265/risk-of-advanced-colorectal-neoplasm-by-the-proposed-combined-united-states-and-united-kingdom-risk-stratification-guidelines
#13
Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
BACKGROUND AND AIMS: The U.K. guidelines for risk stratification after colon polypectomy differ from the U.S. guidelines in 2 ways: the U.K. guidelines consider ≥5 adenomas as high risk and do not consider histology (villous or high-grade dysplasia) in the assessment. Thus, we aimed to investigate the risk of advanced colorectal neoplasm (CRN) by categorized risk groups, considering both ≥5 adenomas and histology. METHODS: A total of 2570 patients with ≥1 adenoma at index colonoscopy were included...
October 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28977952/colorectal-adenoma-recurrence-rates-among-post-polypectomy-patients-in-the-placebo-controlled-groups-of-randomized-clinical-trials-a-meta-analysis
#14
Xin Shi, Zhiping Yang, Qiong Wu, Daiming Fan
BACKGROUND: Evidence regarding the benefit of therapy to prevent the post-polypectomy recurrence of colorectal adenoma is limited. Endoscopic recurrence is the main outcome according to an evaluation of trials involving recurrence prevention. AIM: To estimate the recurrence rates of post-polypectomy colorectal adenoma in placebo-controlled arms of randomized clinical trials and to identify the prognostic factors influencing these rates. METHODS: We combined data from all randomized controlled trials evaluating therapies for colorectal adenoma using placebo from 1988 to 2016...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28970290/a-comparison-of-the-resection-rate-for-cold-and-hot-snare-polypectomy-for-4-9-mm-colorectal-polyps-a-multicentre-randomised-controlled-trial-crescent-study
#15
Takuji Kawamura, Yoji Takeuchi, Satoshi Asai, Isao Yokota, Eisuke Akamine, Minoru Kato, Takuji Akamatsu, Kazuhiro Tada, Yoriaki Komeda, Mineo Iwatate, Ken Kawakami, Michiko Nishikawa, Daisuke Watanabe, Atsushi Yamauchi, Norimasa Fukata, Masaaki Shimatani, Makoto Ooi, Koichi Fujita, Yasushi Sano, Hiroshi Kashida, Satoru Hirose, Hiroyoshi Iwagami, Noriya Uedo, Satoshi Teramukai, Kiyohito Tanaka
OBJECTIVE: To investigate the success rate of cold snare polypectomy (CSP) for complete resection of 4-9 mm colorectal adenomatous polyps compared with that of hot snare polypectomy (HSP). DESIGN: A prospective, multicentre, randomised controlled, parallel, non-inferiority trial conducted in 12 Japanese endoscopy units. Endoscopically diagnosed sessile adenomatous polyps, 4-9 mm in size, were randomly assigned to the CSP or HSP group. After complete removal of the polyp using the allocated technique, biopsy specimens from the resection margin after polypectomy were obtained...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28928815/the-concept-of-semi-clean-colon-using-the-pit-pattern-classification-system-has-the-potential-to-be-acceptable-in-combination-with-a-3-year-surveillance-colonoscopy
#16
Yasuharu Maeda, Shin-Ei Kudo, Kunihiko Wakamura, Hideyuki Miyachi, Masashi Misawa, Yuichi Mori, Noriyuki Ogata, Toyoki Kudo, Kenta Kodama, Tomokazu Hisayuki, Takemasa Hayashi, Atsushi Katagiri, Fumio Ishida
Histological features of colorectal lesions are currently evaluated via a magnifying chromoendoscopy [pit pattern (PIT) classification]. Advanced histological features are rarely observed in diminutive (≤5 mm) adenomatous polyps (DAPs). The Japanese guidelines indicate that diminutive neoplastic lesions without carcinomatous findings may be left untreated and followed up. At the present institution, DAPs with type IIIL PIT are left untreated in various cases, whereas lesions with type III, IV or V PIT are typically resected via routine colonoscopy...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28898922/cold-versus-hot-endoscopic-mucosal-resection-for-nonpedunculated-colorectal-polyps-sized-6-10-mm-a-randomized-trial
#17
Vasilios Papastergiou, Konstantina D Paraskeva, Maria Fragaki, Ioannis Dimas, Emmanouil Vardas, Angeliki Theodoropoulou, Nicoletta Mathou, Athanasios Giannakopoulos, Konstantinos Karmiris, Afroditi Mpitouli, Dimitra Apessou, Linda Giannikaki, John A Karagiannis, Grigorios Chlouverakis, Gregorios A Paspatis
Background and study aims Cold snare polypectomy is an established method for the resection of small colorectal polyps; however, significant incomplete resection rates still leave room for improvement. We aimed to assess the efficacy of cold snare endoscopic mucosal resection (CS-EMR), compared with hot snare endoscopic mucosal resection (HS-EMR), for nonpedunculated polyps sized 6 - 10 mm. Patients and methods This study was a dual-center, randomized, noninferiority trial. Consecutive adult patients with at least one nonpedunculated polyp sized 6 - 10 mm were enrolled...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28884225/safety-of-endoscopic-mucosal-resection-emr-of-large-non-pedunculated-colorectal-adenomas-in-the-elderly
#18
K Bronsgeest, J F Huisman, A Langers, J J Boonstra, B E Schenk, W H de Vos Tot Nederveen Cappel, H F A Vasen, J C H Hardwick
BACKGROUND: Endoscopic mucosal resection (EMR) has been proven to be safe and effective for the treatment of colorectal adenomas. However, data are limited on the safety of this technique for large polyps and in elderly patients. Aims of our study were to examine the bleeding and perforation rates in patients with large non-pedunculated adenomas (≥20mm) and to evaluate the influence of size (≥40mm) and age (≥75 years) on the complication rates. METHODS: In this multicenter retrospective study, patients who underwent EMR of non-pedunculated adenomas ≥20mm between January 2012 and March 2016 were included...
September 8, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28882577/assessing-colon-polypectomy-competency-and-its-association-with-established-quality-metrics
#19
Anna M Duloy, Tonya R Kaltenbach, Rajesh N Keswani
BACKGROUND & AIMS: Inadequate polypectomy leads to incomplete resection, interval colorectal cancer, and adverse events. However, polypectomy competency is rarely reported and quality metrics are lacking. The primary aims of this study were to (1) assess polypectomy competency among a cohort of gastroenterologists, and (2) measure the correlation between polypectomy competency and established colonoscopy quality metrics (adenoma detection rate [ADR] and withdrawal time [WT]). METHODS: We conducted a prospective observational study to assess polypectomy competency amongst 13 high-volume screening colonoscopists at an academic medical center...
September 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28882576/endoscopic-features-and-clinical-outcomes-of-colorectal-mucosa-associated-lymphoid-tissue-lymphoma
#20
Min Kyung Jeon, Hoonsub So, Jooryung Huh, Hee Sang Hwang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kee Don Choi, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
BACKGROUND AND AIMS: Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease. The purpose of this study was to investigate the clinical and endoscopic features of colorectal MALT lymphoma. METHODS: Patients diagnosed with colorectal MALT lymphoma at Asan Medical Center from 2002 to 2016 were eligible. Medical records were reviewed to investigate clinical features and treatment outcomes. Endoscopic pictures were assessed to characterize the endoscopic features of colorectal MALT lymphoma...
September 4, 2017: Gastrointestinal Endoscopy
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