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https://www.readbyqxmd.com/read/28655057/evaluating-surgeon-specific-performance-for-endoscopic-sinus-surgery
#1
Luke Rudmik, Yuan Xu, Jeremiah A Alt, Adam Deconde, Timothy L Smith, Rodney J Schlosser, Hude Quan, Zachary M Soler
Importance: Several identified factors have raised questions concerning the quality of care for endoscopic sinus surgery (ESS), including the presence of large geographic variation in the rates and extent of surgery, poorly defined indications, and lack of ESS-specific quality metrics. Combined with the risk of major complications, ESS represents a high-value target for quality improvement. Objective: To evaluate differences in surgeon-specific performance for ESS using a risk-adjusted, 5-year ESS revision rate as a quality metric...
June 22, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28654863/stat6-promotes-intestinal-tumorigenesis-in-a-mouse-model-of-adenomatous-polyposis-by-expansion-of-mdscs-and-inhibition-of-cytotoxic-cd8-response
#2
Asha Jayakumar, Alfred L M Bothwell
Intestinal tumorigenesis in the ApcMin/+ model is initiated by aberrant activation of Wnt pathway. Increased IL-4 expression in human colorectal cancer tissue and growth of colon cancer cell lines implied that IL-4-induced Stat6-mediated tumorigenic signaling likely contributes to intestinal tumor progression in ApcMin/+ mice. Stat6 also appears to promote expansion of myeloid-derived suppressor cells (MDSCs) cells. MDSCs promote polyp formation in the ApcMin/+ model. Hence, Stat6 could have a broad role in coordinating both polyp cell proliferation and MDSC expansion...
June 24, 2017: Neoplasia: An International Journal for Oncology Research
https://www.readbyqxmd.com/read/28652912/efficacy-of-submucosal-epinephrine-injection-for-the-prevention-of-postpolypectomy-bleeding-a-meta-analysis-of-randomized-controlled-studies
#3
REVIEW
Thawatchai Tullavardhana, Prinya Akranurakkul, Withoon Ungkitphaiboon, Dolrudee Songtish
BACKGROUND: Bleeding is the most common major complication following colonoscopic polypectomy. The purpose of this study is to evaluate whether submucosal epinephrine injections could prevent the occurrence of postpolypectomy bleeding. METHOD: The dataset was defined by searching PubMed, EMBASE, Google Scholar, and the Cochrane database for appropriate randomized controlled studies published before April 2015. A meta-analysis was conducted to investigate the preventative effect of submucosal epinephrine injection for overall, early, and delayed postpolypectomy bleeding...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28652665/application-of-novel-magnified-single-balloon-enteroscopy-for-a-patient-with-cronkhite-canada-syndrome
#4
Masaki Murata, Shigeki Bamba, Kenichiro Takahashi, Hirotsugu Imaeda, Atsushi Nishida, Osamu Inatomi, Tomoyuki Tsujikawa, Ryoji Kushima, Mitsushige Sugimoto, Akira Andoh
We present a case of Cronkhite-Canada syndrome (CCS) in which the entire intestine was observed using a prototype of magnifying single-balloon enteroscope (SIF Y-0007, Olympus). CCS is a rare, non-familial gastrointestinal polyposis with ectodermal abnormalities. To our knowledge, this is the first report showing magnified intestinal lesions of CCS. A 73-year-old female visited our hospital with complaints of diarrhea and dysgeusia. The blood test showed mild anemia and hypoalbuminemia. The esophagogastroduodenoscopy and colonoscopy revealed diffuse and reddened sessile to semi-pedunculated polyps, resulting in the diagnosis of CCS...
June 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28652417/k-ras-mutations-as-the-earliest-driving-force-in-a-subset-of-colorectal-carcinomas
#5
REVIEW
Nikolaos Margetis, Myrsini Kouloukoussa, Kyriaki Pavlou, Spyridon Vrakas, Theodoros Mariolis-Sapsakos
K-ras oncogene is a key factor in colorectal cancer. Based on published and our data we propose that K-ras could be the oncogene responsible for the inactivation of the tumor-suppressor gene APC, currently considered as the initial step in colorectal tumorigenesis. K-ras fulfills the criteria of the oncogene-induced DNA damage model, as it can provoke well-established causes for inactivating tumor-suppressors, i.e. DNA double-strand breaks (causing allele deletion) and ROS production (responsible for point mutation)...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28652161/the-surgical-management-of-bladder-polyps-in-the-setting-of-exstrophy-epispadias-complex-eec
#6
John Jayman, Ali Tourchi, Masha Shabaninia, Mahir Maruf, Heather DiCarlo, John P Gearhart
PURPOSE: To investigate the surgical course for treating bladder polyps in patients with Exstrophy Epispadias Complex (EEC). EEC bladder polyps are unique pathological entities, with a distinct difference between polyps discovered at birth and polyps developed after failed exstrophy closure. MATERIALS AND METHODS: A prospectively maintained database of 1300 patients with EEC was reviewed for bladder exstrophy (BE) patients with bladder polyps. The following data was obtained: patient demographics, polyp type, past medical and surgical history, and continence outcomes...
June 23, 2017: Urology
https://www.readbyqxmd.com/read/28648577/impact-of-cap-assisted-colonoscopy-on-learning-curve-and-quality-in-colonoscopy-a-randomized-controlled-trial
#7
Zhouwen Tang, Daniel S Zhang, Aaron P Thrift, Kalpesh K Patel
BACKGROUND AND AIMS: Colonoscopy competency assessment in trainees have traditionally been informal. Comprehensive metrics such as the Assessment of Competency in Endoscopy (ACE) tool suggest competency thresholds are higher than assumed. cap-assisted colonoscopy (CAC) may improve competency but data in novice trainees are lacking. We compare CAC versus standard colonoscopy (SC) among novice trainees in a randomized controlled trial. METHODS: All colonoscopies performed by 3 gastroenterology fellows without prior experience were eligible for enrollment...
June 22, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28648575/inadequate-boston-bowel-preparation-scale-scores-predict-the-risk-of-missed-neoplasia-on-next-colonoscopy
#8
Matthew A Kluge, J Luke Williams, Connie K Wu, Brian C Jacobson, Paul C Schroy, David A Lieberman, Audrey H Calderwood
BACKGROUND AND AIMS: The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed using the Boston Bowel Preparation Scale (BBPS). METHODS: In this observational study of prospectively collected data within a large, national endoscopic consortium, we identified patients aged 50 to 75 who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2)...
June 22, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28647893/the-overdiagnosis-of-what-on-the-relationship-between-the-concepts-of-overdiagnosis-disease-and-diagnosis
#9
Bjørn Hofmann
Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease...
June 24, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28647136/polypectomy-for-the-complete-endoscopic-resection-of-small-colorectal-polyps
#10
Qisheng Zhang, Peng Gao, Bin Han, Jianhua Xu, Yucui Shen
BACKGROUND AND AIMS: Small colorectal polyps are frequently encountered and may be incompletely removed during colonoscopy. The optimal technique for removal of small colorectal polyps is uncertain. The aim of this study was to compare the incomplete resection rate (IRR) using endoscopic mucosal resection (EMR) or cold snare polypectomy (CSP) for the removal of small adenomatous polyps. METHODS: This was a prospective randomized controlled study from a tertiary referral center...
June 21, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28647042/transanal-endoscopic-microsurgery-for-the-treatment-of-uncommon-rectal-lesions
#11
Manuel Ferrer-Márquez, Francisco Rubio-Gil, Sofía Ortega-Ruiz, Isabel Blesa-Sierra, Antonio Álvarez-García, Jaime Jorge-Cerrudo, Elisabet Vidaña-Márquez, Ricardo Belda-Lozano, Ángel Reina-Duarte
INTRODUCTION: Transanal endoscopic microsurgery (TEM) was developed as a less aggressive alternative treatment for rectal lesions (mainly adenomas and adenocarcinomas). However, its use for other rectal lesions has become more frequent, trying to reduce the morbidity associated with more invasive techniques. The aim of this study is to describe our experience in the use of TEM in other rectal lesions. METHODS: Retrospective and descriptive study including patients operated with TEM (from June 2008 to December 2016) for the treatment of rectal lesions different from adenomas or adenocarcinomas...
June 21, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28643886/ileocolic-intussusception-from-an-inflammatory-fibroid-polyp-a-rare-cause-of-adult-small-bowel-obstruction
#12
Sabrina Mader, Joseph Ting, Hajir Nabi
No abstract text is available yet for this article.
June 23, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28643319/-progress-of-the-application-of-optical-coherence-tomography-in-gastrointestinal-tumor-surgery
#13
Yongsheng Li, Hao Liu, Haipeng Huang, Yu Zhu, Haijun Deng, Jiang Yu, Site Luo, Li Huo, Li Lin, Huikai Xie, Guoxin Li
Optical coherence tomography (OCT) is a real-time, cross-sectional optical imaging technology. It is analogous to ultrasonography, except that OCT uses light waves instead of sound waves, and can provide three-dimensional morphological images of living tissues with a micrometer resolution. Through the use of endoscopes, needles, catheters and laparoscopes, OCT has demonstrated tremendous imaging potential in tumor surgery. The current studies suggest that OCT has potential for clinical applications in the following fields of gastrointestinal tumor surgery: (1) Early tumor detection and diagnosis: OCT can distinguish differences between polyp tissue, normal tissue and malignant tissue...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643073/endoscopic-resection-of-giant-fibrovascular-esophageal-polyps
#14
Marc A Ward, Kristin W Beard, Ezra N Teitelbaum, Ahmed M Sharata, Christy M Dunst, Lee L Swanstrom, Kevin M Reavis
BACKGROUND: Giant fibrovascular esophageal polyps are rare benign intraluminal tumors that originate from the submucosa of the cervical esophagus [Owens et al. (JAMA 103: 838-842, 1994), Totten et al. (JAMA 25:606-622, 1953)]. Due to their indolent course, these tumors tend to reach enormous proportions before patients develop symptoms. Accurately diagnosing these tumors is difficult, as endoscopy may miss 25% of these lesions because these polyps exhibit normal intact esophageal mucosa [Levine et al...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642452/laparoscopic-treatment-of-colo-colic-intussusception-secondary-to-a-lipomatous-polyp
#15
Carlo V Feo, Daniele Marcello, Claudio F Feo
INTRODUCTION: Colo-colic intussusception is extremely rare in adults and few cases have been described secondary to a lypomatous polyp. CASE REPORT: We present the case of a 50-year old man with chronic abdominal pain who was diagnosed a colo-colic intussusception secondary to a lipoma of the left colon. The patient underwent laparoscopic resection of the splenic flexure without reduction, which occurred spontaneously after induction of the pneumoperitoneum, and final histology confirmed a submucosal lipoma with no evidence of malignancy...
June 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28641945/surveillance-after-positive-colonoscopy-based-on-adenoma-characteristics
#16
Ido Laish, Ilia Seregeev, Timna Naftali, Fred M Konikoff
BACKGROUND: Patients with adenomatous polyps are at increased risk for developing colorectal cancer based on the characteristics and number of polyps, but less is known about the individual and combined contribution of these factors. This study aimed to better characterize the risk of advanced adenoma and cancer in patients with positive baseline colonoscopy. METHODS: Patients who had polyps at baseline colonoscopy were included in this retrospective cohort study (N=1165) and were categorized into 6 groups: (1) 1-2 non-advanced adenomas (NAA's), (2) ≥3 NAA's, (3) advanced tubular adenoma, (4) small tubulovillous adenoma (TVA), (5) large TVA and (6) multiple advanced adenomas (MAA's)...
May 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28640361/global-and-targeted-serum-metabolic-profiling-of-colorectal-cancer-progression
#17
Yin Long, Beatriz Sanchez-Espiridion, Moubin Lin, Lindsey White, Lopa Mishra, Gottumakkala S Raju, Scott Kopetz, Cathy Eng, Michelle A T Hildebrandt, David W Chang, Yuanqing Ye, Dong Liang, Xifeng Wu
BACKGROUND: Patients with colorectal adenoma polyps (PLPs) are at higher risk for developing colorectal cancer (CRC). However, the development of improved and robust biomarkers to enable the screening, surveillance, and early detection of PLPs and CRC continues to be a challenge. The aim of this study was to identify biomarkers of progression to CRC through metabolomic profiling of human serum samples with a multistage approach. METHODS: Metabolomic profiling was conducted with the Metabolon platform for 30 CRC patients, 30 PLP patients, and 30 control subjects, and this was followed by the targeted validation of the top metabolites in an additional set of 50 CRC patients, 50 PLP patients, and 50 controls with liquid chromatography-tandem mass spectrometry...
June 22, 2017: Cancer
https://www.readbyqxmd.com/read/28640228/development-and-validation-of-a-high-throughput-mass-spectrometry-based-urine-metabolomic-test-for-the-detection-of-colonic-adenomatous-polyps
#18
Lu Deng, David Chang, Rae R Foshaug, Roman Eisner, Victor K Tso, David S Wishart, Richard N Fedorak
Background: Colorectal cancer is one of the leading causes of cancer deaths worldwide. The detection and removal of the precursors to colorectal cancer, adenomatous polyps, is the key for screening. The aim of this study was to develop a clinically scalable (high throughput, low cost, and high sensitivity) mass spectrometry (MS)-based urine metabolomic test for the detection of adenomatous polyps. Methods: Prospective urine and stool samples were collected from 685 participants enrolled in a colorectal cancer screening program to undergo colonoscopy examination...
June 22, 2017: Metabolites
https://www.readbyqxmd.com/read/28639154/inflammatory-myofibroblastic-tumor-of-the-gallbladder-a-case-report-and-literature-review
#19
Takahiro Yamada, Takeshi Hisa, Satoshi Shiozawa, Akiharu Kudo, Ryutaro Furukawa
A 50-year-old man had undergone chemotherapy and radiotherapy for malignant lymphoma 1 year earlier. Follow-up computed tomography revealed a gallbladder polyp. Transabdominal ultrasound demonstrated a 20-mm hypoechoic sessile polyp with basal waist in the gallbladder fundus; the surface was covered with a hyperechoic layer of non-uniform thickness. On contrast-enhanced computed tomography, the polyp showed an early uniform and sustained staining pattern. Magnetic resonance imaging revealed that the polyp had low and slightly high signal intensities on T1- and T2-weighted imaging, respectively...
June 21, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28639142/serrated-polyps-of-colon-and-rectum-a-clinicopathologic-review
#20
REVIEW
Bita Geramizadeh, Scott Robertson
BACKGROUND: In the past decade, there have been significant changes in the classification and nomenclature of colorectal polyps. Previously, only two groups of lesions were widely recognized, the adenoma and the hyperplastic polyp. Adenomas were considered the only precursor of colorectal cancer, and hyperplastic polyps were considered innocent with no malignant potential. However, recent discoveries about molecular pathways of colorectal cancers have significantly changed our understanding of these neoplasms...
June 22, 2017: Journal of Gastrointestinal Cancer
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