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https://www.readbyqxmd.com/read/29151306/evaluation-of-risk-factors-for-the-recurrence-of-colorectal-polyps-and-colorectal-cancer
#1
Öztürk Ateş, Bülent Sivri, Saadettin Kılıçkap
Background/aim: Colorectal adenomatous polyps are precursors of colorectal cancer (CRC), which can be prevented with surveillance colonoscopy. This study aimed to assess risk factors for the recurrence of colorectal polyps and CRC following polypectomy. Materials and methods: In this single-center trial, a total of 510 patients who applied to the endoscopy unit of Hacettepe University Hospital for various reasons and who were diagnosed with at least one colorectal adenomatous polyp between 2000 and 2010 were retrospectively analyzed...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29133196/cold-endoscopic-mucosal-resection-of-large-sessile-serrated-polyps-at-colonoscopy-with-video
#2
Nicholas J Tutticci, David G Hewett
BACKGROUND AND AIMS: The optimal technique for the resection of sessile serrated polyps (SSPs) is unknown, with established limitations and risks with conventional polypectomy. Although cold snare polypectomy is safe, the efficacy of piecemeal resection for large lesions is untested. In this study, we evaluate the safety and efficacy of cold endoscopic mucosal resection (EMR) for large SSPs. METHODS: Patients presenting for elective colonoscopy at an academic endoscopy center with 1 or more SSPs ≥10mm in size were enrolled, excluding those on anticoagulants or antiplatelets other than aspirin...
November 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29105290/endoscopic-resection-of-large-colorectal-adenomas-clinical-experience-of-a-tertiary-referral-center
#3
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/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/29072121/colonic-stasis-and-chronic-constipation-demystifying-proposed-risk-factors-for-colon-polyp-formation-in-a-spinal-cord-injury-veteran-population
#5
Jason Colizzo, Jonathan Keshishian, Ambuj Kumar, Gitanjali Vidyarthi, Donald Amodeo
BACKGROUND AND AIMS: Patients with spinal cord injury (SCI) suffer significant morbidity from neurogenic bowel. Chronic constipation has long-been a proposed risk factor for polyp development. We performed a retrospective cohort study in veterans with SCI to assess polyp presence in the setting of colonic stasis. METHODS: All consecutive patients at the James A. Haley Veterans Affairs Hospital with SCI and neurogenic bowel who completed screening colonoscopy between January 1, 2004 to June 30, 2013 were included...
October 26, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29072082/chemoprevention-of-polyp-recurrence-with-curcumin-followed-by-silibinin-in-a-case-of-multiple-colorectal-adenomas
#6
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/29063773/-pneumoperitoneum-after-colonoscopy-to-cut-or-not-to-cut
#7
K Kmochová, P Záruba, M Ryska, M Zavoral, Š Suchánek
Colon perforation is a very serious complication of colonoscopy. The correct diagnosis and management of therapy improve the prognosis of patients. The treatment can be conservative, endoscopic and surgical. In this case report we present microperforation as a complication of polypectomy in the caecum during colonoscopy, followed by laparoscopic surgery.Key words: colonoscopy - complication -perforation polypectomy.
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
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
#8
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/29020699/the-first-homemade-colonoscopy-trainer
#9
Dominik Andrzej Walczak, Maciej Grajek, Paulina Agnieszka Walczak, Magdalena Tuliszka-Gołowkin, Roman Massopust, Dariusz Pawełczak, Zbigniew Pasieka, Łukasz Krakowczyk, Adam Maciejewski
Introduction Colonoscopy trainers have gained recognition for improving endoscopy skills and preparing for real procedures on humans. Unfortunately, due to their high price, commercial simulators are hard to obtain, especially for small medical centers. However, a solution might be to construct a device for themselves. Aim Our goal was to build a relatively cheap and easy-to-construct simulator for residents who want to start learning colonoscopy. Materials and methods The box model colonoscopy trainer was designed and constructed...
October 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28994567/underwater-endoscopic-mucosal-resection-uemr-an-alternative-for-removal-of-large-sessile-colorectal-polyps
#10
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
#11
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
#12
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/28940106/en-bloc-endoscopic-mucosal-resection-is-equally-effective-for-sessile-serrated-polyps-and-conventional-adenomas
#13
Amol Agarwal, Sidyarth Garimall, Frank I Scott, Nuzhat A Ahmad, Michael L Kochman, Gregory G Ginsberg, Vinay Chandrasekhara
BACKGROUND: Sessile serrated polyps (SSPs) are associated with higher rates of incomplete resection compared to conventional adenomas after traditional snare polypectomy. Outcomes after endoscopic mucosal resection (EMR) are less established. The aim of this study was to evaluate the rate of residual neoplasia at surveillance colonoscopy for SSPs compared to conventional adenomas ≥ 10 mm after en bloc EMR. METHODS: Retrospective cohort study of consecutive patients referred for EMR of a colonic lesion ≥ 10 mm from 2005 to 2013...
September 22, 2017: Surgical Endoscopy
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
#14
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/28882577/assessing-colon-polypectomy-competency-and-its-association-with-established-quality-metrics
#15
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/28842055/standardisation-of-polypectomy-technique
#16
REVIEW
Alan Moss, Kumanan Nalankilli
There are several approaches to polypectomy for sessile polyps <20 mm and for pedunculated polyps. Recent evidence is leading towards standardisation of polypectomy technique. Key recent polypectomy developments include: 1. Use of cold snare polypectomy (CSP) for sessile polyps <10 mm; 2. Use of hot snare polypectomy (HSP) following submucosal injection for sessile polyps sized 10-19 mm; 3. Piecemeal cold snare polypectomy (PCSP), with or without prior submucosal injection, for select sessile polyps sized 10-19 mm, where the potential risk for an adverse event is increased (e...
August 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28815039/predicting-adr-from-pdr-and-individual-adenoma-to-polyp-detection-rate-ratio-for-screening-and-surveillance-colonoscopies-a-new-approach-to-quality-assessment
#17
C Schramm, I Scheller, J Franklin, M Demir, F Kuetting, D Nierhoff, T Goeser, U Toex, H M Steffen
BACKGROUND AND AIMS: Adenoma detection rate (ADR) has been established as a quality indicator for screening colonoscopy. Because ADR is cumbersome to obtain in routine practice, polyp detection rate (PDR), polypectomy rate (PR) and adenoma-to-polyp-detection-rate-ratio (APDRR) have been proposed to estimate ADR. This study aimed to evaluate APDRR in order to estimate ADR (ADRest) in different settings. METHODS: Average risk screening and surveillance colonoscopies from a community-based private practice and a tertiary academic hospital setting were retrospectively evaluated...
August 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28804754/use-of-the-full-thickness-resection-device-ftrd-to-prevent-bleeding-after-colonic-polypectomy-in-a-patient-with-a-left-ventricular-assist-device
#18
Richard F Knoop, Hans-Juergen Richer-Schrag, Robert Thimme, Andreas Fischer
Background and study aims  Treatment of colorectal polyps in patients undergoing permanent anticoagulation is associated with a significantly increased risk of peri-interventional bleeding. This specifically applies to polyps > 1 cm where endoscopic full-thickness resection (EFTR) with the full-thickness-resection device (FTRD) can be taken into consideration as an alternative approach to classical snare polypectomy. For these indications, EFTR appears to be superior to conventional techniques especially in terms of sufficient hemostasis due to the mechanical tissue compression achieved by the FTRD's integrated Over-The-Scope Clip (OTSC)...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28781966/obesity-increases-prevalence-of-colonic-adenomas-at-screening-colonoscopy-a-canadian-community-based-study
#19
Theodore F Shapero, Grant I Chen, Tim Devlin, Alison Gibbs, Iain C Murray, Stanley Tran, Corey Weigensberg
BACKGROUND AND AIMS: Obesity is a risk factor for colorectal neoplasia. We examined the influence of obesity and metabolic syndrome (MetS) on prevalence of neoplasia at screening colonoscopy. METHODS: We evaluated 2020 subjects undergoing first screening colonoscopy. Body mass index (BMI) was calculated at enrolment. Hyperlipidemia (HL), hypertension (HT), and diabetes mellitus (DM) were identified. Details of colonoscopy, polypectomy, and histology were recorded...
2017: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28744763/a-case-of-colonic-stenosis-caused-by-cold-snare-polypectomy-for-the-removal-of-a-colonic-polyp
#20
Naotaka Ogasawara, Masaaki Takayama, Satoshi Ono, Shunsuke Katoh, Hirohiko Komai, Yasutaka Hijikata, Masahide Ebi, Yasushi Funaki, Makoto Sasaki, Kunio Kasugai
A 78-year-old woman with hypertension had a positive fecal immunochemical test and underwent colonoscopy, which revealed a 4 mm sessile polyp (Paris type; 0-Is) in the transverse colon. Based on low magnification colonoscopy with narrow band imaging, the polyp was Type 2 according to the NBI International Colorectal Endoscopic classification, diagnosed as an adenoma, and then resected via cold snare polypectomy (CSP). Five days after CSP, she complained of right-sided abdominal pain. Abdominal CT showed focal wall thickening of the transverse colon and focal infiltration of tissues surrounding the transverse colon...
October 2017: Clinical Journal of Gastroenterology
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