Screening and surveillance for colorectal neoplasia: uncertainties of colonoscopic management

2008 ◽  
Vol 118 (5) ◽  
pp. 302-306
Author(s):  
Joel S. Levine
Epigenomics ◽  
2020 ◽  
Author(s):  
Veroushka Ballester ◽  
William R Taylor ◽  
Seth W Slettedahl ◽  
Douglas W Mahoney ◽  
Tracy C Yab ◽  
...  

Aim: Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. Patients & methods: For LS discovery, we evaluated DNA from 53 colorectal case and control tissues using next generation sequencing. For validation, blinded methylation-specific PCR assays to the selected MDMs were performed on 197 cases and controls. Results: OPLAH was the most discriminant MDM with areas under the receiver operating characteristic curve ≥0.97 for colorectal neoplasia in LS and sporadic tissues. ALKBH5, was uniquely hypermethylated in LS neoplasms. Conclusion: Highly discriminant MDMs for colorectal neoplasia in LS were identified with potential use in screening and surveillance.


Nowa Medycyna ◽  
2018 ◽  
Vol 25 (3) ◽  
Author(s):  
Jacek Wadełek

Colonoscopy is a commonly performed procedure for the diagnosis and treatment of a wide range of conditions and symptoms, as well as for the screening and surveillance of colorectal neoplasia. Serious complications, such as bleeding and perforation, are reported in patients undergoing colonoscopy, especially during polypectomy. Bleeding is the most common complication of colonic polypectomy. It can occur immediately following polypectomy or be delayed from hours to up to days. Acute post-polypectomy haemorrhage is usually immediately apparent and amenable to endoscopic therapy. Nonendoscopic treatment modalities include angiographic embolization and surgery. Acute massive bleeding (internal bleeding/haemorrhage) into the lower gastrointestinal tract may cause hypovolaemia, which decreases cardiac output and tissue oxygen supply, which may require emergency surgery. Although colonic perforation is a rare complication, it is associated with a high rate of morbidity and mortality. This unpleasant complication could result in surgical intervention, stoma formation, intra-abdominal sepsis, prolonged hospital stay, and even death. An extra-intestinal structure identified during endoscopic examination is the most common clinical feature of colonic perforation. The management of patients with colonic perforation should be individualized based on patients’ clinical status and underlying diseases, the nature of perforation, and concomitant colorectal pathologies. Patients with both acute massive bleeding and lower gastrointestinal perforation may need emergency laparotomy, which requires perioperative cooperation of an endoscopist, a surgeon and an anaesthetist.


2012 ◽  
Vol 75 (4) ◽  
pp. AB344
Author(s):  
Ma Somsouk ◽  
Susie W. Ng ◽  
Rachel Kornfield ◽  
Kenneth R. McQuaid ◽  
Harry Lampiris ◽  
...  

2021 ◽  
Vol 09 (02) ◽  
pp. E263-E270
Author(s):  
Aasma Shaukat ◽  
Daniel Colucci ◽  
Lavi Erisson ◽  
Sloane Phillips ◽  
Jonathan Ng ◽  
...  

Abstract Background and study aims Detecting colorectal neoplasia is the goal of high-quality screening and surveillance colonoscopy, as reflected by high adenoma detection rate (ADR) and adenomas per colonoscopy (APC). The aim of our study was to evaluate the performance of a novel artificial intelligence (AI)-aided polyp detection device, Skout, with the primary endpoints of ADR and APC in routine colonoscopy. Patients and methods We compared ADR and APC in a cohort of outpatients undergoing routine high-resolution colonoscopy with and without the use of a real-time, AI-aided polyp detection device. Patients undergoing colonoscopy with Skout were enrolled in a single-arm, unblinded, prospective trial and the results were compared with a historical cohort. All resected polyps were examined histologically. Results Eighty-three patients undergoing screening and surveillance colonoscopy at an outpatient endoscopy center were enrolled and outcomes compared with 283 historical control patients. Overall, ADR with and without Skout was 54.2 % and 40.6 % respectively (P = 0.028) and 53.6 % and 30.8 %, respectively, in screening exams (P = 0.024). Overall, APC rate with and without Skout was 1.46 and 1.01, respectively, (P = 0.104) and 1.18 and 0.50, respectively, in screening exams (P = 0.002). Overall, true histology rate (THR) with and without Skout was 73.8 % and 78.4 %, respectively, (P = 0.463) and 75.0 % and 71.0 %, respectively, in screening exams (P = 0.731). Conclusion We have demonstrated that our novel AI-aided polyp detection device increased the ADR in a cohort of patients undergoing screening and surveillance colonoscopy without a significant concomitant increase in hyperplastic polyp resection. AI-aided colonoscopy has the potential for improving the outcomes of patients undergoing colonoscopy.


2001 ◽  
Vol 120 (5) ◽  
pp. A120-A121
Author(s):  
H STRUL ◽  
E BIRENBAUM ◽  
B STERN ◽  
D KAZANOV ◽  
L THEODOR ◽  
...  

2018 ◽  
Author(s):  
A Fábián ◽  
R Bor ◽  
Ö Szabó ◽  
M Rutka ◽  
B Vasas ◽  
...  

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
A Qasim ◽  
A Byrne ◽  
D Byrne ◽  
N Mahmud ◽  
C Muldoon ◽  
...  

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