What is the true effect of endoscopic full-thickness resection on early colorectal cancer?

We read with interest the article by Kuellmer et  al1 evaluating endoscopic full-thickness resection (EFTR) for early colorectal cancer. The authors found that EFTR for early colorectal cancer was feasible and safe. Because their findings are important to current practice, several questions deserve attention.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Letter to the Editor Source Type: research

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Patients with previous colorectal adenomas are at increased risk of colorectal cancer. Current guidelines for postpolypectomy surveillance intervals treat all tubular adenomas 1 to 9 mm in size with low-grade dysplasia as carrying the same level of risk. We evaluated whether 6 to 9 mm adenomas detected at colonoscopy are associated with greater risk of advanced neoplasia at follow-up compared with baseline 1 to 5 mm adenomas.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Source Type: research
In contrast to the adverse event (AE) risk of endoscopic resection (ER) of adenomas, the intra- and postprocedural AE risks of ER of T1 colorectal cancer (CRC) are scarcely reported in the literature. It is unclear whether ER of early CRCs, which grow into the submucosal layer and sometimes show incomplete lifting, is associated with an increased AE risk. We aimed to identify the AE rate after ER of T1 CRCs and to identify risk factors associated with these AEs.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Source Type: research
Dye-based pancolonic chromoendoscopy is recommended for colorectal cancer surveillance in patients with Lynch syndrome. However, there is scarce evidence to support its superiority to high-definition white-light endoscopy. We performed a prospective study assess whether in the hands of high detecting colonoscopists, high-definition, white-light endoscopy is non-inferior to pancolonic chromoendoscopy for detection of adenomas in patients with Lynch syndrome.
Source: Gastroenterology - Category: Gastroenterology Authors: Source Type: research
We examined the incidence of colorectal cancer (CRC) and advanced adenoma (AA) in patients with diverticulitis compared with subjects undergoing screening colonoscopy.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Source Type: research
Jarek Kobiela, Emilio Bertani, Wanda Petz, Cristiano Crosta, Giuseppe De Roberto, Simona Borin, Dario Ribero, Diana Baldassari, Piotr Spychalski, Giuseppe SpinoglioJournal of Minimal Access Surgery 2019 15(4):357-359In robotic right hemicolectomy for colorectal cancer (CRC), appropriate lymphadenectomy and anastomotic leak prevention are critical. Visualisation of lymph nodes and blood flow with near-infrared (NIR) fluorescence DaVinci® imaging system is a recent development. Herein, we present an improved robotic modified complete mesocolic excision (mCME) technique using indocyanine green (ICG) fluorescence. Before ...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Authors: Benson AB, Venook AP, Al-Hawary MM, Arain MA, Chen YJ, Ciombor KK, Cohen SA, Cooper HS, Deming DA, Garrido-Laguna I, Grem JL, Hoffe SE, Hubbard J, Hunt S, Kamel A, Kirilcuk N, Krishnamurthi S, Messersmith WA, Meyerhardt J, Miller ED, Mulcahy MF, Nurkin S, Overman MJ, Parikh A, Patel H, Pedersen KS, Saltz LB, Schneider C, Shibata D, Skibber JM, Sofocleous CT, Stoffel EM, Stotsky-Himelfarb E, Willett CG, Johnson-Chilla A, Gregory KM, Gurski LA Abstract Small bowel adenocarcinoma (SBA) is a rare malignancy of the gastrointestinal tract that has increased in incidence across recent years. Often diagnosed at an...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
AbstractBackgroundFew studies have compared the costs of colorectal endoscopic submucosal dissection (ESD) and endoscopic piecemeal mucosal resection (EPMR).AimsHere, we aimed to investigate the cost-effectiveness of these approaches by analyzing clinical outcomes and costs.MethodsData from patients undergoing colorectal ESD and EPMR were retrospectively reviewed. Clinical outcomes (procedure time, complete resection, and recurrence) were compared, and total direct costs (procedural and follow-up) were assessed.ResultsData from 429 ESD and 115 EPMR patients were included in the analysis. The complete resection rate was sig...
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
To the Editor Sarvepalli et al found that during colorectal cancer screening, most of the differences in adenoma detection rate between endoscopists disappeared when adjusting for patient and colonoscopy characteristics. Adenoma detection rate should have been the quality metric for programs of colorectal cancer screening long ago. This is not yet the case, despite colonoscopy having been endorsed in the United States as the preferred strategy for colorectal cancer screening as early as 2000. One team even published arbitrary and very different distributions of values from one report to another one. The steering committee ...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
This article provides information on assessment of the malignant potential of colorectal neoplasms. It takes a modern approach on the topic and integrates relevant information that aligns with the thinking process. The theory of thinking fast (reflex) and slow (rational) is used. By doing so, it is hoped that the learning process can be expedited and practiced immediately. The focus is on preresection assessment of nonpolypoid colorectal neoplasms. Assessment of polypoid, sessile-serrated adenoma/polyp, or inflammatory bowel disease dysplasia is briefly discussed. PMID: 31445686 [PubMed - in process]
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
Abstract Ineffective polypectomy technique may lead to incomplete polyp resection, high complication rates, interval colorectal cancer, and costly referral to surgery. Despite its central importance to endoscopy, training in polypectomy is not standardized nor has the most effective training approach been defined. Polypectomy competence is rarely reported and quality metrics for this skill are lacking. Use of tools and measurements to assess polypectomy outcomes is low. There is a need for standardization of training and remediation in polypectomy; defining standards of competent polypectomy and how it is feasibly...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
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