Prevention is better than cure: the challenges of prophylactic therapy for post-EMR bleeding

The sequence of events leading to the development of colorectal cancer, currently the third most common malignancy in Western countries, is effectively disrupted by the resection of its precursor lesions. Colonoscopy is the mainstay in lesion detection, and endoscopic polypectomy is the conventional therapeutic response for the overwhelming majority of identified polyps. Approximately 2% of lesions are larger (>20  mm) and are laterally spreading lesions (LSLs). EMR is considered the standard of care for the majority of these because it has been proved to be safer, less resource-intensive, and less expensive than surgery.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research

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CONCLUSION: Also in our experience adenomatous polyps play a crucial role in the development of colorectal cancer. Therefore, it seems quite essential to avert colorectal cancers gradually. Colonoscopy is a non-invasive method of diagnosis and a treatment of colorectal polyps. Proper and careful colonoscopy examination is indispensable in the discovery of colorectal polyps and subsequent follow-up. Timely and routine colonoscopy is considered as an important approach for thwarting the development of malignant neoplasms. KEY WORDS: Adenomatous polyps, Colorectal cancer, Colorectal polyps, Post-polypectomy. PMID: 309...
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
AbstractBackgroundColorectal cancer remains a considerable challenge in healthcare nowadays. Most patients ’ disease develops via the adenoma–carcinoma sequence; colonoscopy with polypectomy effectively reduces both mortality and incidence by removing precancerous adenomas. Previous studies showed that polypectomy without electrocautery (cold snaring polypectomy) is a safe and time-saving procedure t o manage polyps
Source: Trials - Category: Research Source Type: clinical trials
Endosc Int Open 2017; 05: E580-E586 DOI: 10.1055/s-0043-105491 Background and aim Removal of polyps during colonoscopy effectively prevents the development of colorectal cancer. So far, snare resection with high frequency current with or without prior submucosal saline injection is the method of choice. The aim of this study was to evaluate the feasibility, safety, and outcome of cold snare resection during routine endoscopy. Methods In this prospective study, 522 patients undergoing outpatient colonoscopy were included. Cold snare resection for diminutive ( 9 – 15 mm) was performed using a de...
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Post-polypectomy bleeding and incomplete polyp removal are important complication and quality concerns of colonoscopy for colon cancer prevention. We investigated endoscopic mucosal stripping (EMS) as a simple modification of traditional polypectomy techniques to reduce both concerns.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Monday – ASGE poster Source Type: research
Objective Endoscopic mucosal resection (EMR) is effective for large laterally spreading flat and sessile lesions (LSLs). Sessile serrated adenomas/polyps (SSA/Ps) are linked to the relative failure of colonoscopy to prevent proximal colorectal cancer. We aimed to examine the technical success, adverse events and recurrence following EMR for large SSA/Ps in comparison with large conventional adenomas. Design Over 74 months till August 2014, prospective multicentre data of LSLs ≥20 mm were analysed. A standardised dye-based conventional EMR technique followed by scheduled surveillance colonoscopy was used. Res...
Source: Gut - Category: Gastroenterology Authors: Tags: Endoscopy, Colon cancer Source Type: research
March is Colon Cancer Awareness Month, today’s TBT post provides some helpful information on colorectal cancer. Michelle was a healthy, active 47 year old. She tried to eat right and she exercised. It looked like the hard work was paying off: no health issues and lots of energy. Her work in the healthcare field motivated her to see her doctors regularly for checkups, to get mammograms and to have her blood work done annually. She knew she was getting close to the magical age of 50 and that soon she would need to get a colonoscopy to screen for colorectal cancer.  Since she had no family history of the disease sh...
Source: Disruptive Women in Health Care - Category: Consumer Health News Authors: Tags: Cancer TBT Source Type: blogs
Development and improvement of endoscopic techniques and devices have changed the treatment of colorectal tumors over the last decade. For the treatment of diminutive polyps, the cold snare technique of the West is becoming a promising treatment in the East because of its short procedure time and low rate of delayed bleeding by eliminating the delayed effect of electrocautery. Rather than using piecemeal endoscopic mucosal resection or surgical resection for the treatment of large superficial tumors, the technique of the East of endoscopic submucosal dissection (ESD) achieves a high success rate of en bloc R0 resection, en...
Source: Digestive Endoscopy - Category: Gastroenterology Authors: Tags: Review Source Type: research
The development and improvement of endoscopic techniques and devices have changed the treatment of colorectal tumors over the last decade. For the treatment of diminutive polyps, the cold snare technique from the West is becoming a promising treatment in the East as well because of short procedure times and a low rate of delayed bleeding by eliminating the delayed effect of electrocautery. For the treatment of large superficial tumors, instead of piecemeal endoscopic mucosal resection or surgical resection, endoscopic submucosal dissection (ESD) from the East, which achieves a high success rate of en bloc R0 resections ena...
Source: Digestive Endoscopy - Category: Gastroenterology Authors: Tags: Review Source Type: research
EndoscopyDOI: 10.1055/s-0034-1392774 Background and study aims: Colectomy protects against colorectal cancer in familial adenomatous polyposis (FAP); however, some patients with FAP refuse surgery. The aim of this study was to evaluate the feasibility and safety of endoscopic management of these patients. Patients and methods: A retrospective review of medical records was performed to identify adult patients with FAP who refused colectomy and were managed by repeated colonoscopies to remove numerous polyps between 2001 and 2012. Polyps were removed by hot snare polypectomy or endoscopic mucosal resection. Polyps of
Source: Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Small colonic polyps are commonly encountered at colonoscopy and are usually removed due to the risk of progression to colorectal cancer. Cold snare polypectomy is used to remove these lesions without diathermy. In essence, the polyp is transected by a snare, along with a rim of surrounding normal mucosa. This theoretically allows complete polyp removal without the potential complications of electrocautery, particularly delayed bleeding and perforation. However, the adequacy of cold snare polypectomy (in terms of completeness of resection) has not been studied in a real world setting.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstract Source Type: research
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