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Review
Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art
Alessia Chini, Michele Manigrasso, Grazia Cantore, Rosa Maione, Marco Milone, Francesco Maione, Giovanni Domenico De Palma
Clin Endosc 2022;55(2):183-190.   Published online February 24, 2022
DOI: https://doi.org/10.5946/ce.2021.254
AbstractAbstract PDFPubReaderePub
Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential.

Citations

Citations to this article as recorded by  
  • Multi-view orientational attention network combining point-based affinity for polyp segmentation
    Yan Liu, Yan Yang, Yongquan Jiang, Zhuyang Xie
    Expert Systems with Applications.2024; 249: 123663.     CrossRef
  • The Influence of Mechanical Bowel Preparation on Volatile Organic Compounds for the Detection of Gastrointestinal Disease—A Systematic Review
    Ashwin Krishnamoorthy, Subashini Chandrapalan, Sofie Bosch, Ayman Bannaga, Nanne K.H. De Boer, Tim G.J. De Meij, Marcis Leja, George B. Hanna, Nicoletta De Vietro, Donato Altomare, Ramesh P. Arasaradnam
    Sensors.2023; 23(3): 1377.     CrossRef
  • The Detection of Colorectal Cancer through Machine Learning-Based Breath Sensor Analysis
    Inese Poļaka, Linda Mežmale, Linda Anarkulova, Elīna Kononova, Ilona Vilkoite, Viktors Veliks, Anna Marija Ļeščinska, Ilmārs Stonāns, Andrejs Pčolkins, Ivars Tolmanis, Gidi Shani, Hossam Haick, Jan Mitrovics, Johannes Glöckler, Boris Mizaikoff, Mārcis Lej
    Diagnostics.2023; 13(21): 3355.     CrossRef
  • 3,928 View
  • 238 Download
  • 4 Web of Science
  • 3 Crossref
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Original Articles
Artificial Intelligence-Based Colorectal Polyp Histology Prediction by Using Narrow-Band Image-Magnifying Colonoscopy
Istvan Racz, Andras Horvath, Noemi Kranitz, Gyongyi Kiss, Henriett Regoczi, Zoltan Horvath
Clin Endosc 2022;55(1):113-121.   Published online September 23, 2021
DOI: https://doi.org/10.5946/ce.2021.149
AbstractAbstract PDFPubReaderePub
Background
/Aims: We have been developing artificial intelligence based polyp histology prediction (AIPHP) method to classify Narrow Band Imaging (NBI) magnifying colonoscopy images to predict the hyperplastic or neoplastic histology of polyps. Our aim was to analyze the accuracy of AIPHP and narrow-band imaging international colorectal endoscopic (NICE) classification based histology predictions and also to compare the results of the two methods.
Methods
We studied 373 colorectal polyp samples taken by polypectomy from 279 patients. The documented NBI still images were analyzed by the AIPHP method and by the NICE classification parallel. The AIPHP software was created by machine learning method. The software measures five geometrical and color features on the endoscopic image.
Results
The accuracy of AIPHP was 86.6% (323/373) in total of polyps. We compared the AIPHP accuracy results for diminutive and non-diminutive polyps (82.1% vs. 92.2%; p=0.0032). The accuracy of the hyperplastic histology prediction was significantly better by NICE compared to AIPHP method both in the diminutive polyps (n=207) (95.2% vs. 82.1%) (p<0.001) and also in all evaluated polyps (n=373) (97.1% vs. 86.6%) (p<0.001)
Conclusions
Our artificial intelligence based polyp histology prediction software could predict histology with high accuracy only in the large size polyp subgroup.

Citations

Citations to this article as recorded by  
  • Colon polyps: updates in classification and management
    David Dornblaser, Sigird Young, Aasma Shaukat
    Current Opinion in Gastroenterology.2024; 40(1): 14.     CrossRef
  • Employing deep learning for predicting the thermal properties of water and nano-encapsulated phase change material
    Saihua Xu, Ali Basem, Hasan A Al-Asadi, Rishabh Chaturvedi, Gulrux Daminova, Yasser Fouad, Dheyaa J Jasim, Javid Alhoee
    International Journal of Low-Carbon Technologies.2024; 19: 1453.     CrossRef
  • Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
    Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
    Clinical Endoscopy.2023; 56(5): 553.     CrossRef
  • AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
  • Artificial Intelligence-Based Colorectal Polyp Histology Prediction: High Accuracy in Larger Polyps
    Naoki Muguruma, Tetsuji Takayama
    Clinical Endoscopy.2022; 55(1): 45.     CrossRef
  • Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Ji Young Chang
    Clinical Endoscopy.2022; 55(5): 699.     CrossRef
  • Response to Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Istvan Racz, Andras Horvath, Zoltán Horvath
    Clinical Endoscopy.2022; 55(5): 701.     CrossRef
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  • 7 Web of Science
  • 7 Crossref
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Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?
Ji Hyun Song, Shai Friedland
Clin Endosc 2021;54(3):397-403.   Published online February 9, 2021
DOI: https://doi.org/10.5946/ce.2020.226
AbstractAbstract PDFPubReaderePub
Background
/Aims: Cold snare polypectomy (CSP) is an effective method of polyp removal for small colorectal polyps. However, the effect of submucosal injection in cold snare endoscopic mucosal resection (CS-EMR) for small polyps is unclear. Therefore, this study aimed to evaluate the effect of submucosal injection in CS-EMR for small polyps.
Methods
Between 2018 and 2019, 100 consecutive small colorectal polyps (5–10 mm) were identified in 58 patients. The first 50 consecutive polyps were removed by CS-EMR, and the remaining 50 were removed by CSP. Demographic data, clinical data, endoscopic findings, procedure times, complication rates, and pathology data were collected.
Results
No difference in the complete resection rate was observed between the CS-EMR and CSP groups. A total of 9 polyps showed post-polypectomy bleeding (7 had immediate bleeding, 1 had delayed bleeding, and 1 had both immediate and delayed bleeding). No difference in the bleeding rate was observed between the two groups. In multivariate analysis, warfarin (odds ratio [OR], 42.334; 95% confidence interval [CI], 1.006–1,781.758) and direct-acting oral anticoagulants (OR, 35.244; 95% CI, 3.853–322.397) showed a significantly increased risk of bleeding.
Conclusions
The effect of submucosal injection in CSP was not significant for small colorectal polyps.

Citations

Citations to this article as recorded by  
  • Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis
    Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Colorectal cold snare polypectomy: Current standard technique and future perspectives
    Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Tetsuo Morishita
    Digestive Endoscopy.2023; 35(3): 278.     CrossRef
  • The efficacy and safety of cold snare polypectomy with submucosal injection for the removal of polyps less than 20 mm in size: a systematic review and meta‐analysis
    Zheng Liang, Yongqiu Wei, Shutian Zhang, Peng Li
    Journal of Gastroenterology and Hepatology.2023; 38(11): 1892.     CrossRef
  • Impact of Submucosal Saline Injection During Cold Snare Polypectomy for Colorectal Polyps Sized 3–9 mm: A Multicenter Randomized Controlled Trial
    Yi Mou, Liansong Ye, Xiaobo Qin, Rui Feng, Lifan Zhang, Qin Hu, Tingting Cao, Xinyue Zhou, Wu Wen, Chuanming Zhang, Zonghua Chen, Yi Liu, Zhimin Yang, Tao Huo, Fang Pan, Xuelian Li, Bing Hu
    American Journal of Gastroenterology.2023; 118(10): 1848.     CrossRef
  • Cold resection for colorectal polyps: where we are and where we are going?
    Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
    Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719.     CrossRef
  • Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis
    Mohamed Abdallah, Khalid Ahmed, Daniyal Abbas, Mouhand F. H. Mohamed, Gaurav Suryawanshi, Nicholas McDonald, Natalie Wilson, Shifa Umar, Aasma Shaukat, Mohammad Bilal
    Endoscopy.2023; 55(12): 1083.     CrossRef
  • Endoscopic treatment of colorectal polyps and early colorectal cancer
    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • 4,438 View
  • 167 Download
  • 8 Web of Science
  • 7 Crossref
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Review
Should We Resect and Discard Low Risk Diminutive Colon Polyps
Pujan Kandel, Michael B. Wallace
Clin Endosc 2019;52(3):239-246.   Published online January 21, 2019
DOI: https://doi.org/10.5946/ce.2018.136
AbstractAbstract PDFPubReaderePub
Diminutive colorectal polyps <5 mm are very common and almost universally benign. The current strategy of resection with histological confirmation of all colorectal polyps is costly and may increase the risk of colonoscopy. Accurate, optical diagnosis without histology can be achieved with currently available endoscopic technologies. The American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable endoscopic Innovations supports strategies for optical diagnosis of small non neoplastic polyps as long as two criteria are met. For hyperplastic appearing polyps <5 mm in recto-sigmoid colon, the negative predictive value should be at least 90%. For diminutive low grade adenomatous appearing polyps, a resect and discard strategy should be sufficiently accurate such that post-polypectomy surveillance recommendations based on the optical diagnosis, agree with a histologically diagnosis at least 90% of the time. Although the resect and discard as well as diagnose and leave behind approach has major benefits with regard to both safety and cost, it has yet to be used widely in practice. To fully implement such as strategy, there is a need for better-quality training, quality assurance, and patient acceptance. In the article, we will review the current state of the science on optical diagnose of colorectal polyps and its implications for colonoscopy practice.

Citations

Citations to this article as recorded by  
  • The role of artificial intelligence in colonoscopy
    Hyun Jae Kim, Nasim Parsa, Michael F. Byrne
    Seminars in Colon and Rectal Surgery.2024; 35(1): 101007.     CrossRef
  • Artificial intelligence for characterization of colorectal polyps: Prospective multicenter study
    Glenn De Lange, Victor Prouvost, Gabriel Rahmi, Geoffroy Vanbiervliet, Catherine Le Berre, Sahar Mack, Thibaud Koessler, Emmanuel Coron
    Endoscopy International Open.2024; 12(03): E413.     CrossRef
  • Ecogastroenterology: cultivating sustainable clinical excellence in an environmentally conscious landscape
    Kassem Sharif, Enrique Rodriguez de Santiago, Paula David, Arnon Afek, Ian M Gralnek, Shomron Ben-Horin, Adi Lahat
    The Lancet Gastroenterology & Hepatology.2024; 9(6): 550.     CrossRef
  • Rationalising the use of specimen pots following colorectal polypectomy: a small step towards greener endoscopy
    Karl King Yong, Yun He, Hoi Ching Annie Cheung, Ramya Sriskandarajah, William Jenkins, Robert Goldin, Sabina Beg
    Frontline Gastroenterology.2023; 14(4): 295.     CrossRef
  • Measurements, Algorithms, and Presentations of Reality: Framing Interactions with AI-Enabled Decision Support
    Niels van Berkel, Maura Bellio, Mikael B. Skov, Ann Blandford
    ACM Transactions on Computer-Human Interaction.2023; 30(2): 1.     CrossRef
  • Real-World Validation of a Computer-Aided Diagnosis System for Prediction of Polyp Histology in Colonoscopy: A Prospective Multicenter Study
    James Weiquan Li, Clement Chun Ho Wu, Jonathan Wei Jie Lee, Raymond Liang, Gwyneth Shook Ting Soon, Lai Mun Wang, Xuan Han Koh, Calvin Jianyi Koh, Wei Da Chew, Kenneth Weicong Lin, Mann Yie Thian, Ronnie Matthew, Guowei Kim, Christopher Jen Lock Khor, Kwo
    American Journal of Gastroenterology.2023; 118(8): 1353.     CrossRef
  • The Utility of Narrow-Band Imaging International Colorectal Endoscopic Classification in Predicting the Histologies of Diminutive Colorectal Polyps Using I-Scan Optical Enhancement: A Prospective Study
    Yeo Wool Kang, Jong Hoon Lee, Jong Yoon Lee
    Diagnostics.2023; 13(16): 2720.     CrossRef
  • Optical diagnosis of colorectal polyps using novel blue light imaging classification among trainee endoscopists
    Christopher Koehn, Douglas K. Rex, Jimmy Allen, Umer Bhatti, Indira Bhavsar‐Burke, Viveksandeep Thoguluva Chandrasekar, Abhishek Challa, Abhiram Duvvuri, Lara Dakhoul, John Ha, Nour Hamade, S. Bradley Hicks, Claire Jansson‐Knodell, Edward Krajicek, Shanke
    Digestive Endoscopy.2022; 34(1): 191.     CrossRef
  • Too Good to Be True? Evaluation of Colonoscopy Sensitivity Assumptions Used in Policy Models
    Carolyn M. Rutter, Pedro Nascimento de Lima, Jeffrey K. Lee, Jonathan Ozik
    Cancer Epidemiology, Biomarkers & Prevention.2022; 31(4): 775.     CrossRef
  • Non-optical polyp-based resect and discard strategy: A prospective clinical study
    Mahsa Taghiakbari, Celia Hammar, Mira Frenn, Roupen Djinbachian, Heiko Pohl, Erik Deslandres, Simon Bouchard, Mickael Bouin, Daniel von Renteln
    World Journal of Gastroenterology.2022; 28(19): 2137.     CrossRef
  • No-Code Platform-Based Deep-Learning Models for Prediction of Colorectal Polyp Histology from White-Light Endoscopy Images: Development and Performance Verification
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Seung In Seo, Young Joo Yang, Gwang Ho Baik, Jong Wook Kim
    Journal of Personalized Medicine.2022; 12(6): 963.     CrossRef
  • Artificial intelligence-assisted colonoscopy: a narrative review of current data and clinical applications
    JW Li, LM Wang, TL Ang
    Singapore Medical Journal.2022; 63(3): 118.     CrossRef
  • Impact of the Volume and Distribution of Training Datasets in the Development of Deep-Learning Models for the Diagnosis of Colorectal Polyps in Endoscopy Images
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Young Joo Yang, Gwang Ho Baik
    Journal of Personalized Medicine.2022; 12(9): 1361.     CrossRef
  • How to safely apply a 'Resect and Discard' policy for small colorectal polyps–real‐world data comparing endoscopic polyp evaluation and subsequent histological outcome
    Georgios Marinopoulos, Maja Kopczynska, Robert Clark, Nadeem Sarwar, Yeng Ang, Arash Assadsangabi
    GastroHep.2021; 3(1): 12.     CrossRef
  • Characterization of Optical Coherence Tomography Images for Colon Lesion Differentiation under Deep Learning
    Cristina L. Saratxaga, Jorge Bote, Juan F. Ortega-Morán, Artzai Picón, Elena Terradillos, Nagore Arbide del Río, Nagore Andraka, Estibaliz Garrote, Olga M. Conde
    Applied Sciences.2021; 11(7): 3119.     CrossRef
  • Clinical validation of the SIMPLE classification for optical diagnosis of colorectal polyps
    Ahmed Amine Alaoui, Kussil Oumedjbeur, Roupen Djinbachian, Étienne Marchand, Paola N. Marques, Mickael Bouin, Simon Bouchard, Daniel von Renteln
    Endoscopy International Open.2021; 09(05): E684.     CrossRef
  • Colonoscopy and artificial intelligence: Bridging the gap or a gap needing to be bridged?
    Tiing Leong Ang, James Weiquan Li
    Artificial Intelligence in Gastrointestinal Endoscopy.2021; 2(2): 36.     CrossRef
  • RNA-sequencing identification and validation of genes differentially expressed in high-risk adenoma, advanced colorectal cancer, and normal controls
    Namjoo Kim, Jeong-An Gim, Beom Jae Lee, Byung il Choi, Seung Bin Park, Hee Sook Yoon, Sang Hee Kang, Seung Han Kim, Moon Kyung Joo, Jong-Jae Park, Chungyeul Kim, Han-Kyeom Kim
    Functional & Integrative Genomics.2021; 21(3-4): 513.     CrossRef
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    Chang Seok Bang, Jae Jun Lee, Gwang Ho Baik
    Journal of Medical Internet Research.2021; 23(8): e29682.     CrossRef
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    Roger Fonollà, Quirine E.W. van der Zander, Ramon M. Schreuder, Sharmila Subramaniam, Pradeep Bhandari, Ad A.M. Masclee, Erik J. Schoon, Fons van der Sommen, Peter H.N. de With
    Artificial Intelligence in Medicine.2021; 121: 102178.     CrossRef
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    Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
    Clinical Endoscopy.2021; 54(5): 633.     CrossRef
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    Iness Soltani, Daniel von Renteln
    Current Treatment Options in Gastroenterology.2020; 18(2): 175.     CrossRef
  • Colon capsule endoscopy in colorectal cancer screening: a randomised controlled trial
    Lasse Kaalby, Ulrik Deding, Morten Kobaek-Larsen, Anne-Line Volden Havshoi, Erik Zimmermann-Nielsen, Marianne Kirstine Thygesen, Rasmus Kroijer, Thomas Bjørsum-Meyer, Gunnar Baatrup
    BMJ Open Gastroenterology.2020; 7(1): e000411.     CrossRef
  • A CNN CADx System for Multimodal Classification of Colorectal Polyps Combining WL, BLI, and LCI Modalities
    Roger Fonollà, Quirine E. W. van der Zander, Ramon M. Schreuder, Ad A. M. Masclee, Erik J. Schoon, Fons van der Sommen, Peter H. N. de With
    Applied Sciences.2020; 10(15): 5040.     CrossRef
  • UEG Week 2019 Poster Presentations

    United European Gastroenterology Journal.2019; 7(S8): 189.     CrossRef
  • 9,593 View
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  • 23 Web of Science
  • 25 Crossref
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Original Articles
Endoscopic Mucosal Resection with Circumferential Incision for the Treatment of Large Sessile Polyps and Laterally Spreading Tumors of the Colorectum
Young Mi Hong, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang
Clin Endosc 2015;48(1):52-58.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.52
AbstractAbstract PDFPubReaderePub
Background/Aims

Endoscopic mucosal resection (EMR) is the standard treatment for colorectal polyps such as adenomas and early cancers with no risk of lymph node metastasis. However, endoscopic resection of large colorectal polyps (≥20 mm diameter) is difficult to perform. We evaluated the clinical outcomes of EMR with circumferential incision (EMR-CI) for the resection of large sessile polyps (Is) and laterally spreading tumors (LSTs) in the colorectum.

Methods

Between February 2009 and March 2011, we resected 80 large colorectal polyps by EMR-CI. We retrospectively investigated the en bloc resection rate, histologic complete resection rate, recurrence rate, and complications.

Results

The median polyp size was approximately 25 mm (range, 20 to 50), and the morphologic types included Is (13 cases), LST-granular (37 cases), and LST-nongranular (30 cases). The en bloc and complete histologic resection rates were 66.3% and 45.0%, respectively. The recurrence rate was 0% (median follow-up duration, 23 months), and perforation occurred in five cases (6.3%).

Conclusions

EMR-CI is an effective treatment modality for 20 to 30 mm-sized colorectal polyps, and may be considered as a second line therapeutic option if ESD is difficult.

Citations

Citations to this article as recorded by  
  • Hybrid endoscopic submucosal dissection as a salvage option for difficult colorectal conventional endoscopic submucosal dissection
    Shin Morimoto, Hidenori Tanaka, Yudai Takehara, Noriko Yamamoto, Fumiaki Tanino, Yuki Kamigaichi, Ken Yamashita, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka
    Surgical Endoscopy.2024; 38(1): 222.     CrossRef
  • Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment
    Mahsa Taghiakbari, Dong Hyun Danny Kim, Roupen Djinbachian, Daniel von Renteln
    eGastroenterology.2024; 2(2): e100025.     CrossRef
  • Hybrid Endoscopic Resection With Endo-knife and Snare for Colorectal Lesions: A Systematic Review and Meta-analysis
    Shinji Yoshii, Takefumi Kikuchi, Yuki Hayashi, Masahiro Nojima, Hiro-o Yamano, Hiroshi Nakase
    Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 135.     CrossRef
  • Endoscopic Submucosal Dissection, Endoscopic Mucosal Resection, and Transanal Minimally Invasive Surgery for the Management of Rectal and Anorectal Lesions: A Narrative Review
    Pedro Moreira, Pedro Cardoso, Guilherme Macedo, João Santos-Antunes
    Journal of Clinical Medicine.2023; 12(14): 4777.     CrossRef
  • Indications and outcomes of colorectal hybrid endoscopic submucosal dissection: a large multicenter 10-year study
    Yuki Okamoto, Shiro Oka, Shinji Tanaka, Shinji Nagata, Masaki Kunihiro, Toshio Kuwai, Yuko Hiraga, Seiji Onogawa, Takeshi Mizumoto, Hideharu Okanobu, Morihisa Akagi, Kazuaki Chayama
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    Chang Kyo Oh, Young Wook Cho, In Hyoung Choi, Han Hee Lee, Chul‐Hyun Lim, Jin Su Kim, Bo‐In Lee, Young‐Seok Cho
    Journal of Gastroenterology and Hepatology.2022; 37(3): 568.     CrossRef
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    Massimo Conio, Raffaele Manta, Rosa Angela Filiberti, Todd H. Baron, Luigi Pasquale, Mario Marini, Antonella De Ceglie
    Gastrointestinal Endoscopy.2022; 96(5): 829.     CrossRef
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    Gijs Kemper, Ayla S. Turan, Erik J. Schoon, Ruud W. M. Schrauwen, Ludger S. M. Epping, Christian Gerges, Torsten Beyna, Horst Neuhaus, Ufuk Gündug, Peter D. Siersema, Erwin J. M. van Geenen
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    Endrit Shahini, Diogo Libânio, Giacomo Lo Secco, Antonio Pisani, Alberto Arezzo
    World Journal of Gastrointestinal Endoscopy.2021; 13(8): 275.     CrossRef
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    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
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    Koichi Okamoto, Naoki Muguruma, Kaizo Kagemoto, Yasuhiro Mitsui, Daisaku Fujimoto, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, Hiroshi Miyamoto, Tetsuji Takayama
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    Dong-Hoon Yang, Min-Seob Kwak, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Hyun Gun Kim, Shai Friedland
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    Antonella De Ceglie, Cesare Hassan, Benedetto Mangiavillano, Takahisa Matsuda, Yutaka Saito, Lorenzo Ridola, Pradeep Bhandari, Federica Boeri, Massimo Conio
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  • Should antibiotics be administered after endoscopic mucosalresection in patients with colon polyps?
    Zhimeng SHI, Hui QIU, Huangang LIU, Honggang YU
    TURKISH JOURNAL OF MEDICAL SCIENCES.2016; 46: 1486.     CrossRef
  • Endoscopic Approach for Superficial Colorectal Neoplasms
    Jun-feng Xu, Lang Yang, Peng Jin, Jian-qiu Sheng
    Gastrointestinal Tumors.2016; 3(2): 69.     CrossRef
  • Many Options to Manage Laterally Spreading Tumors
    Dong Kyung Chang
    Clinical Endoscopy.2015; 48(1): 4.     CrossRef
  • 9,712 View
  • 118 Download
  • 22 Web of Science
  • 18 Crossref
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Diagnostic Yield and Therapeutic Impact of Rectal Retroflexion: A Prospective, Single-Blind Study Conducted in Three Centers
Félix Téllez-Ávila, Josué Barahona-Garrido, Sandra García-Osogobio, Gustavo López-Arce, Jesús Camacho-Escobedo, Angela Saúl, Salvador Herrera-Gómez, Javier Elizondo-Rivera, Rafael Barreto-Zúñiga
Clin Endosc 2014;47(1):79-83.   Published online January 24, 2014
DOI: https://doi.org/10.5946/ce.2014.47.1.79
AbstractAbstract PDFPubReaderePub
Background/Aims

No clear data have been established and validated regarding whether rectal retroflexion has an important and therapeutic impact. The aim of the present study was to evaluate the diagnostic yield and therapeutic impact of rectal retroflexion compared with straight view examination.

Methods

A prospective single-blind study was conducted. Consecutive patients evaluated between October 2011 and April 2012 were included.

Results

A total of 934 patients (542 women, 58%) were included. The mean age was 57.4±14.8 years. Retroflexion was successful in 917 patients (98.2%). Distinct lesions in the anorectal area were detected in 32 patients (3.4%), of which 10 (1%) were identified only on retroflex view and 22 (2.4%) on both straight and retroflex views. Of the 32 identified lesions, 16 (50%) were polyps, nine (28.1%) were angiodysplasias, six (18.8%) were ulcers, and one (3.1%) was a flat lesion. All 10 patients (1%) in whom lesions were detected only by rectal retroflexion showed a therapeutic impact.

Conclusions

Rectal retroflexion has minimal diagnostic yield and therapeutic impact. However, its low rate of major complications and the possibility of detecting lesions undetectable by straight viewing justify its use.

Citations

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  • Consenso de endoscopia en enfermedad inflamatoria intestinal de la Organización Panamericana de Crohn y Colitis (PANCCO) y la Sociedad Interamericana de endoscopia (SIED)
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Focused Review Series: Optical Diagnosis and New Management Strategy of Colorectal Polyps
Introduction: What Are New Roles of Current Colonoscopy?
Hyung Wook Kim
Clin Endosc 2013;46(2):118-119.   Published online March 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.2.118
AbstractAbstract PDFPubReaderePub

The recent advances in endoscopic imaging technologies make great changes in the management of colorectal polyps. These changes include optical histologic diagnosis with high definition colonscopy, new management strategies such as resect and discard or do not resect, and differentiation of depth of submucosal invasion. In this focused review series, these new paradigms in management of colorectal polyps are discussed by three, world famous authors. First, Amit Rastogi explained optical diagnosis of small colorectal polyp with high definition colonoscopy using narrow band imaging. Second, Cesare Hassan explained new paradigms for colonoscopic management of diminutive colorectal polyps: resect and discard or do not resect. In the last, Shinji Tanaka described, in detail, endoscopic assessment of invasive colorectal cancer: slight vs. deep submucosal invasion. These focused review series introduce the new roles of current colonoscopy to readers and will help the readers to know how to use the new imaging technologies and paradigms in clinical practices.

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The Pathological Differences of Colorectal Polyps Examined between the Use of a Forcep Biopsy and Endoscopic Resection
In Do Song, M.D., Jeong Wook Kim, M.D. and In Soo Oh, M.D.
Korean J Gastrointest Endosc 2008;37(1):14-19.   Published online July 30, 2008
AbstractAbstract PDF
Background
/Aims: Complete excision of colorectal polyps is not always performed for various reasons. We investigated the discrepancy between the histologic findings of polyps excised by a forcep biopsy and histologic findings of polyps excised by endoscopic resection. Methods: We reviewed 137 patients with 206 colorectal polyps removed by endoscopic resection following forcep biopsies. Endoscopic records and pathological reports of patients were analyzed retrospectively. Results: The discrepancy of the histological type was 18.4% between the histologic findings of a polyp evaluated after a forceps biopsy and the histologic findings of a polyp evaluated after endoscopic resection. The discrepancy of high-grade dysplasia (HGD) and a cancerous condition was 22.3% using the two procedures. A total of 15.5% of adenomas without HGD and 3.0% of hyperplasia in the forcep biopsy specimens were identified as adenomas with HGD in the resected specimens. A total of 18.2% of adenomas with HGD and 4.1% of adenomas without HGD in the forcep biopsy specimens were identified as adenomas with carcinoma in the resected specimens. The discrepancy rates of the histological type for HGD and a cancerous condition were high for penduculated polyps with a diameter of less than 10 mm and for polyps with a diameter of greater than 16 mm. Conclusions: Approaches to review the histology of an entire colorectal polyp should be performed, especially for polyps with an adenomatous histology and for polyps of the pedunculated form with a diameter of less than 10 mm and a diameter of greater than 16 mm after a forcep biopsy. (Korean J Gastrointest Endosc 2008;37:14-19)
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