Finding and Removing Difficult Polyps (safely)
|
|
- Beverly McCoy
- 6 years ago
- Views:
Transcription
1 Finding and Removing Difficult Polyps (safely) David Lieberman MD Chief, Division of Gastroenterology and Hepatology Oregon Health and Science University
2 Colonoscopy Clouds Interval Cancers
3 Interval Cancer: What is the risk? After Polypectomy Incidence: % in 3-5 yrs cancers /1000 person yrs After (-) Colonoscopy 2-9% of ALL cancers (within 6-36 months) Pabby, GIE 2005; 61: Alberts; NEJM : Robertson; Gastroenterol 2005;129:34-41 Bertagnolli; NEJM 2006;355: Arber; NEJM 2006; 355: Baron; Gastroenterol 2006; 131: Lieberman; Gastroenterol 2007; 133: Cooper et al; Gastroenterol 2010: 138: S24 Singh, Am J Gastroenterol 28 Sept 2010 on line Baxter et al; Gastroenterol 2011; 140: 65-72
4 CRC risk reduction with colonoscopy Study n F/U CRC risk Notes Singh, 2006 Manitoba Bressler, 2007 Ontario Prevalent vs Incident CRC Lakoff, 2008 Ontario Baxter, 2009 Ontario Case-Control 35,975 (-) colonoscopy 5 SIR 0.55 ( ) Proximal CRC 28% of prevalent CRC 47% of interval CRC 12,427 CRC cases 3 Proximal CRC 32% of prevalent CRC 55% of interval CRC Less protection or No protection in Proximal Colon 110,402 (-) CSP 14 RR 0.25 ( ) 10,292 CRC cases Mortality OR =0.69 ( ) Proximal CRC No reduction in risk until year #8 of f/u Proximal CRC OR=0.99 Distal CRC OR=0.33 ( ) Brenner, 2011 Germany Case-Control 1688 CRC cases 10 OR (all) 0.23 Proximal CRC OR=0.44 Distal CRC OR 0.16 Singh;JAMA 2006;295: Bressler; Gastroenterol 2007; 132: Lakoff; ClinGastro Hep 2008;6: Baxter;Ann Intern Med 2009; 150:1-8 Brenner Ann Intern Med 2011; 154:22-30
5 Interval Cancer: WHY? New, fast growing lesions Sawhney et al; Gastroenterology 2006; 131: Incomplete removal (19-27%) Pabby et al; Gastrointest Endosc 2005; 61: Soetikno;JAMA 2008; 299: Farrar; CGH 2006; 4:
6 Interval Cancer: WHY? New, fast growing lesions Incomplete removal (19-27%) Missed lesions 2-12% of polyps > 1cm are missed!! Less protection in proximal colon
7 Robertson, Lieberman, Winawer; DDW 2008 Interval Cancer NCI Pooling Project 58 Interval Cancers
8 Finding Polyps
9 Rex; CGH 2010; 8: Improving Detection: Looking behind folds Looking behind folds Recent Literature Result 3 rd eye 11% gain Retroflexion colonoscopy Omni-vision Cap-assisted Hewitt; DDW 2010 Transparent retractable extension device Horiuchi; CGH 2010; 8: degree view 31% increase in ADR Most < 5mm
10 Hewitt; DDW 2010 Improving Polyp Detection: Cap-fitted Colonoscopy n Adenoma(s) Miss rate >6mm Cap-Fitted (66%) No Dif 23% Regular (68%) 35% Miss rate <5mm Courtesy of Dr. Hewitt
11 Rex; CGH 2010; 8: Innovations in colonoscopy: Detecting more polyps Finding more polyps High-Definition White light (HDWL) Recent Literature Buchner; CGH 2010;8:364 Result Slightly higher ADR
12 Rex; CGH 2010; 8: Innovations in colonoscopy: Detecting more polyps Finding more polyps Recent Literature Result NBI Horiuchi; CGH 2010; 8:379 No significant ADR increase 6 RCT s: 5 negative
13 Rex; CGH 2010; 8: Innovations in colonoscopy: Detecting more polyps Finding more polyps Recent Literature Result Autofluorescence DDW 2010 Mixed Results FICE ( Fuji intelligent chromoendoscopy) Pohl; GUT 2009; 58: 73 (-) study
14 Leggett and Whitehall; Gastro 2010;138: Serrated Polyps Proximal Pathway may account for up to 20% of CRC Genetic pathways are partially characterized Normal function: Induces senesence CpG island Methylation: Silence MLH1 Sessile Serrated Polyp
15 Lambert et al; GIE 2009; 70: Sessile Serrated Lesion
16 Rex; CGH 2010; 8: Innovations in colonoscopy: Finding more polyps High-Definition White light (HDWL) Result Adenoma detection rate (ADR) Slightly improved ADR NBI 6 RCTs: 5 (-) Chromoendoscopy FICE (Fuji intelligent chromo endoscopy) Autofluorescence I-Scan (digital chromoendoscopy) Technique may trump gadgets Increase small polyp detection (-) Mixed results?? GI FELLOW ++ VIDEO ++
17 Removing Polyps Completely
18 Robertson, Lieberman, Winawer; DDW 2008 Interval Cancer NCI Pooling Project 58 Interval Cancers
19 Rex; CGH 2010; 8: Innovations in colonoscopy: Polyp Assessment Finding more polyps Recent Literature Result Chromoendoscopy Rex, 2006 Soetikno, ) Increase small polyp detection 2) Improve polyp assessment
20 Incomplete Polyp Removal
21 Incomplete Polyp Removal??
22 Serrated Polyp Huang;Am J Gastro 2011;106:
23 Soetikno, JAMA 2008 Incomplete Polyp Removal Indigo-carmine Lessons: 1. Fully characterize the lesion 2. Not all polyps should be removed
24 Removing Polyps.Safely
25 Ko et al;abstract 2007; paper submitted Adverse events within 30 days of colonoscopy CORI Practice Sites (n = 18) 18, 271 patients with 30d f/u GI Bleed 1.53 Perforation 0.16 Other GI 0.38 Potentially related non-gi Angina/MI 0.66 Stroke/TIA 0.48 ALL Serious Events 3.34 Events/1000 procedures
26 Colonoscopy: Serious Adverse Events /1000 Setting Year n Bleed Perforation Other* Medicare; Claims data 30d f/u Community; Prospective Screening/Surv; 30d f/u ,220* CV events with 7.0/1000 polypectomy , /1000 Warren et al; Ann Intern Med 2009; 150: Ko, Lieberman; Clin Gastro Hep; 2010; 8:
27 Ko et al;abstract 2007; paper submitted Adverse events within 30 days of Risk Factors colonoscopy 18, 271 patients with 30d f/u Risk Factor Polypectomy with cautery > 1 polypectomy with cautery OR (95% CI) 2.31 (1.20,4.44) 3.99 (2.10,7.57) Pre-procedure warfarin 3.45 (1.66,7.22) Pre-procedure clopidogrel use 3.08 (1.10,8.67) Biopsy without cautery 0.30 (0.07,1.26) Polypectomy without cautery 1.37 (0.41,4.59)
28 Lessons 1. Older patients carefully balance risk and benefit 2. Anti-coagulation and clopidogrel are risk factors 3. Snare without cautery: LOWER RISK
29 Minimizing Harms of Colonoscopy: Orientation Polypectomy making it easier Torque to optimal position
30 Endoscopic Mucosal Resection (EMR) Standard Inject and Cut EMR (Saline assisted polypectomy) Soetikno et al. GIE 2003
31 Minimizing Harms of Colonoscopy: Be Prepared Bleeding : #1 GI complication of polypectomy Thick Stalk: consider epinephrine injection Have toys ready: Clips Loops Injection
32 Minimizing Harms of Colonoscopy Not all polyps should be removed Assess likelihood of incomplete removal Large, flat, carpeting polyps Non-lift with saline injection Possibly higher risk: Large cecal lesions
33 Minimizing Harms of Colonoscopy An incomplete colon is NOT always a failure Cecum
34 How can we improve colonoscopy?
35 Improving Colonoscopy Find important pathology Prep Meticulous withdrawal technique Assess important pathology Chromo-endoscopy for flat lesions Remove important pathology Prevent interval cancer Safely
Carol A. Burke, MD, FACG
Updated Guidelines for CRC C Screening and Surveillance Carol A. Burke MD, FACG, FASGE, FACP Cleveland Clinic, Cleveland, OH Gastroenterology t 2012;143:844 143 Gut 2010;59:666 1 Caveat for all Recommendations
More informationColorectal Cancer Screening: Colonoscopy, Potential and Pitfalls. Disclosures: None. CRC: still a major public health problem
Colorectal Cancer Screening: Colonoscopy, Potential and Pitfalls Disclosures: None Jonathan P. Terdiman, M.D. Professor of Clinical Medicine University of California, San Francisco CRC: still a major public
More informationBenchmarking For Colonoscopy. Technology and Technique to Improve Adenoma Detection
Benchmarking For Colonoscopy Technology and Technique to Improve Adenoma Detection Objectives 1. Review the latest data on performance characteristics and efficacy for colon cancer prevention 2. Highlight
More informationImproving you ADR. Robert Enns Colonoscopy Education Day October 2018
Improving you ADR Robert Enns Colonoscopy Education Day October 2018 ADR Applying to CSP Assume 50% ADR in FIT positive patients Out of 40 patients only 20 will have polyps Out of 20 likely 15 will be
More informationImproving Your Adenoma Detection Rate
Improving Your Adenoma Detection Rate JILL TINMOUTH, ASSOCIATE PROFESSOR, UNIVERSITY OF TORONTO JERRY MCGRATH, ASSOCIATE PROFESSOR, MEMORIAL UNIVERSITY OF NEWFOUNDLAND FEB. 11 2017 X CanMEDS Roles Covered
More informationDifficult Polypectomy 2015 Tool of the Trade
Difficult Polypectomy 2015 Tool of the Trade Jonathan Cohen, MD FACG FASGE Clinical Professor of Medicine NYU Langone School of Medicine Improving Therapeutics in the Colon Improved detection of polyp
More informationColon Polyps: Detection, Inspection and Characteristics
Colon Polyps: Detection, Inspection and Characteristics Stephen Kim, M.D. Assistant Professor of Medicine Interventional Endoscopy Services UCLA Division of Digestive Diseases September 29, 2018 1 Disclosures
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Aberrant crypt foci, chromocolonoscopy for, 539 540 Absorptive stains, for chromocolonoscopy, 522 524 Accessories, for colonoscopy, 680 684
More informationRetroflexion and prevention of right-sided colon cancer following colonoscopy: How I approach it
Retroflexion and prevention of right-sided colon cancer following colonoscopy: How I approach it Douglas K Rex 1 MD, MACG 1. Indiana University School of Medicine Division of Gastroenterology/Hepatology
More informationImproving the Adenoma Detection Rate. ADR is a (the) priority quality indicator
Improving the Adenoma Detection Rate Douglas K. Rex, MD, MACG Indiana University School of Medicine Indianapolis, IN ADR is a (the) priority quality indicator Endorsed Adenoma Detection Rate Cecal intubation
More informationQuality indicators for colonoscopy and colonoscopist. Mirjana Kalauz Clinical Hospital Center Zagreb
Quality indicators for colonoscopy and colonoscopist Mirjana Kalauz Clinical Hospital Center Zagreb Why is quality monitoring important in CRC screening programme? Quality adjustment in all endoscopic
More informationTechnology and Interventions to Improve ADR
Technology and Interventions to Improve ADR Aasma Shaukat, MD MPH, FACG GI Section Chief, Minneapolis VAMC Associate Professor, University of Minnesota Outline Why is quality important? Fundamentals of
More informationRectal EMR: Techniques and Tips
Rectal EMR: Techniques and Tips Dr Paul Urquhart Epworth Eastern Eastern Health (Head of Endoscopy) The context of EMR Basic Technique Recurrence Perforation Bleeding Introduction 1 I don t treat rectal
More informationProf Rupert Leong, Director of Endoscopy, Head of IBD Professor of Medicine UNSW, University of Sydney, Concord Hospital Australia IBDSydney
10:30-10:50 25 Sept 2017 Monday A-PSDE / WEO Colorectal Cancer Screening Committee (CRCSC) Meeting Room S228 (2/F) Prof Rupert Leong, Director of Endoscopy, Head of IBD Professor of Medicine UNSW, University
More informationColorectal Cancer Screening and Surveillance
1 Colorectal Cancer Screening and Surveillance Jeffrey Lee MD, MAS Assistant Clinical Professor of Medicine University of California, San Francisco jeff.lee@ucsf.edu Objectives Review the various colorectal
More informationPredict, Resect and discard : Yes we can! (at least in some hands)
Diminutive polyps : Real time endoscopic histology Predict, Resect and discard : Yes we can! (at least in some hands) Robert Benamouzig Hôpital Avicenne AP-HP & Paris 13 University France Why it is important?
More informationTips to Improve ADRs during Colonoscopy
Tips to Improve ADRs during Colonoscopy Aasma Shaukat, MD, MPH, FACG GI Section Chief, Minneapolis VAMC Associate Professor, University of Minnesota Outline Why is quality important? Fundamentals of high-quality
More informationPost-colonoscopy colorectal cancers in Lynch syndrome
Post-colonoscopy colorectal cancers in Lynch syndrome Francesc Balaguer, MD PhD High Risk Colorectal Cancer Clinic Head of the Gastroenterology Department Hospital Clínic de Barcelona fprunes@clinic.cat
More informationThe Natural History of Right-Sided Lesions
The Natural History of Right-Sided Lesions Jasper L.A. Vleugels Dept of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands. None Disclosures Agenda Is there evidence that
More informationDevices To Improve Colon Polyp Detection
Devices To Improve Colon Polyp Detection ACG/VGS Regional Postgraduate Course Sep 10-11, 2016 Williamsburg, VA VIVEK KAUL, MD, FACG Segal-Watson Professor of Medicine Chief, Division of Gastroenterology
More informationQuality in Endoscopy and Cost Effective Practice
Quality in Endoscopy and Cost Effective Practice Sunanda Kane, MD MSPH FACG Director, ACG Quality Council 1 What is Quality and/or Cost Effectiveness in an Endoscopic Practice? Value Equation Quality (Outcomes,
More informationDouglas K. Rex, MD Indiana University Hospital Indianapolis, IN
Serrated Adenomas: What do they mean and what to do about them? Douglas K. Rex, MD Indiana University Hospital Indianapolis, IN Colorectal Cancer Molecular Basis Pathway Frequency Genes MSI Precursor Speed
More informationAdvanced Imaging and the Colon- Which Technology Should I Adopt?
Advanced Imaging and the Colon- Which Technology Should I Adopt? Michael B Wallace MD, MPH, FACG Mayo Clinic Florida Learning Objectives Identify imaging and education methods to increased adenoma detection
More informationCOLON: Innovations 3 steps, 3 parts..
COLON: Innovations 3 steps, 3 parts.. Detection: I see an abnormality (usually a polyp) Characterization: Is this abnormality neoplastic? (for example: an adenoma) Treatment: it is neoplastic. Can I treat
More informationInterval Cancers: What is Next?
Interval Cancers: What is Next? Douglas Corley, MD, PhD Kaiser Permanente, Northern California Gastroenterologist, TPMG Director of Delivery Science & Applied Research Defining the mission Mercury project:
More informationMissed Lesions at Endoscopy. Dr Russell Walmsley, MD, FRCP, FRACP Gastroenterologist WDHB Chair Endoscopy Guidance Group for New Zealand
Missed Lesions at Endoscopy Dr Russell Walmsley, MD, FRCP, FRACP Gastroenterologist WDHB Chair Endoscopy Guidance Group for New Zealand Missed Lesions at Endoscopy Is there a problem? With Gastroscopy
More informationColorectal Cancer Screening: A Clinical Update
11:05 11:45am Colorectal Cancer Screening: A Clinical Update SPEAKER Kevin A. Ghassemi, MD Presenter Disclosure Information The following relationships exist related to this presentation: Kevin A. Ghassemi,
More informationWEO CRC SC Meeting. Barcelona, Spain October 23, 2015
WEO CRC SC Meeting Barcelona, Spain October 23, 2015 Identification of serrated polyposis syndrome in the context of population-based CRC screening programs Evelien Dekker Academic Medical Center Amsterdam,
More informationPerformance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative
Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative Name: Institution: Michal F. Kaminski, MD, PhD Dept. of
More informationHow to characterize dysplastic lesions in IBD?
How to characterize dysplastic lesions in IBD? Name: Institution: Helmut Neumann, MD, PhD, FASGE University Medical Center Mainz What do we know? Patients with IBD carry an increased risk of developing
More informationHow to Screen a patient with a Family History of Adenoma(s)
How to Screen a patient with a Family History of Adenoma(s) CDDW Banff 3-5-17 David Lieberman MD Chief, Division of Gastroenterology and Hepatology Oregon Health and Science University Disclosures 2016
More informationPerformance targets for lesion detection in surveillance
Performance targets for lesion detection in surveillance WEO CRC Meeting 2018, Washington DC Uri Ladabaum, M.D., M.S. Professor of Medicine; Director, GI Cancer Prevention Division of Gastroenterology
More informationSurveying the Colon; Polyps and Advances in Polypectomy
Surveying the Colon; Polyps and Advances in Polypectomy Educational Objectives Identify classifications of polyps Describe several types of polyps Verbalize rationale for polypectomy Identify risk factors
More informationGIQIC18 Appropriate follow-up interval of not less than 5 years for colonoscopies with findings of 1-2 tubular adenomas < 10 mm
GI Quality Improvement Consortium, Ltd. (GIQuIC) 1 Following is an overview of the clinical quality measures in GIQuIC that can be reported to CMS for the Quality performance category of the Merit-Based
More informationOptimal Colonoscopy Surveillance Interval after Polypectomy
REVIEW Clin Endosc 2016;49:359-363 http://dx.doi.org/10.5946/ce.2016.080 Print ISSN 2234-2400 On-line ISSN 2234-2443 Open Access Optimal Colonoscopy Surveillance Interval after Polypectomy Tae Oh Kim Department
More information2. Describe pros/cons of screening interventions (including colonoscopy, CT colography, fecal tests)
Learning Objectives 1. Review principles of colon adenoma/cancer biology that permit successful prevention regimes 2. Describe pros/cons of screening interventions (including colonoscopy, CT colography,
More informationWhen is a programmed follow-up meaningful and how should it be done? Professor Alastair Watson University of Liverpool
When is a programmed follow-up meaningful and how should it be done? Professor Alastair Watson University of Liverpool Adenomas/Carcinoma Sequence Providing Time for Screening Normal 5-20 yrs 5-15 yrs
More informationQuality in Endoscopy: Can We Do Better?
Quality in Endoscopy: Can We Do Better? Erik Rahimi, MD Assistant Professor Division of Gastroenterology, Hepatology, and Nutrition UT Health Science Center at Houston McGovern Medical School Ertan Digestive
More informationDysplasia 4/19/2017. How do I practice Chromoendoscopy for Surveillance of Colitis? SCENIC: Polypoid Dysplasia in UC. Background
SCENIC: Polypoid in UC Definition How do I practice for Surveillance of Colitis? Themos Dassopoulos, M.D. Director, BSW Center for IBD Themistocles.Dassopoulos@BSWHealth.org Tel: 469-800-7189 Cell: 314-686-2623
More informationSupporting Information 2. ESGE QIC Lower GI Delphi voting process: Round 1 Working Group chair: Michal F. Kaminski, Poland
Supporting Information 2. ESGE QIC Lower GI Delphi voting process: Round 1 Working chair: Michal F. Kaminski, Poland Population Interventions Comparator Outcome Additional evidence 1.1 Rate of adequate
More informationCircumstances in which colonoscopy misses cancer
1 Department of Medicine, University of Toronto, Toronto, Canada 2 Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada 3 The Dalla Lana School of Public Health,
More informationChromoendoscopy and Endomicroscopy for detecting colonic dysplasia
Chromoendoscopy and Endomicroscopy for detecting colonic dysplasia Ralf Kiesslich I. Medical Department Johannes Gutenberg University Mainz, Germany Cumulative cancer risk in ulcerative colitis 0.5-1.0%
More informationTitle Description Type / Priority
Merit-based Incentive Payment system (MIPS) 2019 Qualified Clinical Data Registry (QCDR) Measure Specifications Summary Listing of QCDR measures supported by the NHCR Measure # NHCR4 NHCR5 GIQIC12 GIQIC15
More informationEndoscopic Submucosal Dissection ESD
Endoscopic Submucosal Dissection ESD Peter Draganov MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Florida Gastrointestinal Cancer Lesion that Can be Treated
More informationClinical Roundtable Monograph
Clinical Roundtable Monograph Gastroenterology & Hepatology August 2018 Incomplete Resection Rates in Polyps Smaller Than 2 Centimeters Proceedings From a Live Clinical Roundtable Held During Digestive
More informationThe Importance of Complete Colonoscopy and Exploration of the Cecal Region
The Importance of Complete Colonoscopy and Exploration of the Cecal Region Kuangi Fu, Takahiro Fujii, Takahisa Matsuda, and Yutaka Saito 2 2.1 The Importance of a Complete Colonoscopy Ever since case-control
More informationDescription. Section: Medicine Effective Date: July 15, Subsection: Original Policy Date: September 13, 2012 Subject: Page: 1 of 17
Page: 1 of 17 Last Review Status/Date: June 2016 Description Chromoendoscopy refers to the application of dyes or stains during endoscopy to enhance tissue differentiation or characterization. When used
More informationQuality Measures In Colonoscopy: Why Should I Care?
Quality Measures In Colonoscopy: Why Should I Care? David Greenwald, MD, FASGE Professor of Clinical Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx, New York ACG/ASGE Best
More informationChromoendoscopy or Narrow Band Imaging with Targeted biopsies Should be the Cancer Surveillance Endoscopy Procedure of Choice in Ulcerative Colitis
Chromoendoscopy or Narrow Band Imaging with Targeted biopsies Should be the Cancer Surveillance Endoscopy Procedure of Choice in Ulcerative Colitis Bret A. Lashner, M.D. Professor of Medicine Director,
More information2015 Winter School 대장종양성병변의진단과치료. Dong Kyung Chang. Sungkyunkwan University, School of Medicine Samsung Medical Center
2017 gastroenterology Winter School 77 2015 Winter School 대장종양성병변의진단과치료 Dong Kyung Chang Sungkyunkwan University, School of Medicine Samsung Medical Center Colon Polyps (Epithelial origin) Neoplastic Premalignant
More informationAlberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background... 3 Terms, Definitions
More informationAdvanced techniques for resection of large polyps. John G. Lee, MD February 2, 2018
Advanced techniques for resection of large polyps John G. Lee, MD February 2, 2018 Background 1cm - large polyp on screening 2cm - large for polypectomy 3cm giant polyp 10-15% of polyps can t be removed
More informationFEP Medical Policy Manual
FEP Medical Policy Manual Effective Date: April 15, 2018 Related Policies: 2.01.87 Confocal Laser Endomicroscopy 6.01.32 Virtual Colonoscopy/CT Colonography Chromoendoscopy as an Adjunct to Colonoscopy
More informationColorectal Cancer Screening: Cost-Effectiveness and Adverse events October, 2005
Colorectal Cancer Screening: Cost-Effectiveness and Adverse events October, 2005 David Lieberman MD Chief, Division of Gastroenterology Oregon Health and Science University Portland VAMC Portland, Oregon
More informationIncidence and Management of Hemorrhage after Endoscopic Removal of Colorectal Lesions
Showa Univ J Med Sci 12(3), 253-258, September 2000 Original Incidence and Management of Hemorrhage after Endoscopic Removal of Colorectal Lesions Masaaki MATSUKAWA, Mototsugu FUJIMORI, Takahiko KOUDA,
More informationDiagnostic and Therapeutic Approaches to Dysplasia in Inflammatory Bowel Diseases
Diagnostic and Therapeutic Approaches to Dysplasia in Inflammatory Bowel Diseases Parakkal Deepak, M.B.B.S., M.S. Assistant Professor of Medicine Division of Gastroenterology John T. Milliken Department
More informationA survey of colonoscopic polypectomy practice amongst Israeli gastroenterologists
Original article Annals of Gastroenterology (2013) 26, 1-6 A survey of colonoscopic polypectomy practice amongst Israeli gastroenterologists Dan Carter a, Marc Beer-Gabel a, Andrew Zbar b, Benjamin Avidan
More informationExperience and challenges of implementing optical diagnosis into clinical practice UK and European Perspective
Experience and challenges of implementing optical diagnosis into clinical practice UK and European Perspective WEO Image Enhanced Endoscopy San Diego, USA Dr James East Consultant Gastroenterologist Honorary
More informationDo any benign polyps require an operation?
Do any benign polyps require an operation? Kevin Waschke MD.,CM., FRCPC, FASGE McGill University Health Center President Elect Canadian Association of Gastroenterology Colonoscopy Education Day - Tuesday
More informationRisk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy
Gut and Liver, Vol. 9, No. 1, January 2015, pp. 66-72 ORiginal Article Risk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young
More informationSpartan Medical Research Journal
Spartan Medical Research Journal Research at Michigan State University College of Osteopathic Medicine Volume 2 Number 2 Winter, 2017 Pages 14-21 Title: Endoscopic Combined Snare-Forceps Technique for
More informationEXPERT WORKING GROUP Surveillance after neoplasia removal. Meeting Chicago, May 5th 2017 Chair: Rodrigo Jover Uri Ladabaum
EXPERT WORKING GROUP Surveillance after neoplasia removal Meeting Chicago, May 5th 2017 Chair: Rodrigo Jover Uri Ladabaum AIM To improve the quality of the evidences we have regarding post- polypectomy
More informationPage 1 of 8 Performing your original search, incomplete polyp resection during colonoscopy, meta analysis, in PMC will retrieve 161 records. Gut Liver. 2015 Jan; 9(1): 66 72. Published online 2015 Jan
More informationScreening for Colorectal Cancer in the Elderly. The Broad Perspective
Screening for Colorectal Cancer in the Elderly Charles J. Kahi, MD, MSCR Indiana University School of Medicine Richard L. Roudebush VA Medical Center Indianapolis, Indiana ACG Regional Midwest Course Symposium
More informationChromoendoscopy as an Adjunct to Colonoscopy
Chromoendoscopy as an Adjunct to Colonoscopy Policy Number: 2.01.84 Last Review: 1/2018 Origination: 7/2017 Next Review: 7/2018 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will not provide
More informationHamideh Salimzadeh, PhD Assistant Professor, Digestive Diseases Research Center,Tehran University of Medical Sciences, Shariati Hospital, North
Hamideh Salimzadeh, PhD Assistant Professor, Digestive Diseases Research Center,Tehran University of Medical Sciences, Shariati Hospital, North Kargar Avenue 14666 Tehran, Iran. Tel: +98-21-82415415 Fax:
More informationColon Cancer Screening Trends. U.S. Cancer Stastistics 2010
ACG Annual Meeting Emily Couric Memorial Lecture Colon Cancer Screening Evolution to Eradication David A. Johnson MD FACG Professor of Medicine Chief of Gastroenterology Eastern VA Medical School Norfolk
More informationBENEFIT APPLICATION BLUE CARD/NATIONAL ACCOUNT ISSUES
Medical Policy BCBSA Ref. Policy: 2.01.84 Last Review: 11/15/2018 Effective Date: 11/15/2018 Section: Medicine Related Policies 2.01.87 Confocal Laser Endomicroscopy 6.01.32 Virtual Colonoscopy/Computed
More informationDigestive Health Southwest Endoscopy 2016 Quality Report
Digestive Health 2016 Quality Report Our 2016 our quality and value management program focused on one primary area of interest: Performing high quality colonoscopy High quality Colonoscopy We selected
More informationAdvances in diagnostic and therapeutic colonoscopy
REVIEW C URRENT OPINION Advances in diagnostic and therapeutic colonoscopy Victoria Gómez and Michael B. Wallace Purpose of review We review current studies on endoscopic and technologic advances for the
More informationChromoendoscopy - Should It Be Standard of Care in IBD?
Chromoendoscopy - Should It Be Standard of Care in IBD? John F. Valentine, MD, FACG Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Utah What is the point of
More informationResearch Article Endoscopic Management of Nonlifting Colon Polyps
Diagnostic and Therapeutic Endoscopy Volume 2013, Article ID 412936, 5 pages http://dx.doi.org/10.1155/2013/412936 Research Article Endoscopic Management of Nonlifting Colon Polyps Shai Friedland, 1,2
More informationGuidelines for Colonoscopy Surveillance After Screening and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer
Guidelines for Colonoscopy Surveillance After Screening and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer David A. Lieberman, 1 Douglas K. Rex, 2 Sidney J. Winawer,
More informationEndoscopic techniques for surveillance and treatment of FAP
Endoscopic techniques for surveillance and treatment of FAP Evelien Dekker MD PhD Department of Gastroenterology & Hepatology Academic Medical Center Amsterdam The Netherlands FAP: endoscopic surveillance
More informationCRC Risk Factors. U.S. Adherence Rates Cancer Screening. Genetic Model of Colorectal Cancer. Epidemiology and Clinical Consequences of CRC
10:45 11:45 am Guide to Colorectal Cancer Screening SPEAKER Howard Manten M.D. Presenter Disclosure Information The following relationships exist related to this presentation: Howard Manten MD: No financial
More informationMeasuring the quality of colonoscopy: Where are we now and where are we going?
Measuring the quality of colonoscopy: Where are we now and where are we going? Timothy D. Imler, MD Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana
More informationPost-polypectomy follow-up after. removal of colorectal neoplasia
Post-polypectomy follow-up after removal of colorectal neoplasia Post-polypectomy endoscopic surveillance For each type of polyp BENEFIT 1. What is the risk of CRC/Adv. Neo. (AN) w/out surveillance?
More informationAccepted Manuscript. En bloc resection for mm polyps to reduce post-colonoscopy cancer and surveillance. C. Hassan, M. Rutter, A.
Accepted Manuscript En bloc resection for 10-20 mm polyps to reduce post-colonoscopy cancer and surveillance C. Hassan, M. Rutter, A. Repici PII: S1542-3565(19)30412-4 DOI: https://doi.org/10.1016/j.cgh.2019.04.022
More informationGI Quality Improvement Consortium, Ltd. (GIQuIC) QCDR Non-PQRS Measure Specifications
GI Quality Improvement Consortium, Ltd. (GIQuIC) 1 Following is an overview of the clinical quality measures in GIQuIC that can be reported to CMS for the Physician Quality Report System (PQRS) via GIQuIC
More informationCASE DISCUSSION: The Patient with Dysplasia: Surgery or Active Surveillance? Noa Krugliak Cleveland, MD David T. Rubin, MD
CASE DISCUSSION: The Patient with Dysplasia: Surgery or Active Surveillance? Noa Krugliak Cleveland, MD David T. Rubin, MD Disclosure Statement NKC: No relevant conflicts to disclose. DTR: No relevant
More informationColonoscopy Quality Assessment
Colonoscopy Quality Assessment Nabil F. Fayad 1, 2, Charles J. Kahi 1, 2 1. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
More informationTHE BIG, AWKWARD, FLAT POLYP THAT CAN T BE REMOVED WITH A (SINGLE) SNARE THE CASE FOR EMR AND ESD
THE BIG, AWKWARD, FLAT POLYP THAT CAN T BE REMOVED WITH A (SINGLE) SNARE THE CASE FOR EMR AND ESD Surgical Oncology Network meeting Dr. Eric Lam MD FRCPC October 14, 2017 DISCLOSURES None OBJECTIVES Appreciate
More informationGastric Polyps. Bible class
Gastric Polyps Bible class 29.08.2018 Starting my training in gastroenterology, some decades ago, my first chief always told me that colonoscopy may seem technically more challenging but gastroscopy has
More informationChemoprevention of Colorectal Cancer: Where We Stand
Chemoprevention of Colorectal Cancer: Where We Stand Andrew T. Chan, MD, MPH Division of Gastroenterology Massachusetts General Hospital 2 nd World Congress on Controversies in Gastroenterology Xi an,
More informationImproving the quality of endoscopic polypectomy by introducing a colonoscopy quality assurance program
Alexandria Journal of Medicine (13) 49, 317 322 Alexandria University Faculty of Medicine Alexandria Journal of Medicine www.sciencedirect.com ORIGINAL ARTICLE Improving the quality of endoscopic polypectomy
More informationThe suction pseudopolyp technique: a novel method for the removal of small flat nonpolypoid lesions of the colon and rectum
The suction pseudopolyp technique: a novel method for the removal of small flat nonpolypoid lesions of the colon and rectum Authors V. Pattullo 1, M. J. Bourke 1, K. L. Tran 2, D. McLeod 2, S. J. Williams
More informationGI Coding Updates. Rhonda Buckholtz, CPC, CPCI, CPMS, CRC, CDEO, CHPSE, CGSC, COBGC, CENTC, CPEDC
GI Coding Updates Rhonda Buckholtz, CPC, CPCI, CPMS, CRC, CDEO, CHPSE, CGSC, COBGC, CENTC, CPEDC Copyright/Disclaimer 2014 AAPC text CPT copyright 2016 American Medical Association. All rights reserved.
More informationThe Influence of Snare Size on the Utility and Safety of Cold Snare Polypectomy for the Removal of Colonic Polyps in Japanese Patients
Elmer ress Original Article J Clin Med Res. 2016;8(9):662-666 The Influence of Snare Size on the Utility and Safety of Cold Snare Polypectomy for the Removal of Colonic Polyps in Japanese Patients Hisatsugu
More informationEMR, ESD and Beyond. Peter Draganov MD. Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Florida
EMR, ESD and Beyond Peter Draganov MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Florida Gastrointestinal Cancer Lesion that Can be Treated by Endoscopy
More informationmalignant polyp Daily Challenges in Digestive Endoscopy for Endoscopists and Endoscopy Nurses BSGIE Annual Meeting 18/09/2014 Mechelen
Plan Incidental finding of a malignant polyp 1. What is a polyp malignant? 2. Role of the pathologist and the endoscopist 3. Quantitative and qualitative risk assessment 4. How to decide what to do? Hubert
More informationADR AT A GLANCE. Facts to Know about the Adenoma Detection Rate
ADR AT A GLANCE 14846 Facts to Know about the Adenoma Detection Rate TABLE OF CONTENTS Introduction INTRODUCTION 3 Adenoma detection rate (ADR) is defined as the percentage of average-risk patients age
More informationPersonalized Aspirin Therapy
Personalized Aspirin Therapy Nadir Arber, MD, MSc, MHA Head - Integrated Cancer Prevention Center Tel Aviv Medical Centre and Tel Aviv University Heidelberg 2014 CRC is Preventable Early detection Chemoprevention
More informationExtended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate Authors Yasuhiro Abe 1,HaruakiNabeta 1, Ryota Koyanagi 1, Taro Nakamichi 1, Hayato Hirashima 1, Alan Kawarai
More informationShort and longterm outcomes after endoscopic resection of malignant polyps.
Short and longterm outcomes after endoscopic resection of malignant polyps. Short and longterm outcomes High risk features Lymph node metastasis Lymph node metastases sm1 sm2 sm3 Son 2008 3.1 % 14.9% 25.0
More informationCorporate Medical Policy
Corporate Medical Policy Chromoendoscopy as an Adjunct to Colonoscopy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: chromoendoscopy_as_an_adjunct_to_colonoscopy 7/2012 11/2017
More informationThe New Grade A: USPSTF Updated Colorectal Cancer Screening Guidelines, What does it all mean?
The New Grade A: USPSTF Updated Colorectal Cancer Screening Guidelines, What does it all mean? Robert A. Smith, PhD Cancer Control, Department of Prevention and Early Detection American Cancer Society
More informationEmerging Interventions in Endoscopy. Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital
Emerging Interventions in Endoscopy Margaret Vance Nurse Consultant in Gastroenterology St Mark s Hospital Colon Cancer Colon cancer is common. 1 in 20 people in the UK will develop the disease 19 000
More information11/9/2015 OUTLINE. Quality Indicators for the Doctor Performing Screening Colonoscopy: What you should expect from your Endoscopist
Quality Indicators for the Doctor Performing Screening Colonoscopy: What you should expect from your Endoscopist Anil K Sharma MD FACP Professor of Clinical Medicine, University of Rochester Chief of Gastroenterology,
More informationMANAGEMENT OF BARRETT S RELATED NEOPLASIA IN 2018
MANAGEMENT OF BARRETT S RELATED NEOPLASIA IN 2018 Sachin Wani Medical Director Esophageal and Gastric Center Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus DISCLOSURES
More informationAccepted Article. Association between the location of colon polyps at baseline and surveillance colonoscopy - A retrospective study
Accepted Article Association between the location of colon polyps at baseline and surveillance colonoscopy - A retrospective study Ana Oliveira, Paulo Freire, Paulo Souto, Manuela Ferreira, Sofia Mendes,
More information