Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions i...Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma.The adenoma detection rate is a key performance indicator.Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer.Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection.This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate;minimum withdrawal times,dynamic patient position change and proximal colon retroflexion.展开更多
Barrett's esophagus(BE) is an important condition given its significant premalignant potential and dismal five-year survival outcomes of advanced esophageal adenocarcinoma. It is therefore suggested that patients ...Barrett's esophagus(BE) is an important condition given its significant premalignant potential and dismal five-year survival outcomes of advanced esophageal adenocarcinoma. It is therefore suggested that patients with a diagnosis of BE undergo regular surveillance in order to pick up dysplasia at an earlier stage to improve survival. Current "gold-standard" surveillance protocols suggest targeted biopsy of visible lesions followed by four quadrant random biopsies every 2 cm. However, this method of Barrett's surveillance is fraught with poor endoscopist compliance as the procedures are time consuming and poorly tolerated by patients. There are also significant miss-rates with this technique for the detection of neoplasia as only 13% of early neoplastic lesions appear as visible nodules. Despite improvements in endoscope resolution these problems persist. Chromoendoscopy is an extremely useful adjunct to enhance mucosal visualization and characterization of Barrett's mucosa. Acetic acid chromoendoscopy(AAC) is a simple, non-proprietary technique that can significantly improve neoplasia detection rates. This topic highlight summarizes the current evidence base behind AAC for the detection of neoplasia in BE and provides an insight into the direction of travel for further research in this area.展开更多
文摘Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma.The adenoma detection rate is a key performance indicator.Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer.Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection.This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate;minimum withdrawal times,dynamic patient position change and proximal colon retroflexion.
文摘Barrett's esophagus(BE) is an important condition given its significant premalignant potential and dismal five-year survival outcomes of advanced esophageal adenocarcinoma. It is therefore suggested that patients with a diagnosis of BE undergo regular surveillance in order to pick up dysplasia at an earlier stage to improve survival. Current "gold-standard" surveillance protocols suggest targeted biopsy of visible lesions followed by four quadrant random biopsies every 2 cm. However, this method of Barrett's surveillance is fraught with poor endoscopist compliance as the procedures are time consuming and poorly tolerated by patients. There are also significant miss-rates with this technique for the detection of neoplasia as only 13% of early neoplastic lesions appear as visible nodules. Despite improvements in endoscope resolution these problems persist. Chromoendoscopy is an extremely useful adjunct to enhance mucosal visualization and characterization of Barrett's mucosa. Acetic acid chromoendoscopy(AAC) is a simple, non-proprietary technique that can significantly improve neoplasia detection rates. This topic highlight summarizes the current evidence base behind AAC for the detection of neoplasia in BE and provides an insight into the direction of travel for further research in this area.
