InFocus - Issue 2, October 2015
Scientific Update
Update on colonoscopy: what you can expect at UEG Week in Barcelona
Ankie Reumkens, Roel Bogie and Silvia Sanduleanu, Maastricht University Medical Center, the Netherlands
UEG week (UEGW) 2015 in Barcelona is approaching fast. Important meetings and symposia are included in the program, such as ‘From guidelines to clinical practice’. Recent practice guidelines on colonoscopy surveillance and polyp resection will be presented. But how are these guidelines translated into clinical practice? This and many other hot topics will be discussed during this event. We have previewed the program in colonoscopy topics and summarized key oral presentations and posters as you can read below. We wish you a pleasant and informative UEG week!
Quality
Quality in colonoscopy remains one of the main subjects for UEGW. High quality bowel preparation is necessary to maximize the adenoma detection rates (P0154, P0193, IP214, IP215). The expertise of the endoscopist will impact on the outcome of colonoscopy (IP459, IP460) and therefore training programs and monitoring of performance benchmarks are mandatory (IP461, 462). The quality and effectiveness of colonoscopy are primarily affected by the visualization of the entire colonic mucosa. Like last UEGW, presenters are addressing water-assisted colonoscopy techniques, comparing it to CO2 insufflation (OP244, P0161, P0162, P1404) and its impact on patient comfort, adenoma and polyp detection rates.
Imaging
New developments on image enhanced endoscopy will be presented (IP127, IP541), with special attention on i-scan (P0809, P1355, P1396). In particular the role of i-scan chromoendoscopy (P0186) in the group of Munoz et al. and the detection of colonic dysplastic lesions during IBD surveillance using dye spraying by Iacucci et al (OP188).
What’s new in image-assisted diagnosis of inflammatory bowel diseases (IBD) (IP541)? Endoscopic assessment in ulcerative colitis will be discussed in OP235. New devices are proposed to improve visualization of the colonic mucosa (P0168, P0171, P1399). Furthermore, advances in capsule endoscopy and enteroscopy will be shown (IP270, P0232, P0235) along with new insights on potential applications.
What’s new in colonoscopy resection techniques?
Recently, the British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland published guidelines for the management of large non-pedunculated colorectal polyps. These guidelines provide a framework for the management of large colorectal polyps in addition to identifying key performance indicators1. We expect that this will be a major topic during the UEGW (P0155-158).
The Japanese perspective on endoscopic mucosal resection techniques in the colon will be demonstrated. Recently, Oka and coll evaluated local recurrence and risk factors for endoscopic mucosal resection in a multicenter prospective study2. Japanese guidelines on endoscopic submucosal dissection will be discussed at the UEGW on Monday (IP140, IP142, IP143).
The Colorectal ESD Standardization Implementation Working Group lists piecemeal endoscopic mucosal resection (EMR) as a treatment option (IP 142, IP 143). Practical guidelines for EMR and endoscopic submucosal dissection (ESD) will be handed out in the Resection Techniques session (IP203, IP204, IP605).
Screening/Surveillance
Screening for colorectal cancer is now running in many European countries. However, specific features of the national programs may differ. An update about the screening programs will be provided (IP306). Colonoscopy surveillance after endoscopic and surgical resection of colorectal neoplasms is recommended. Common features and differences between current post-polypectomy surveillance guidelines have been summarized in a recently published study3. The UEGW 2015 program will provide a practical update and new insights on colonoscopic surveillance practice (IP205, OP151).
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References:
1 Rutter MD, Chattree A, Barbour JA, Thomas-Gibson S, Bhandari P, Saunders BP, et al. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps. Gut. 2015 Jun 23. PubMed PMID: 26104751. Epub 2015/06/25. Eng.
2 Oka S, Tanaka S, Saito Y, Iishi H, Kudo SE, Ikematsu H, et al. Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan. The American journal of gastroenterology. 2015 May;110(5):697-707. PubMed PMID: 25848926. Epub 2015/04/08. eng.
3 Bogie R, Sanduleanu S. Optimizing post-polypectomy surveillance: A practical guide for the endoscopist. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. 2015 Jul 15. PubMed PMID: 26179809. Epub 2015/07/17. Eng.
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