Automatic optical diagnosis of small colorectal lesions by laser-induced autofluorescence.

Background And Study Aims: Endoscopic optical diagnosis can potentially replace histopathological evaluation of small colorectal lesions. The aim of this study was to evaluate diagnostic performance of WavSTAT, a novel system for automatic optical diagnosis based on laser-induced autofluorescence spectroscopy.

Patients And Methods: Consecutive patients who were scheduled for colonoscopy were included in the study.

Evaluating the endoscopic reference score for eosinophilic esophagitis: moderate to substantial intra- and interobserver reliability.

Background And Study Aims: Recently the Endoscopic Reference Score (EREFS) for endoscopic assessment of eosinophilic esophagitis was introduced, with good interobserver agreement for most signs. The EREFS has not yet been evaluated by other investigators and intraobserver agreement has not been assessed. The aim of this study was to further validate the EREFS by assessing interobserver and intraobserver agreement of endoscopic signs in patients with eosinophilic esophagitis.

The accuracy of polyp assessment during colonoscopy in FIT-screening is not acceptable on a routine basis.

Background: During colonoscopy, correct assessment of polyps is important. Recognition of early carcinomas is needed for tailor-made treatment and avoidance of unnecessary complications. Moreover, accurate diagnosis of diminutive lesions could result in a safe resect and discard strategy.

Length of hospital stay and associated hospital costs with infliximab versus cyclosporine in severe ulcerative colitis.

Background: Cyclosporine and infliximab (IFX) seem equally effective as rescue therapy in hospitalized patients with severe ulcerative colitis (UC), although associated hospital stay and costs may differ.

Aim: The aim of this study was to compare the duration of hospital stay and associated costs from initiation of rescue therapy to time of discharge in hospitalized patients with corticosteroid-refractory UC receiving cyclosporine or IFX. Colectomy rates after 6 months were used as the outcome parameter for treatment success.

Narrow-band imaging for the detection of polyps in patients with serrated polyposis syndrome: a multicenter, randomized, back-to-back trial.

Background: Serrated polyposis syndrome (SPS) is characterized by the presence of multiple serrated polyps spread throughout the colon. Patients with SPS are considered to be at risk of colorectal cancer and are advised to undergo endoscopic surveillance. Narrow-band imaging (NBI) may improve the detection of polyps during these surveillance colonoscopies.

Endoscopic gastric volume reduction with a novel articulating plication device is safe and effective in the treatment of obesity (with video).

Background: Endoscopic volume reduction of the stomach may provide a minimally invasive alternative for surgical procedures in the treatment of obesity.

Objective: To assess safety and preliminary effectiveness in the first human application of a novel endoscopic stapling technique.

Design: Prospective, observational, phase 1 study.

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures. Main recommendations 1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforation, including the definition of procedures that carry a high risk of this complication.

Is "really conscious" sedation with solely an opioid an alternative to every day used sedation regimes for colonoscopies in a teaching hospital? Midazolam/fentanyl, propofol/alfentanil, or alfentanil only for colonoscopy: a randomized trial.

Background: We investigated the satisfaction of patients and endoscopists and concurrently safety aspects of an "alfentanil only" and two clinically routinely used sedation regimes in patients undergoing colonoscopy in a teaching hospital.

Methods: One hundred and eighty patients were prospectively randomized in three groups: M (midazolam/fentanyl), A (alfentanil), and P (propofol/alfentanil); M and A were administered by an endoscopy nurse, P by an anesthesia nurse. Interventions, heart rate, saturation, electrocardiogram, noninvasive blood pressure, and expiratory CO₂ were monitored using video assistance.

A pSMAD/CDX2 complex is essential for the intestinalization of epithelial metaplasia.

The molecular mechanisms leading to epithelial metaplasias are poorly understood. Barrett's esophagus is a premalignant metaplastic change of the esophageal epithelium into columnar epithelium, occurring in patients suffering from gastroesophageal reflux disease. Mechanisms behind the development of the intestinal subtype, which is associated with the highest cancer risk, are unclear.

Differences in respiratory-induced pancreatic tumor motion between 4D treatment planning CT and daily cone beam CT, measured using intratumoral fiducials.

Background: In radiotherapy, the magnitude of respiratory-induced tumor motion is often measured using a single four-dimensional computed tomography (4DCT). This magnitude is required to determine the internal target volume. The aim of this study was to compare the magnitude of respiratory-induced motion of pancreatic tumors on a single 4DCT with the motion on daily cone beam CT (CBCT) scans during a 3-5-week fractionated radiotherapy scheme.

Bridge-to-surgery stent placement versus emergency surgery for acute malignant colonic obstruction.

Background: Endoscopic self-expanding metal stent (SEMS) placement as a bridge to surgery is an option for acute malignant colonic obstruction. There is ongoing debate regarding the superiority and oncological safety of SEMS placement compared with emergency surgery. This retrospective study aimed to compare outcomes of these treatment approaches.

Incidence of colonic neoplasia in patients with serrated polyposis syndrome who undergo annual endoscopic surveillance.

Background & Aims: Patients with serrated polyposis syndrome (SPS) are advised to undergo endoscopic surveillance for early detection of polyps and prevention of colorectal cancer (CRC). The optimal surveillance and treatment regimen is unknown. We performed a prospective study to evaluate a standardized endoscopic treatment protocol in a large cohort of patients with SPS.

Perforation in colorectal stenting: a meta-analysis and a search for risk factors.

Background: Recent studies suggest that there is a substantial risk of perforation after colorectal stent placement.

Objective: To identify risk factors for perforation from colonic stenting.

Design: A meta-analysis of 86 studies published between 2005 and 2011.

Yield of screening colonoscopy in first-degree relatives of patients with serrated polyposis syndrome.

Goals: We aimed to evaluate the diagnostic yield of screening colonoscopies in first-degree relatives (FDRs) of patients with serrated polyposis syndrome (SPS).

Background: Patients with SPS are at an increased risk for colorectal cancer. Although inheritance patterns are unknown, FDRs of these patients have an increased risk for both colorectal cancer and SPS.

A novel colonoscopy reporting system enabling quality assurance.

Background And Study Aims: The quality of colonoscopy can only be measured if colonoscopy reports include all key quality indicators. In daily practice, reporting is often incomplete and not standardized. This study describes a novel, structured colonoscopy reporting system, which aims to generate standardized and complete reports and to facilitate the automatic analysis of colonoscopy quality indicators.

Adalimumab for Crohn's disease: long-term sustained benefit in a population-based cohort of 438 patients.

Background And Aims: Adalimumab is an effective therapy for induction and maintenance of Crohn's disease. However, results in clinical trials don't necessarily reflect daily clinical practice. Therefore, we assessed real-life long-term clinical response to adalimumab in a large population-based cohort and identified clinical parameters affecting response

Methods: All consecutive patients in North-Holland that started adalimumab between 2003 and 2011 were included, of which medical charts were reviewed.

Endoscopic transluminal necrosectomy in necrotising pancreatitis: a systematic review.

Objective: We performed a systematic review to assess the outcome of endoscopic transluminal necrosectomy in necrotising pancreatitis with additional focus on indication, disease severity, and methodological quality of studies.

Design: We searched the literature published between January 2005 and June 2013. Cohorts, including patients with (infected) necrotising pancreatitis, undergoing endoscopic necrosectomy were included.

High proximal migration rate of a partially covered "big cup" duodenal stent in patients with malignant gastric outlet obstruction.

Endoscopic placement of self-expandable metal stents (SEMS) has emerged as a palliative treatment for patients with malignant gastric outlet obstruction (GOO). Recently, a new partially covered "big cup" SEMS has been developed to prevent both stent migration and tissue ingrowth. The aim of the study was to evaluate safety and efficacy of this SEMS in a cohort of patients with incurable malignant GOO.

Peroral endoscopic myotomy for achalasia.

Background: Treatment of achalasia is complicated by symptom recurrence and a significant risk for severe complications. Endoscopic myotomy was developed in the search for a highly efficacious treatment with lower risks. Since its introduction in 2010, several centers have adopted the technique and published excellent short-term results of open label series.

Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711].

Background: Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care.

Prevalence of serrated polyps and association with synchronous advanced neoplasia in screening colonoscopy.

Background And Study Aims: Serrated polyps of the large intestine comprise a heterogeneous group of lesions with distinct histological and malignant features. The aim of the study was to estimate the prevalence of serrated polyp subtypes in a cohort of individuals undergoing screening colonoscopy, and to identify associations between the detection of serrated polyp subtypes and advanced neoplasia.

Patients And Methods: Data on serrated polyps, adenomas, and cancers were collected from participants of a randomized screening trial that compared colonoscopy with computed tomography colonography.

[Acute upper abdominal pain after excessive vomiting: Boerhaave's syndrome].

Background: Boerhaave's syndrome is a spontaneous oesophageal rupture caused by excessive vomiting. Left untreated the mortality rate is high. Surgical intervention was always the treatment of first choice, but increasingly a minimally invasive approach involving the endoscopic placement of an oesophageal stent is being carried out.

Combining risk factors with faecal immunochemical test outcome for selecting CRC screenees for colonoscopy.

Objective: Faecal immunochemical testing (FIT) is increasingly used in colorectal cancer (CRC) screening but has a less than perfect sensitivity. Combining risk stratification, based on established risk factors for advanced neoplasia, with the FIT result for allocating screenees to colonoscopy could increase the sensitivity and diagnostic yield of FIT-based screening. We explored the use of a risk prediction model in CRC screening.