Living on the EDGE: Canadian Experience With EUS-directed Transgastric ERCP (EDGE) in Patients With Roux-en-Y Gastric Bypass Anatomy.

Introduction: Roux-en-Y gastric bypass (RYGB) surgery imposes anatomic barriers to endoscopic retrograde cholangiopancreatography (ERCP). Potential options for biliary access in these patients include laparoscopic-assisted ERCP or balloon enteroscopy. However, these approaches require specialized equipment and/or operating room personnel and are associated with high rates of failure and adverse events compared to conventional ERCP.

Underwater endoscopic mucosal resection without submucosal injection (UEMR) for large colorectal polyps: A community-based series.

Background: Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an appealing therapy for large colorectal polyps. However, this technique is not practiced widely and there are limited data evaluating UEMR in community settings.

Methods: The study comprised patients undergoing UEMR of large (≥20 mm) sessile colorectal lesions at a community-based center.

Plasma Septin9 versus fecal immunochemical testing for colorectal cancer screening: a prospective multicenter study.

Background: Screening improves outcomes related to colorectal cancer (CRC); however, suboptimal participation for available screening tests limits the full benefits of screening. Non-invasive screening using a blood based assay may potentially help reach the unscreened population.

Objective: To compare the performance of a new Septin9 DNA methylation based blood test with a fecal immunochemical test (FIT) for CRC screening.

Esophagogastroduodenoscopy-assisted bowel preparation for colonoscopy.

Aim: To compare the quality and tolerance of esophagogastroduodenoscopy (EGD)-assisted and conventional split-dose polyethylene glycol electrolyte solution for inpatient colonoscopy.

Methods: The study was a randomized controlled trial in hospitalized patients. Hospitalized patients undergoing colonoscopy the day following EGD for evaluation of gastrointestinal (GI) bleeding or other symptoms.

Endoscopic ultrasonography-guided endoscopic retrograde cholangiopancreatography: endosonographic cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) is the standard approach to gaining access to the biliary and pancreatic ductal systems. However, in a small subset of cases anatomic constraints imposed by disease states or abnormal anatomy preclude ductal access via conventional ERCP. With the advent of endoscopic ultrasonography (EUS), with its unique capabilities of accurate imaging and ductal access via transmural puncture, there is now an alternative to surgical and percutaneous radiologic approaches in situations inaccessible to ERCP: endosonographic cholangiopancreatography (ESCP).

Effect of a time-dependent colonoscopic withdrawal protocol on adenoma detection during screening colonoscopy.

Background & Aims: Screening colonoscopy can prevent cancer by removal of adenomatous polyps. Recent evidence suggests that insufficient time for inspection during overly rapid colonoscope withdrawal may compromise adenoma detection. We conducted a study of the effect of a minimum prespecified time for instrument withdrawal and careful inspection on adenoma detection rates during screening colonoscopy.

Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.

Background: Colonoscopy is commonly used to screen for neoplasia. To assess the performance of screening colonoscopy in everyday practice, we conducted a study of the rates of detection of adenomas and the amount of time taken to withdraw the colonoscope among endoscopists in a large community-based practice.

Methods: During a 15-month period, 12 experienced gastroenterologists performed 7882 colonoscopies, of which 2053 were screening examinations in subjects who had not previously undergone colonoscopy.

Safety, efficacy, and patient tolerance of a three-dose regimen of orally administered aqueous sodium phosphate for colonic cleansing before colonoscopy.

Background: Sodium phosphate, administered orally, is an effective, well-tolerated colonic cleansing agent. However, colonoscopic visualization is suboptimal in many patients after a conventional 2-dose regimen. This study assessed the safety, the efficacy, and patient tolerance of a 3-dose regimen of sodium phosphate.

Carbohydrate-electrolyte rehydration protects against intravascular volume contraction during colonic cleansing with orally administered sodium phosphate.

Background: Colonic cleansing with sodium phosphate causes intravascular volume contraction in some patients. This study tested the hypothesis that carbohydrate-electrolyte oral rehydration would attenuate the hypovolemic changes associated with administration of sodium phosphate.

Methods: Adult outpatients were randomized to ingest either regular clear fluids or a carbohydrate-electrolyte rehydration solution during precolonoscopy purgation by ingestion of aqueous sodium phosphate.