13 results match your criteria: "Gastroenterology and Liver Unit at the Royal Hallamshire Hospital[Affiliation]"

Objective: A prospective technical feasibility study of cap assisted ESD for 'curative intent' in patients with residual or local neoplastic recurrence following EMR. Primary end points were second stage R0 resection rate, safety and recurrence.

Method: Salvage ESD was performed using the Olympus GIF-XQ240 gastroscope and KD-630L insulation tipped knife.

View Article and Find Full Text PDF

Background: The diagnosis of intraepithelial neoplasia is pivotal for ongoing clinical management decisions in ulcerative colitis. Previous studies have compared the diagnostic yield of endomicroscopy with conventional "white light" endoscopy and hence the overall objective increase of endomicroscopy targeted biopsies as compared to chromoscopy guided alone is not apparent.

Aims: We performed a prospective randomised controlled study to compare the diagnostic yield of intraepithelial neoplasia and cancer in patients undergoing ulcerative colitis screening using chromoscopy assisted endomicroscopy (group A) versus pan-colonic chromoscopy assisted colonoscopy (group B).

View Article and Find Full Text PDF

Recently, miniaturization of a novel confocal laser endomicroscope (Optiscan Pty, Notting Hill, Victoria, Australia) has permitted functional integration into the distal tip of a conventional video colonoscope (Pentax EC3870K; Pentax, Tokyo, Japan) enabling imaging of the surface epithelium and the underlying lamina propria during ongoing video endoscopy. Using endomicroscopy and intravenous sodium fluorescein as a contrast agent, 'virtual histology' can be created, which allows visualization of both the surface epithelium, and some of the lamina propria (down to a quarter of a millimetre), including the microvasculature. Confocal endomicroscopy may have major implications in the future of colonoscopy as uniquely it allows in vivo diagnosis of colonic intraepithelial neoplasia and carcinoma enabling 'smart' biopsy targeting and hence potentially influencing 'on table' management decisions.

View Article and Find Full Text PDF

Introduction: Flat and depressed neoplastic lesions of the colorectum [Paris type (PT) 0-II] localized to the superficial submucosal (sm) layer can be managed using endoscopic mucosal resection. Successful endoluminal management can be enhanced using endoscopic or ultrasound tools that help predict the degree of sm invasion. Previous studies addressing invasive depth estimation using high-magnification chromoscopic colonoscopy showed a low specificity for deep sm layer 3 invasion with miniprobe ultrasound demonstrating better nodal and T stage in vivo prediction.

View Article and Find Full Text PDF

Background: The potential of endoscopic mucosal resection (EMR) for treating flat dysplastic lesions in chronic ulcerative colitis (CUC) has not been addressed so far. Historically, such lesions were referred for colectomy. Furthermore, there are only limited data to support endoscopic resection of exophytic adenoma-like mass (ALM) lesions in colitis.

View Article and Find Full Text PDF

Background: In hereditary nonpolyposis colorectal cancer flat and diminutive adenomas occur, particularly in the right colon. Such lesions may assume a high risk of malignant transformation. Interval cancers are known to occur in this group.

View Article and Find Full Text PDF

Goals: To prospectively assess the safety and efficacy of high-frequency ultrasound assisted mini-probe endoscopic mucosal resection for the treatment of colorectal submucosal tumors. Primary endpoints were tumor free vertical/horizontal resection margins and positive histopathologic diagnosis. Outcome data over a 24-month period were assessed.

View Article and Find Full Text PDF

Introduction: Endoscopic mucosal resection is a safe resection tool for selected flat, sessile and lateral spreading tumours of the colon. Transanal microsurgical resection of select rectal neoplastic lesions is another accepted modality. Recent data suggests transanal microsurgery may have high complication rates.

View Article and Find Full Text PDF

Rectal aberrant crypt foci identified using high-magnification-chromoscopic colonoscopy: biomarkers for flat and depressed neoplasia.

Am J Gastroenterol

June 2005

Gastroenterology and Liver Unit at the Royal Hallamshire Hospital; and Academic Unit of Pathology, Section of Oncology and Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield, United Kingdom.

Background: Aberrant crypt foci may represent preneoplastic lesions in the human colon. The prevalence of aberrant crypt foci detected using magnification chromoscopic colonoscopy is known to follow a stepwise progression from normal subjects to those with exophytic adenomas and colon cancer. No studies have addressed the prevalence of rectal aberrant crypt foci in patients with flat and depressed colonic lesions that cluster within the right hemi-colon and may undergo de novo neoplastic transformation.

View Article and Find Full Text PDF

Background: For patients with coeliac disease (CD), compliance with a gluten-free diet, when eating food not prepared at home may be difficult.

Aims: We assessed whether there are differences in the eating habits of coeliac patients when compared to the general public. In addition, we compared chefs' knowledge with the public's knowledge about CD.

View Article and Find Full Text PDF

Background: EMR is used to treat flat and sessile lesions in the colon. The aim of this study was to prospectively assess the efficacy of high-magnification chromoscopic colonoscopy in predicting complete resection margins after EMR.

Methods: A total of 1250 patients underwent colonoscopy by using a magnifying colonoscope.

View Article and Find Full Text PDF

AL amyloidosis complicating multiple myeloma is rare but well recognized. Endoscopic appearances of amyloid in the gastrointestinal tract can, however, be highly variable. Macroscopic appearances of the duodenum can range from scalloping (often seen in celiac disease) to that of duodenitis; erosive disease, frank ulceration and even protruberant masses.

View Article and Find Full Text PDF