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Patient interest in video recording of colonoscopy:A survey

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World Journal of Gastroenterology 2010年第4期16卷 458-461页

作者： Meghana Raghavendra douglas k.rex Division of Gastroenterology/Hepatology Indiana University Medical CenterIndianapolisIN 46202United States

AIM:To find if patients are interested in obtaining a video recording of their colonoscopy ***:We conducted a survey of outpatients presenting for colonoscopy regarding their interest in obtaining a video recording of their ***:Two hundred and forty-eight patients(mean age 57.9 years;57% male) were *** hundred and one patients(81%) were interested in obtaining a video *** significant predictors of patients' interest in the video recording were *** reading a brief educational paragraph explaining missed lesions during colonoscopy,135 patients(54%) were more interested in having a video recording,and none were less *** hundred and fifty-six patients(63%) were willing to pay for a video *** multivariable analyses,younger age was predictive of willingness to pay for a video *** history of colorectal cancer and a family history of colorectal cancer were predictive of willingness to pay a greater ***:Patients undergoing colonoscopy expressed substantial interest in obtaining a videorecording of their *** of missing lesions during colonoscopy increased interest in having a videorecording.

关键词： Colonoscopy Video recording Survey

Routine rectal retroflexion during colonoscopy has a low yield for neoplasia

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World Journal of Gastroenterology 2008年第42期14卷 6503-6505页

作者： Abdo Saad douglas kevin rex Department of Medicine Division of Gastroenterology/Hepatology Indiana University School of Medicine Indianapolis IN 46202 United States

AIM： To investigate the value of retroflexion in detecting neoplasia in the distal rectum. METHODS： This was a prospective observational study performed in an academic endoscopy unit. Consecutive patients undergoing colonoscopy had careful forward viewing of the distal rectum by retroflexion. Of 1502 procedures, 1076 （72%） procedures were performed with a 140^o angle of view colonoscope and 426 （28%） were performed with a 170^o angle of view colonoscope. The outcome measurement was the yield of neoplasia in the distal rectum detected by forward viewing vs retroflexion. RESULTS： A total of 1502 patients, including 767 （51%） females and 735 （49%） males, with mean age of 58.8 ± 12.5 years were enrolled. Retroflexion was successful in 1411 （93.9%） patients, unsuccessful or not performed because the rectum appeared narrow in 91 （6.1%）. Forty patients had a polyp detected in the distal rectal mucosa. Thirty-three were visible in both the forward and retroflexed view （25 hyperplastic, 8 adenomatous）. Seven polyps were visualized only by retroflexion （6 hyperplastic sessile polyps, one 4 mm sessile tubular adenoma）. There was no significant difference in information added by retroflexion with 140^o vs 170^o angle of view instrument. CONCLUSION： To our knowledge, this is the largest reported evaluation of retroflexion in the rectum. Routine rectal retroflexion did not detect clinically important neoplasia after a careful forward examination of the rectum to the dentate line. Since retroflexion has risks and may cause discomfort, theuse of routine retroflexion should be at the discretion of the endoscopist.

关键词： Colonoscopy Colorectal polyps Retroflexion Rectum

Reinterpretation of histology of proximal colon polyps called hyperplastic in 2001

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World Journal of Gastroenterology 2009年第30期15卷 3767-3770页

作者： Omer khalid Sofyan Radaideh Oscar W Cummings Michael J O'Brien John R Goldblum douglas k.rex Department of Medicine Indiana University Medical CenterIndianapolisIN 46202United States Department of Pathology Indiana University Medical CenterIndianapolisIN 46202United States Department of Anatomic Pathology Boston University Medical CenterBostonMA 02118United States Department of Anatomic Pathology Cleveland ClinicClevelandOH 44195United States Division of Gastroenterology/Hepatology Indiana University Medical CenterIndianapolisIN 46202United States

AIM： To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007.METHODS： ≥ 5 mm in interpreted pathologists 2007 by 3 GI Forty consecutive proximal colon polyps size, removed in 2001, and originally as hyperplastic polyps by general at Indiana University, were reviewed in pathologists.CONCLUSION： Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.

关键词： Colonoscopy Colorectal polyps Hyperplasticpolyps Inter-observer variability Serrated adenomas Sessile serrated polyps

Multicenter,randomized study to optimize bowel for colon capsule endoscopy

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World Journal of Gastroenterology 2017年第48期23卷 8615-8625页

作者： David kastenberg Wilmot C Burch Jr David P Romeo Pankaj k kashyap David C Pound Neophytos Papageorgiou Ignacio Fernández-Urien Sainz Carly E Sokach douglas k.rex Division of Gastroenterology Thomas Jefferson University Franklin Gastroenterology PLLC Dayton Gastroenterology Inc. Pinnacle Research Group LLC Indianapolis Gastroenterology and hepatology Department of Gastroenterology American Medical Center Department of Gastroenterology Servicio de Digestivohospital de Navarra Sidney kimmel Medical College at Thomas Jefferson University Indiana University hospital

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation *** This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system(Pill Cam? COLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the Control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,CCE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,Control = 77.3%;P = 0.88) and individual segments. In the Study group,CCE completion was superior(Study = 90.9%,Control = 76.9%;P = 0.048) and colonic transit was more often < 40 min(Study = 21.8%,Control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,Control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study *** A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior CCE completion.

关键词： Bowel preparation Purgative Capsule endoscopy Endoscopy Capsule colonoscopy Large intestine

Outcomes of submucosal(T1b) esophageal adenocarcinomas removed by endoscopic mucosal resection

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 763-769页

作者： Darren D Ballard Neel Choksi Jingmei Lin Eun-Young Choi B Joseph Elmunzer Henry Appelman douglas k.rex Hala Fatima William kessler John M DeWitt Division of Gastroenterology and Hepatology Medical College of Wisconsin Division of Gastroenterology University of Michigan Department of Pathology Indiana University Department of Pathology University of Michigan Division of Gastroenterology and Hepatology University of South Carolina Division of Gastroenterology and Hepatology Indiana University

AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma(EAC) following endoscopic mucosal resection(EMR) and associated *** Patients undergoing EMR with pathologically confirmed T1 b EAC at two academic referral centers were retrospectively *** were divided into 4 groups based on treatment following EMR:Endoscopic therapy alone(group A),endoscopic therapy with either chemotherapy,radiation or both(group B),surgicalresection(group C) or no further treatment/lost to follow-up(<12 mo)(group D).Pathology specimens were reviewed by a central ***-up data was obtained from the academic centers,primary care physicians and/or referring *** analysis was performed to identify factors predicting recurrence of *** Fifty-three patients with T1 b EAC underwent EMR,of which 32(60%) had adequate follow-up ≥ 12 mo(median 34 mo,range 12-103).There were 16 patients in group A,9 in group B,7 in group C and 21 in group *** follow-up in groups A to C was 34 mo(range 12-103).Recurrent EAC developed overall in 9 patients(28%) including 6(38%) in group A(median:21 mo,range:6-73),1(11%) in group B(median:30 mo,range:30-30) and 2(29%) in group C(median 21 mo,range:*** of 9 recurrences were local;of the 6 recurrences,5 were treated with endoscopy *** predictors of recurrence of EAC were *** Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy.

关键词： Esophageal cancer Submucosal T1b Endoscopic mucosal resection Chemotherapy Esophagectomy