Colon Tumours and Colonoscopy

Abstract

IntroductionThis year saw few outstanding abstracts but several interesting papers, particularly on new technology, surveillance, and colonoscopic therapy. Colonic endoscopic mucosal resection (EMR) has certainly ªcome of ageº, with many groups reporting their experience from around the world. PreparationWith much attention being directed at new technology and the therapeutic potential of colonoscopy, it is important to remember that getting the basics right is all-important. This includes ensuring a clean bowel and a comfortable patient. A multicentre European study from the European Panel on the Appropriateness of Endoscopy (EPAGE) highlighted the difficulties with bowel preparation, assessing cleansing quality in 5832 patients [1]. Preparation was poor (solid or liquid stool not aspirable) in 10.3 % of cases, with no difference between men and women. Factors related to poor preparation included in-patient preparation and high American Society of Anesthesiologists (ASA) risk levels. Not unsurprisingly, poor preparation resulted in prolonged insertion and withdrawal times, a higher rate of incomplete colonoscopy (24.4 %), a lower rate of polypectomy, and a reduced rate of cancer detection.Worldwide, polyethylene glycol (PEG)±electrolyte solution and Phospho-Soda (Fleet) appear to be the most popular bowel preparations for colonoscopy. A multicentre trial in Germany compared Phospho-Soda alone, Phospho-Soda plus senna, and PEG± electrolyte (4 l). Cleansing, tolerability, and acceptability were similar in the three groups [2].