Colonoscopy screening and surveillance guidelines

Saito, Yutaka; Oka, Shiro; Kawamura, Takuji; Shimoda, Ryo; Sekiguchi, Masau; Tamai, Naoto; Hotta, Kinichi; Matsuda, Takahisa; Misawa, Masashi; Tanaka, Shinji; Iriguchi, Yousuke; Nozaki, Ryoichi; Yamamoto, Hironori; Yoshida, Masahiro; Fujimoto, Kazuma; Inoue, Haruhiro

doi:10.1111/den.13972

Cited by 83 publications

(116 citation statements)

References 289 publications

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“…No dietary restrictions were indicated on the day before the colonoscopy. In Japan, there are many facilities where nurses check the defecation status after preparation drug administration; and if there are still brown stools, enemas are additionally administered [ 24 ]. In our hospital, nurses in the endoscopy center presented the patients with example pictures of stool condition after preparation and asked whether their feces were clear.…”

Section: Methodsmentioning

confidence: 99%

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Ischemic Colitis Caused by Bowel Preparation for Colonoscopy

et al. 2021

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Background: Ischemic colitis is an adverse event which may occur during bowel preparation for colonoscopy. This study aims to clarify both the incidence and the risk factors of this complication. Methods:This was a single-center, retrospective, observational study. All outpatients who were prescribed standardized preparation drugs for colonoscopy at the Kyoto Second Red Cross Hospital between November 2011 and March 2020 were included in the study. A split bowel preparation was carried out as follows; magnesium citrate with or without sodium picosulfate hydrate was/were used as a preparation drug on the day before the colonoscopy, and polyethylene glycol electrolyte solution or sodium phosphate was used on the morning of the endoscopic procedure. Patients were extracted from the electronic medical records and matched with the endoscopy database by examination date and hospital identification number. Following the endoscopic findings, both the incidence and risk factors for ischemic colitis arising after bowel preparation were examined.Results: Among the 14,924 patients analyzed, ischemic colitis was observed in 14 patients (0.09%). Multivariate analysis revealed that old age (≥ 75 years old) and strong preparation (magnesium citrate with sodium picosulfate and polyethylene glycol electrolyte solution) for constipated patients were independent risk factors for ischemic colitis (odds ratio: 3.64 (95% confidence interval (CI): 1.36 -9.77) and 4.27 (95% CI: 1.45 -12.53), respectively). Conclusions:The age 75 years and above and strong preparation for patients with constipation were independent risk factors for ischemic colitis prior to colonoscopy. Careful attention should be paid to bowel preparation before colonoscopy for patients aged ≥ 75 years and for those with constipation.

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Section: Methodsmentioning

confidence: 99%

“…The primary endpoint was the development of ischemic colitis. The secondary endpoints were the quality of preparation evaluated using the Aronchick scale [ 24 ] and the proportion of patients who required saline enema because of inadequate preparation.…”

Section: Methodsmentioning

confidence: 99%

Ischemic Colitis Caused by Bowel Preparation for Colonoscopy

et al. 2021

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“…Radical surgery was performed following endoscopic resection for lesions with a category iv pathological result or lesions with a positive vertical margin 2–4,13 . The follow‐up schedule was based on Japanese guidelines and widely implemented practices worldwide, as described in Figures 2 and 3 2–4,15 . When recurrence was detected, endoscopic treatment or radical surgery was performed, according to the tumor progression level.…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness analysis of endoscopic resection for colorectal laterally spreading tumors: Endoscopic submucosal dissection versus piecemeal endoscopic mucosal resection

Sekiguchi

Igarashi

Mizuguchi

et al. 2021

Digestive Endoscopy

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Objectives:The cost-effectiveness of endoscopic submucosal dissection (ESD) and piecemeal endoscopic mucosal resection (pEMR) for colorectal laterally spreading tumors (LSTs) remains unclear. We examined the cost-effectiveness of these procedures for cases of colon/rectal LST-non-granular-type ≥2 cm and LST-granular-mixed-type ≥3 cm. Methods:We performed a simulation model analysis using parameters based on clinical data from the National Cancer Center Hospital, Tokyo, and previous literature. The number of recurrences and surgeries and the required costs for 5 years following ESD and pEMR were assessed. Japanese cost data were used in the base-case analysis, and probabilistic sensitivity analysis (PSA) was performed. The Swedish cost data were used in the scenario analysis.Results: Endoscopic submucosal dissection yielded a considerably lower number of recurrences and surgeries but required a higher cost than pEMR. The recurrence rates following ESD and pEMR were 0.9-1.3% and 21.1-25.9%, respectively. The incremental cost-effectiveness ratios for an avoided recurrence and surgery for ESD against pEMR were 376, 335,187,476 JPY (69,689 USD), respectively. PSA demonstrated that the probability of ESD being chosen as a more cost-effective option than pEMR was >50% at willingness-to-pay values of ≥400,000-500,000 JPY (3795-4744 USD) for avoiding a recurrence and ≥9,500,000-10,500,000 JPY (90,143-99,631 USD) for avoiding a surgery. In the scenario analysis, the required cost was also lower for ESD.Conclusions: Our findings suggest potentially favorable costeffectiveness of ESD, depending on cost settings and the willingness-to-pay value for avoiding recurrence/surgery.

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“… 1 Colonoscopy is considered as the gold standard test to detect and remove colorectal neoplasia and by this, its efficacy to reduce incidence and mortality from CRC has been widely demonstrated. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of colorectal tumors: Differences between Japan and the West and future prospects

Saito

Ono²,

García

et al. 2021

DEN Open

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Dye‐based chromoendoscopy has long been used routinely for endoscopic diagnosis of gastrointestinal tumors including colorectal tumors in Japan. In the West, on the other hand, dye‐based chromoendoscopy was not so commonly used. However, with the development of narrow band imaging (NBI), image‐enhanced endoscopy diagnosis has rapidly increased in the West. The most critical difference between Japan and the West is the histopathological evaluation of the lesions, which determines a major cause of differences in diagnostic and treatment strategies. In the West, intramucosal adenocarcinoma is not diagnosed until the cancer has invaded submucosal layer. In Japan, on the other hand, cancer is mainly diagnosed based on nuclear and structural atypia, and thus intramucosal adenocarcinoma is diagnosed in lesions that correspond to high‐grade adenoma in the West. In the West, since intramucosal carcinoma is not diagnosed by pathology, all benign adenomas are treated by piecemeal endoscopic resection, and only cancer invading the superficial submucosal layer is indicated for endoscopic submucosal dissection (ESD). Because of the risk of lymph node metastasis in the deep submucosal invasion, the European Society of Gastrointestinal Endoscopy and American Society for Gastrointestinal Endoscopy guidelines state that only superficial submucosal cancer is an indication for ESD. Unfortunately, it is impossible to selectively extract only superficial submucosal invasive cancer even with the use of magnified NBI and pit pattern observation. Therefore, we think that pathologists need to diagnose intramucosal adenocarcinoma with the potential to invade the submucosal layer based on the nuclear and structural atypia. Consequently, intramucosal adenocarcinoma and superficial submucosal cancers should be considered for en‐bloc ESD.

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Colonoscopy screening and surveillance guidelines

Cited by 83 publications

References 289 publications

Ischemic Colitis Caused by Bowel Preparation for Colonoscopy

Ischemic Colitis Caused by Bowel Preparation for Colonoscopy

Cost‐effectiveness analysis of endoscopic resection for colorectal laterally spreading tumors: Endoscopic submucosal dissection versus piecemeal endoscopic mucosal resection

Diagnosis and treatment of colorectal tumors: Differences between Japan and the West and future prospects

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