Endoscopic Management of Nonpolypoid Colorectal Lesions in Colonic IBD

East, James E.; Toyonaga, Takashi; Suzuki, Noriko

doi:10.1016/j.giec.2014.03.003

Cited by 29 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent systematic review of ten studies, which followed 376 patients with IBD with resected polypoid dysplasia for a mean of 54 months, reported an annualized incidence for CRC of 0.5% [39]. Endoscopic resection is also suggested for non-polypoid dysplasia, but data on subsequent colorectal cancer risk is not yet available [40]. Though recent advances in endoscopic imaging have improved the recognition of nonpolypoid lesions in patients with IBD, their natural history and outcomes for complete endoscopic resection are less known.…”

Section: Optimal Resection Techniquementioning

confidence: 99%

See 1 more Smart Citation

Surveillance of patients with inflammatory bowel disease

East

Kaltenbach

2016

Best Practice & Research Clinical Gastroenterology

Self Cite

View full text Add to dashboard Cite

Patients with inflammatory bowel disease involving the colon are at increased risk for developing colorectal cancer. Colonoscopy surveillance is important to identify and treat IBD associated dysplasia. The SCENIC consensus provides evidence-based recommendations for optimal surveillance and management of dysplasia in IBD. Chromoendoscopy, with the surface application of dyes to enhance mucosal visualization, is the superior endoscopic surveillance strategy to detect dysplasia. Most dysplasia is visible, and can be endoscopically resected. Future studies should determine the effect of new surveillance strategies on the incidence of CRC and mortality in patients with IBD.

show abstract

Section: Optimal Resection Techniquementioning

confidence: 99%

“…Hybrid endoscopic mucosal resection and endoscopic submucosal dissection (ESD) are other potential techniques, often determined by the lesion characteristics as well as the endoscopist's skills and experience (Fig. 2) [40,42,43].…”

Section: Optimal Resection Techniquementioning

confidence: 99%

Surveillance of patients with inflammatory bowel disease

East

Kaltenbach

2016

Best Practice & Research Clinical Gastroenterology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Endoscopic mucosal resection (EMR), however, is inadequate for the resection of dysplastic lesions within colitic mucosa [11]. Submucosal fibrosis due to background inflammation can hamper adequate lifting and endoscopic treatment [12]. The nonlifting sign makes it difficult to resect dysplasia within colitic mucosa by EMR.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Submucosal Dissection in Patients with Ulcerative Colitis

et al. 2018

View full text Add to dashboard Cite

Patients with ulcerative colitis have an increased risk of developing colorectal cancer. This risk has been estimated to reach about 7% at 20 years of disease, 7–14% at 25 years, and as high as 30% after 35 years. The guidelines for the management of inflammatory bowel disease recommend endoscopic resection of circumscribed dysplasia and ongoing colonoscopic surveillance as a reasonable strategy in patients with ulcerative colitis. Submucosal fibrosis due to background inflammation could hamper adequate lifting and endoscopic treatment. Endoscopic mucosal resection (EMR) is difficult for dysplasia within colitic mucosa due to the non-lifting sign. Although endoscopic submucosal dissection (ESD) generally has higher risks of perforation and bleeding compared to EMR, the technique can achieve complete en bloc resection regardless of the lesion size or severity of submucosal fibrosis. Several studies have shown that ESD for circumscribed dysplasia in ulcerative colitis is feasible. While ESD can avert unnecessary surgery, submucosal fibrosis makes the intervention technically demanding in cases of ulcerative colitis. ESD should be performed by expert endoscopists using the most suitable equipment and devices available.

show abstract

“…114,115 The diagnosis of IBD makes EMR difficult because of submucosal scarring as is evidenced by pseudopolyps, loss of vascularity, or active inflammation. 116 In a study on 79 flat Paris 0-II lesions in IBD in which EMR was performed, there was a 3-month recurrence rate of 2.4%, with no additional lesions detected on subsequent follow-up for a period of 4 years. 117 The emphasis to reduce occurrence of interval CRC should be to attempt complete resection with appropriate endoscopic follow-up to exclude residual polyp and recurrence.…”

Section: Endoscopic Mucosal Resectionmentioning

confidence: 98%

“…The latter might make R0 resection difficult despite the use of sharp-tipped needle knives and small-caliber-tip transparent hoods. 116 Because our experience in ESD is evolving, the practical approach for Western endoscopists would be to mark the lesion, followed by lifting and an initial incision using either a snare tip or endoknife and its extension using the EMR snare technique. This is described as the "hybrid ESD" to distinguish from the classical procedure.…”

Section: Endoscopic Submucosal Dissectionmentioning

confidence: 99%

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Tharian

George

Navaneethan

2016

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.

show abstract

Endoscopic Management of Nonpolypoid Colorectal Lesions in Colonic IBD

Cited by 29 publications

References 22 publications

Surveillance of patients with inflammatory bowel disease

Surveillance of patients with inflammatory bowel disease

Endoscopic Submucosal Dissection in Patients with Ulcerative Colitis

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Contact Info

Product

Resources

About