United European Gastroenterology Week review: Endoscopy and inflammatory bowel disease

Abstract

W ITH OVER 13 000 participants every year, United European Gastroenterology (UEG) Week is one of the most important events in gastroenterology. In 2015, Barcelona was the host city for UEG Week and attendees were invited to join a broad spectrum of lectures, courses and live demonstrations throughout the disciplines of general medicine, surgery, pediatrics, gastrointestinal (GI) oncology and endoscopy.As UEG Week is one of the most important medical events, every year, new medical devices are launched at the conference and the GI community introduces the latest research activities in their field. Although the present article cannot summarize every excellent research presentation, it will highlight some of the most exciting new developments in the field of endoscopy and irritable bowel disease (IBD).Perforation is a redoubtable complication during endoscopy. Derbyshire et al. aimed to evaluate the overall rate of perforations in the English National Health Service Bowel Cancer Screening Programme consisting of over 263 129 endoscopic procedures carried out in more than 31 bowel cancer screening centers. 1 Overall, 147 perforations were identified (rate of 0.06%). 69.2% of perforations were therapeutic and the endoscopists visualized the perforation in 12.8% of cases. Endoscopic clipping was carried out in 10.2%. In contrast, most diagnostic perforations occurred in the sigmoid colon. Surgery was done in 54.8% of patients and diagnostic perforations were significantly more often associated with the need for surgery. Of note, a stoma was formed in 26.1% of those having surgery. Diagnostic perforations and surgery were both significantly associated with post-perforation morbidity. Median hospital stay was 9.5 days in this largest multicenter study specifically reporting outcomes after colonoscopic perforation in Europe and 25.2% of patients were admitted to the intensive care unit. Overall mortality rate was calculated as 0.87%.Newest advanced endoscopic imaging modalities aim for better characterization of the mucosal vascular pattern in order to identify predictive markers for invasion and therapeutic response. Kaneko and coworkers introduced the first clinical trial of novel hypoxia imaging in human cancers, including pharyngeal, esophageal, gastric, and colorectal neoplasia. 2 First, the authors determined the corresponding areas of neoplastic and non-neoplastic areas in the endoscopic images and obtained oxygen saturation levels. Afterwards, the authors investigated the changes of hypoxia imaging before and after chemotherapy, and the efficacy of chemotherapy in advanced cancers of the esophagus, stomach, and colorectum. To compare the results with the histological findings, all patients received endoscopic resection of the targeted lesion. Forty patients were studied and hypoxia imaging with the novel laser endoscope allowed for visualization of spatial and temporal information of hypoxic conditions in adenomas, early cancers and advanced cancers. The authors concluded that hypoxia imaging now illustrates a nov...