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Articles and Expert Insights for the Week of January 17, 2020

 
  • Colon

    For Left-Sided Colon Lesions up to 25 mm and Right-Sided Colon Lesions up to 20 mm, Piecemeal EMR Is as Good as en Bloc Resection

    Douglas K. Rex, MD, FASGE reviewing Tate DJ, et al. Gastrointest Endosc 2019 Dec 27.

    Advanced endoscopists are often tempted to remove laterally spreading lesions (LSLs) up to 25 mm in size en bloc. In the current study, LSLs up to 25 mm in the left side of the colon and up to 20 mm in the right colon were considered eligible. Of 570 included lesions, 259 were removed by en bloc EMR and the remainder were removed piecemeal to compare long-term outcomes of size-matched LSLs.


  • Colon

    Observations on FIT-Fecal DNA Testing in Clinical Practice

    Douglas K. Rex, MD, FASGE reviewing Vakil N, et al. Gastrointest Endosc 2020 Jan 2.

    The FIT (fecal immunochemical test)-fecal DNA test is expensive, has a significant false-positive rate, and is dominated by both FIT and colonoscopy from a cost-effectiveness perspective. This study examined outcomes of FIT-fecal DNA testing conducted in one health care system to determine test effectiveness and patient compliance in a clinical setting.


  • Colon

    Small Left-Sided Polyps Seen During Colonoscope Insertion: Remove Them When You See Them

    Douglas K. Rex, MD, FASGE reviewing Teramoto A, et al. Gastrointest Endosc 2019 Dec 23.

    Experienced colonoscopists know that when a small polyp is encountered during insertion, it is best to remove it immediately, as identifying it during withdrawal is sometimes difficult. In this trial, patients were randomized to either removal of a left-sided lesion <1 cm in size during insertion or saving it for removal during withdrawal; researchers sought to determine whether there are clinical advantages to immediate removal of lesions during insertion.


  • Colon

    How Do We Get to 80% Screening?

    Douglas K. Rex, MD, FASGE reviewing Inadomi JM, et al. Clin Gastroenterol Hepatol 2019 Dec 27.

    The National Colorectal Cancer Roundtable set a goal of achieving 80% adherence to colorectal cancer screening in the U.S. by 2018. No individual state has achieved that level, and most states have adherence rates in the 60% to 70% range. This review examined the evidence regarding what measures are effective in increasing adherence.


ASGE JOURNAL SCAN is a premium product offered to its members by ASGE.
American Society for Gastrointestinal Endoscopy


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