Novel Colonoscopic Imaging

Acetic acid compared with i-scan imaging for detecting Barrett's esophagus: a randomized, comparative trial.

Background Traditional surveillance in patients with Barrett's esophagus (BE) has relied on random biopsies. Targeted biopsies that use advanced imaging modalities may significantly improve detection of specialized columnar epithelium (SCE). Objective We compared the efficacy of targeted biopsies that used i -scan or acetic acid to random biopsies in the detection of SCE. Design Patients with visible columnar lined epithelium or known BE were randomized at a 1:1 ratio to undergo acetic acid application or i -scan with targeted biopsies. Setting Targeted biopsies were performed based on surface architecture according to the Guelrud classification followed by 4-quadrant biopsies. Patients A t…

Intraprocedural bowel cleansing with the JetPrep cleansing system improves adenoma detection.

AIM: To investigate the impact of JetPrep cleansing on adenoma detection rates. METHODS: In this prospective, randomized, crossover trial, patients were blindly randomized to an intervention arm or a control arm. In accordance with the risk profile for the development of colorectal carcinoma, the study participants were divided into high-risk and low-risk groups. Individuals with just one criterion (age > 70 years, adenoma in medical history, and first-degree relative with colorectal cancer) were regarded as high-risk patients. Bowel preparation was performed in a standardized manner one day before the procedure. Participants in the intervention arm underwent an initial colonoscopy with sta…

Mini-laparoscopy in the endoscopy unit.

PURPOSE OF REVIEW: The evaluation of liver histology is an important component of the diagnosis and staging of liver diseases. The most common technique employed to sample liver tissue for decades has been percutaneous liver biopsy. Although this is a relatively well tolerated technique in the early stages of liver disease, it carries a high risk of complications, particularly hemorrhage, in patients with advanced cirrhosis. Mini-laparoscopy allows macroscopic assessment and biopsy under direct vision and therefore is a well tolerated and effective technique. RECENT FINDINGS: The major advantages of this technique are direct visualization of the liver surface, thereby allowing inspection fo…

Evolving endoscopic strategies for detection and treatment of neoplastic lesions in inflammatory bowel disease

The paradigm for neoplasia surveillance in IBD is rapidly evolving with advancements in endoscopic imaging technology. Modern technology has demonstrated a remarkably improved capacity to detect and characterize subtle neoplastic lesions. As such, practices of obtaining interval random biopsy specimens to identify “invisible”neoplasia and of recommending total proctocolectomy for treatment of early neoplastic lesions are gradually being phased out. Further research is required to confirm the safety and effectiveness of endoscopic resection of more advanced neoplastic lesions, including DALMs and lesions bearing HG-IEN. Moving forward, studies evaluating CRC risk profiles in IBD patients wou…