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Ray J, Zidong Z, Yuan J, Quan M, Hachem C. The relationship between colon polyps and colonic diverticulosis: a retrospective review. Ann Gastroenterol 2023; 36:314-320. [PMID: 37144013 PMCID: PMC10152812 DOI: 10.20524/aog.2023.0795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/24/2023] [Indexed: 05/06/2023] Open
Abstract
Background Colonic diverticulosis and colon polyps are common findings on colonoscopy. There is currently no consensus regarding a possible connection between the development of polyps and diverticulosis. Multiple research studies have sought to analyze whether the presence of both conditions is associated with the development of colorectal cancer. Our study aims to add to this body of data and to better assess the relationship between diverticulosis and colon polyps. Methods A retrospective chart review was performed of all patients who underwent screening and diagnostic colonoscopies between January 2011 and December 2020. Data collection included patient demographics; number, pathology, and location of colon polyps; incidence of colon cancer; and presence and location of colonic diverticulosis. Results Our study demonstrated that the overall presence of diverticulosis in any location increases the likelihood of having nearby colon polyps, regardless of subtype. The presence of left colonic diverticulosis was particularly associated with adjacent adenomatous and non-adenomatous colon polyps. Conclusions Colonic diverticulosis in any location may lead to an increased incidence of adenomatous colon polyps. It is important to perform careful examination of the mucosa surrounding colon diverticulosis to avoid missing colon polyps.
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Affiliation(s)
- Jennifer Ray
- Division of Gastroenterology and Hepatology, University of Washington (Jennifer Ray)
| | - Zhang Zidong
- Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine (Zhang Zidong)
| | - Jason Yuan
- Saint Louis University School of Medicine (Jason Yuan, Megan Quan)
| | - Megan Quan
- Saint Louis University School of Medicine (Jason Yuan, Megan Quan)
| | - Christine Hachem
- Division of Gastroenterology and Hepatology, Saint Louis University Hospital (Christine Hachem), USA
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Mogollón-González M, Conde-Muiño R, Rodríguez-Fernández A, Navarro-Pelayo M, Domínguez-Bastante M, Palma P. Impact of routine preoperative 18 FDG PET/CT on the surgical management of primary colorectal cancer. J Surg Oncol 2023. [PMID: 37092877 DOI: 10.1002/jso.27291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Determine the usefulness of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (18 FDG-PET/CT) in the preoperative setting of colorectal cancer (CRC), assessing its impact on changes in management strategy. METHODS Retrospective study of CRC patients who underwent preoperative 18 FDG-PET/CT and CT staging scans in a single referral center. The agreement between 18 FDG-PET/CT, contrast-enhanced CT, and colonoscopy for the surgical location was compared using the κ coefficient. Maximum standardized uptake (SUVmax ) value was obtained. Univariate and multivariate analyses were conducted. RESULTS One hundred ninety-five patients were included. 18 FDG-PET/CT improved tumor localization in 84.6% (165/195) of cases (κ value 0.798, p < 0.001), thus correcting endoscopic errors 69.7% (30/43) of the time. In patients with incomplete colonoscopies, 18 FDG-PET/CT detected synchronous tumors in 2.5% (5/195) patients, overlooked by CT staging scans. Based on extracolonic 18 FDG-uptake, the second primary malignancy was diagnosed in 7(3.6%,7/195) patients and total accuracy for lymph node and distant metastasis was 66.1% and 98.4%, respectively. The treatment plan was altered in 30 (15.4%, 30/196) patients. There was a significant association between the SUVmax and tumor size (odds ratio [OR] 4.254, p = 0.003) and the depth of tumor invasion (OR 1.696, p = 0.026). CONCLUSIONS Based on its ability to aid in preoperative evaluation and definitively alter surgical treatment planning, 18 FDG-PET/CT should be further evaluated in primary CRC.
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Affiliation(s)
- Mónica Mogollón-González
- Department of Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Clinical Medicine and Public Health PhD Programme, University of Granada, Granada, Spain
- Instituto de Investigación Sanitaria de Granada (IBS Granada), Granada, Spain
| | - Raquel Conde-Muiño
- Department of Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Sanitaria de Granada (IBS Granada), Granada, Spain
| | - Antonio Rodríguez-Fernández
- Instituto de Investigación Sanitaria de Granada (IBS Granada), Granada, Spain
- Department of Nuclear Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Mar Navarro-Pelayo
- Department of Nuclear Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Pablo Palma
- Department of Surgery, Campus Sant Cugat, International University of Catalonia, Barcelona, Spain
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Medina-Prado L, Hassan C, Dekker E, Bisschops R, Alfieri S, Bhandari P, Bourke MJ, Bravo R, Bustamante-Balen M, Dominitz J, Ferlitsch M, Fockens P, van Leerdam M, Lieberman D, Herráiz M, Kahi C, Kaminski M, Matsuda T, Moss A, Pellisé M, Pohl H, Rees C, Rex DK, Romero-Simó M, Rutter MD, Sharma P, Shaukat A, Thomas-Gibson S, Valori R, Jover R. When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement. Clin Gastroenterol Hepatol 2021; 19:1038-1050. [PMID: 33493699 DOI: 10.1016/j.cgh.2021.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/27/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on the indications and appropriate techniques for colonic tattoo through a modified Delphi process. METHODS The baseline questionnaire was classified into 3 areas: where tattooing should not be used (1 domain, 6 questions), where tattooing should be used (4 domains, 20 questions), and how to perform tattooing (1 domain 20 questions). A total of 29 experts participated in the 3 rounds of the Delphi process. RESULTS A total of 15 statements were approved. The statements that achieved the highest agreement were as follows: tattooing should always be used after endoscopic resection of a lesion with suspicion of submucosal invasion (agreement score, 4.59; degree of consensus, 97%). For a colorectal lesion that is left in situ but considered suitable for endoscopic resection, tattooing may be used if the lesion is considered difficult to detect at a subsequent endoscopy (agreement score, 4.62; degree of consensus, 100%). A tattoo should never be injected directly into or underneath a lesion that might be removed endoscopically at a later point in time (agreement score, 4.79; degree of consensus, 97%). Details of the tattoo injection should be stated clearly in the endoscopy report (agreement score, 4.76; degree of consensus, 100%). CONCLUSIONS This expert consensus has developed different statements about where tattooing should not be used, when it should be used, and how that should be done.
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Affiliation(s)
- Lucía Medina-Prado
- Servicio de Medicina Digestiva, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain
| | - Cesare Hassan
- Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium
| | - Sergio Alfieri
- Surgery Department, Fondazione Policlinico A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital. Portsmouth Hospital NHS Trust, Portsmouth, United Kingdom
| | - Michael J Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia
| | - Raquel Bravo
- Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, University of Barcelona, Centro Esther Koplowitz, Cellex Biomedical Research Center, Barcelona, Catalonia, Spain
| | - Marco Bustamante-Balen
- Gastrointestinal Endoscopy Unit, Gastrointestinal Endoscopy Research Group, Health Research Institute (Instituto de Investigación Sanitaria La Fe. NHS: National Health Service), Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jason Dominitz
- Gastroenterology Department, VA Puget Sound Health Care System, University of Washington, Seattle, Washington
| | - Monika Ferlitsch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Wien, Austria
| | - Paul Fockens
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - Monique van Leerdam
- Department of Gastroenterology and Hepatology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - David Lieberman
- Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon
| | - Maite Herráiz
- Departamento de Digestivo, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Charles Kahi
- Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michal Kaminski
- Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Center, Institute of Oncology, Warsaw, Poland
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Alan Moss
- Department of Endoscopic Services, Western Health, Melbourne Medical School Western Precinct, The University of Melbourne, St. Albans, Victoria, Australia
| | - Maria Pellisé
- Gastroenterology Department, Institute of Digestive and Metabolic Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, University of Barcelona, Centro Esther Koplowitz, Cellex Biomedical Research Center, Barcelona, Catalonia Spain
| | - Heiko Pohl
- Department of Gastroenterology and Hepatology, VA Medical Center, White River Junction, Vermont; Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| | - Colin Rees
- Department of Gastroenterology, South Tyneside NHS Foundation Trust, South Shields, United Kingdom
| | - Douglas K Rex
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Manuel Romero-Simó
- Unidad de Coloproctología, Servicio de Cirugía General, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain
| | - Matthew D Rutter
- University Hospital of North Tees, Stockton on Tees, United Kingdom; Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Prateek Sharma
- Department of Gastroenterology and Hepatology, VA Medical Center, University of Kansas School of Medicine, Kansas City, Kansas
| | - Aasma Shaukat
- Section of Gastroenterology, Department of Medicine, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, Minnesota
| | - Siwan Thomas-Gibson
- Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, and Imperial College, London, United Kingdom
| | - Roland Valori
- Gloucestershire Hospitals National Health Service Foundation Trust, Gloucestershire, United Kingdom
| | - Rodrigo Jover
- Servicio de Medicina Digestiva, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain.
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Sparreboom CL, Komen N, Rizopoulos D, van Westreenen HL, Doornebosch PG, Dekker JWT, Menon AG, Tuynman JB, Daams F, Lips D, van Grevenstein WMU, Karsten TM, Lange JF, D'Hoore A, Wolthuis AM. Transanal total mesorectal excision: how are we doing so far? Colorectal Dis 2019; 21:767-774. [PMID: 30844130 PMCID: PMC6850385 DOI: 10.1111/codi.14601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/25/2019] [Indexed: 12/11/2022]
Abstract
AIM This subgroup analysis of a prospective multicentre cohort study aims to compare postoperative morbidity between transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LaTME). METHOD The study was designed as a subgroup analysis of a prospective multicentre cohort study. Patients undergoing TaTME or LaTME for rectal cancer were selected. All patients were followed up until the first visit to the outpatient clinic after hospital discharge. Postoperative complications were classified according to the Clavien-Dindo classification and the comprehensive complication index (CCI). Propensity score matching was performed. RESULTS In total, 220 patients were selected from the overall prospective multicentre cohort study. After propensity score matching, 48 patients from each group were compared. The median tumour height for TaTME was 10.0 cm (6.0-10.8) and for LaTME was 9.5 cm (7.0-12.0) (P = 0.459). The duration of surgery and anaesthesia were both significantly longer for TaTME (221 vs 180 min, P < 0.001, and 264 vs 217 min, P < 0.001). TaTME was not converted to laparotomy whilst surgery in five patients undergoing LaTME was converted to laparotomy (0.0% vs 10.4%, P = 0.056). No statistically significant differences were observed for Clavien-Dindo classification, CCI, readmissions, reoperations and mortality. CONCLUSION The study showed that TaTME is a safe and feasible approach for rectal cancer resection. This new technique obtained similar postoperative morbidity to LaTME.
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Affiliation(s)
- C. L. Sparreboom
- Department of SurgeryErasmus University Medical CenterRotterdamThe Netherlands
| | - N. Komen
- Department of SurgeryUniversity Hospital AntwerpEdegemBelgium
| | - D. Rizopoulos
- Department of BiostatisticsErasmus University Medical CenterRotterdamThe Netherlands
| | | | - P. G. Doornebosch
- Department of SurgeryIJsselland ZiekenhuisCapelle aan den IJsselThe Netherlands
| | - J. W. T. Dekker
- Department of SurgeryReinier de Graaf GasthuisDelftThe Netherlands
| | - A. G. Menon
- Department of SurgeryIJsselland ZiekenhuisCapelle aan den IJsselThe Netherlands
| | - J. B. Tuynman
- Department of SurgeryVU University Medical CenterAmsterdamThe Netherlands
| | - F. Daams
- Department of SurgeryVU University Medical CenterAmsterdamThe Netherlands
| | - D. Lips
- Department of SurgeryJeroen Bosch ZiekenhuisHertogenboschThe Netherlands
| | | | - T. M. Karsten
- Department of SurgeryOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
| | - J. F. Lange
- Department of SurgeryErasmus University Medical CenterRotterdamThe Netherlands
| | - A. D'Hoore
- Departmenf of Abdominal SurgeryUniversity Hospital LeuvenLeuvenBelgium
| | - A. M. Wolthuis
- Departmenf of Abdominal SurgeryUniversity Hospital LeuvenLeuvenBelgium
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