ASGE Journal Scan

ASGE Journal Scan

ASGE Journal Scan | Esophagus

ESD Is Safe and Effective for Esophageal Lesions in Cirrhotic Patients With Small Esophageal Varices

Endoscopic submucosal dissection (ESD) is an effective strategy for complete resection of superficial esophageal neoplasia. However, such lesions in patients with cirrhosis and portal hypertension

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ASGE Journal Scan | Colon

Cold Snare Defect Protrusions Are Associated With Forced Pull-Throughs and Higher Rate of Residual Polyp

Cold snare polypectomy of colorectal polyps sometimes leaves a cord of white tissue consisting of submucosa and, sometimes, muscularis mucosa. These defects are called “cold

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ASGE Journal Scan | Colon

Are Anesthesia Specialists Necessary for Complex Colorectal Endoscopic Mucosal Resections?

Sedation practice for endoscopy varies widely in the United States. One model is to use anesthesia specialists to administer propofol for complex endoscopic procedures, such

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ASGE Journal Scan | Pancreas

Both Balloon Enteroscopy ERCP and EUS-Guided Antegrade Treatment Are Reasonable Options for Choledocholithiasis After Roux-en-Y Gastrectomy

Managing choledocholithiasis in patients after Roux-en-Y gastrectomy is challenging, and with no excluded stomach, endoscopic ultrasound (EUS)-guided transmural lumen-apposing metal stent placement is significantly more

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ASGE Journal Scan | Stomach and Small Bowel

Do DPP4 Inhibitors and GLP-1 Receptor Agonists Increase the Risk of Intestinal Obstruction?

The treatment of type 2 diabetes has evolved over the past decade, and incretin-based drugs, including dipeptidyl peptidase 4 (DPP4) inhibitors and glucagon-like peptide-1 (GLP-1)

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ASGE Journal Scan | Colon

Being Breastfed Associated With Increased Risk of Colorectal Cancer

This study utilized data from two cohorts of the Nurses’ Health Study involving nearly 159,000 women and 3.5 million person-years of follow-up. The investigators discovered

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ASGE Journal Scan | Colon

Colon Polyps Extending Across an Anastomosis Can Be Effectively Removed by Endoscopic Mucosal Resection

Among 2629 large nonpedunculated colorectal polyps in 2350 patients, 10 were classified as anastomotic and had a median lesion size of 35 mm. All lesions

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ASGE Journal Scan | Esophagus

Manual Review of pH Tracings Helpful in Defining GERD After POEM

The prevalence of GERD after peroral endoscopic myotomy (POEM) ranges from 13% to 58%. This variation is due to a lack of precise definitions and

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ASGE Journal Scan | General Endoscopy

Is There an Environmental Impact From Inappropriate Endoscopy?

Endoscopy plays a significant role in a gastroenterologist’s practice. Unindicated or inappropriate endoscopies increase costs, take away resources from other patients, and may have a

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ASGE Journal Scan | Colon

Post-EMR Adenoma Recurrences Are Effectively Treated Endoscopically

About 15% of large (≥20 mm) nonpedunculated colorectal polyps (LNPCPs) removed by piecemeal endoscopic mucosal resection (EMR) have evidence of recurrence at the first endoscopic

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ASGE Journal Scan | Colon

Texture and Color Enhancement Feature on New Olympus Scopes Improved Detection

Texture and color enhancement imaging (TXI) is a new image-processing feature on the latest generation of Olympus colonoscopes (Tokyo, Japan). These instruments have been commercially

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ASGE Journal Scan | Colon

Risks of Cancer and Cancer Death in Peutz-Jeghers and Juvenile Polyposis From Danish National Registry

Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS) are hamartomatous polyposis syndromes associated with increased cancer risk. The Danish national health registries systematically record health

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ASGE Journal Scan | Colon

Most Patients Who Have Not Had Colorectal Cancer Screening Have Not Been Offered Screening

Previous studies have shown that most patients who had not undergone colorectal cancer (CRC) screening reportedly had not been offered screening by their primary care

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ASGE Journal Scan | Esophagus

Preservation of Oblique Sling Fibers During POEM Does Not Reduce Postprocedure GERD

Peroral endoscopic myotomy (POEM) is a standard treatment option for patients with achalasia but is associated with a high incidence of postprocedure gastroesophageal reflux disease

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ASGE Journal Scan | Pancreas

Performance of Published Criteria in Predicting Choledocholithiasis in Practice

Choledocholithiasis can be identified through multiple means, including a right upper quadrant ultrasound, endoscopic ultrasound (EUS), endoscopic retrograde cholangiography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and

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ASGE Journal Scan | Esophagus

Endoscopic Therapy Is Highly Successful for Early Barrett’s Cancer

For patients with intramucosal esophageal adenocarcinoma (T1a EAC), endoscopic treatment (endoscopic resection, followed by ablation) is the current standard. This study focused on patients with

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ASGE Journal Scan | Colon

Endoscopist Characteristics May Predict Improved Detection With CADe

Most randomized controlled trials (RCTs) of computer-aided detection (CADe) demonstrate increased detection, but some RCTs and real-world experiences with CADe have failed to show a

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ASGE Journal Scan | Colon

Serrated Polyposis Syndrome Remains Very Underdiagnosed by Community Endoscopists

Serrated polyposis syndrome (SPS) is the most common type of polyposis syndrome, affecting as many as one in every 250 persons undergoing screening colonoscopy. It

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ASGE Journal Scan | EUS

Is Upfront EUS-Guided Biliary Drainage a Wise Option in Patients With Malignant Distal Biliary Obstruction?

Traditionally, malignant biliary obstruction is relieved by placing a transpapillary stent during endoscopic retrograde cholangioscopy (ERCP). Pancreatitis is a possible adverse event of ERCP. Additionally,

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ASGE Journal Scan | Colon

Cancers Detected in Second-Round Fecal Immunochemical Test Screening Still Early Stage

The value of colorectal cancer (CRC) screening lies in CRC prevention through polyp detection and prevention of CRC mortality by early-stage CRC detection. Compared with

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ASGE Journal Scan | Colon

Delay in Colonoscopy After Positive FIT May Be Lethal, Particularly in 40- to 49-Year-Olds

These data are from a population-based Chinese screening program involving 595,180 persons aged 40 to 74 years with 16 years of follow-up. There were 42,353

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ASGE Journal Scan | Colon

Behavioral Interventions Have a Large Impact on Colonoscopy Uptake

Twenty-five studies with 30 interventions were analyzed for this study on the effect of behavioral interventions on colonoscopy uptake. Of the interventions evaluated by the

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ASGE Journal Scan | Esophagus

PPIs and Dementia: A Tale of Two Studies – Part One

Previous research has suggested a potential connection between proton pump inhibitors (PPIs) and a higher risk of dementia, causing concern among patients and health care

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ASGE Journal Scan | Esophagus

PPIs and Dementia: A Tale of Two Studies – Part Two

Previous research has suggested a potential connection between proton pump inhibitors (PPIs) and a higher risk of dementia, causing concern among patients and health care

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ASGE Journal Scan | Colon

Risk Factors for Metachronous Advanced Serrated Lesions

Current recommended postpolypectomy surveillance intervals for patients with serrated lesions are based on limited evidence. This single-center study evaluated risk factors for metachronous advanced serrated

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ASGE Journal Scan | Esophagus

Modified POEM Technique Can Be Effective for Postfundoplication Dysphagia

Laparoscopic fundoplication (LF) as a treatment option for GERD involves 3 techniques based on the wrap extension: Nissen (total, 360°), Toupet (posterior, 270°), and Dor

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ASGE Journal Scan | Pancreas

Pure Cut Current for Biliary Sphincterotomy Is Associated With Less Delayed Bleeding and May Reduce Post-ERCP Pancreatitis Risk

Thermal injury from biliary sphincterotomy is thought to play a role in at least a proportion of post-ERCP pancreatitis (PEP) cases. Thus, the present study

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ASGE Journal Scan | Colon

Two Experts Give Advice on Best Basic Colonoscopy Techniques

Among the key and newer points from a recent review on the best performance of basic colonoscopy, including the resection of lesions <20 mm in

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ASGE Journal Scan | Colon

Randomized Controlled Trial of Over-the-Scope Versus Through-the-Scope Suturing of ESD Defects

Over-the-scope suturing (OTSS) requires a double-channel gastroscope, and closure of defects in the right side of the colon may require an overtube. Through-the-scope suturing (TTSS)

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ASGE Journal Scan | Esophagus

Currently Available Drugs Work for Patients With Eosinophilic Esophagitis

Presently, there is no specific drug recommendation as the preferred treatment for active eosinophilic esophagitis (EoE) nor clear guidance on the comparative effectiveness of various

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ASGE Journal Scan | Colon

FDA-Approved Sports Drink-Like Flavored Colonoscopy Preparation

This is a single, blind, multicenter, randomized, controlled trial that compared oral sulfate solution (OSS) to a sports drink-like flavored solution of polyethylene glycol and

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ASGE Journal Scan | Esophagus

Patients With Refractory GERD Should Be Screened for Psychological Symptoms

In patients with GERD, there is a need to understand the poor symptom-reflux association and the potential role of psychological processes in reporting esophageal symptom

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ASGE Journal Scan | Stomach and Small Bowel

Does Low-Dose Aspirin Result in Anemia in Older Patients?

Daily intake of low-dose aspirin increases the risk of major bleeding, but its effect on iron deficiency and anemia is less studied. This study, a

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ASGE Journal Scan | Esophagus

Ultrasound Capsule Endoscopy Produces Images Comparable to EUS Images

The current standard method for diagnosing and staging esophageal subepithelial lesions and tumors is endoscopic ultrasound (EUS). This study focused on a newly developed medical

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ASGE Journal Scan | Pancreas

Large Single-Use Duodenoscope Experience Shows High Success and Low Crossover Rates

Single-use duodenoscopes were developed to eliminate the risk of duodenoscope-associated transmission of infections. However, there are concerns that the performance of single-use duodenoscopes may not

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ASGE Journal Scan | Colon

Meta-Analysis of Appendicitis Risk With Endoscopic Full-Thickness Resection of Appendiceal Orifice Lesions

There is agreement that endoscopic full-thickness resection (EFTR) is a great procedure for lesions extending into the appendiceal orifice (AO) when there has been a

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ASGE Journal Scan | Colon

Early-Onset Colon Cancers Have More Synchronous Advanced Adenomas

In a cross-sectional retrospective study at a single U.S. health care system, colonoscopic findings of 150 randomly selected patients with early-onset colorectal cancer (CRC) were

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ASGE Journal Scan | Colon

Monoallelic Variants in Recessive CRC Genes Not Associated With Increased CRC Risk

Increasingly, we are consulted on or asked to perform colonoscopies on patients who previously underwent multigene panel testing for oncogenes associated with colorectal cancer (CRC).

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Esophagus

One-Fourth of Patients Do Not Get Appropriate Follow-up After Esophageal Food Bolus Impaction

Dealing with esophageal food bolus impactions (FBIs) is a frequent gastrointestinal emergency. Effective handling of esophageal FBIs entails promptly conducting an endoscopic assessment and addressing

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ASGE Journal Scan | Colon

To Optimally Prevent Colorectal Cancer, We Need to Detect Both Adenomas and Serrated Lesions

Recent studies have found that significant fractions of colonoscopists possess adequate detection of conventional adenomas, as measured by adenoma detection rate (ADR), but low detection

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ASGE Journal Scan | Colon

About Half of Cancers in Serrated Polyposis Syndrome Arise Through the Adenoma-Carcinoma Sequence

The serrated pathway of colorectal cancer (CRC) is considered to account for about 20% of all CRCs. Patients with serrated polyposis syndrome (SPS) have higher

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ASGE Journal Scan | Colon

Photodocumentation of Large Colorectal Polyps Is Suboptimal

The U.S. Multi-Society Task Force on Colorectal Cancer recommends that polyps ≥1 cm be photographed before resection to document size and the resection site photographed

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ASGE Journal Scan | Colon

Meta-Analysis of Tip-in Versus Conventional EMR for Colorectal Lesions

Tip-in endoscopic mucosal resection (T-EMR) involves submucosal injection, followed by a small incision into the submucosal mound on the cecal side of the lesion. The

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ASGE Journal Scan | Colon

Cold Snare Looks Good for Pedunculated Polyps Smaller Than 10 mm

This systematic review and meta-analysis identified 6 studies with 1025 patients and 1111 polyps with a mean size ranging from 4 to 8.5 mm. Cold

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ASGE Journal Scan | Esophagus

Increasing Prevalence and Incidence of Eosinophilic Esophagitis Globally

Given reports on the rising global incidence and prevalence of eosinophilic esophagitis (EoE) and the associated societal impact, investigators conducted a systematic review and meta-analysis

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ASGE Journal Scan | Pancreas | Stomach and Small Bowel

Is Digital Gut-Directed Hypnotherapy Better Than Muscle Relaxation in Patients With Irritable Bowel Syndrome?

In addition to dietary modification and pharmacologic therapy, behavioral therapy has become a recognized treatment for irritable bowel syndrome (IBS) and is now integrated into

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ASGE Journal Scan | Esophagus

GERD After Sleeve Gastrectomy Related to Proximal Gastric Pressurization

Sleeve gastrectomy (SG) has become a popular choice for weight loss due to its ease and effectiveness. However, it can worsen symptoms of esophageal reflux

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ASGE Journal Scan | Esophagus

Consider Endoscopic Upper GI Screening in Patients With Head and Neck Squamous Cell Cancer

It is known that some patients with head and neck squamous cell carcinoma (HNSCC) can develop a second primary tumor (SPT). Timely detection of SPTs

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ASGE Journal Scan | Pancreas

More Evidence for Early Cholecystectomy After Gallstone Pancreatitis

Same-admission cholecystectomy is recommended for patients with mild gallstone pancreatitis (GSP) to reduce recurrent GSP events and lower costs. However, adherence to same-admission cholecystectomy remains

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ASGE Journal Scan | Colon

Underwater ESD Associated With Less Post-ESD Coagulation Syndrome in Retrospective Study

Underwater endoscopic submucosal dissection (U-ESD; typically performed with saline rather than water) has several potential advantages over conventional ESD (C-ESD; performed with carbon dioxide insufflation).

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ASGE Journal Scan | Stomach and Small Bowel

Malignant Tumor Bleeding: Is Hemostatic Powder Superior to Standard Endoscopy?

Treating bleeding malignant tumors is challenging because they tend to be diffusely friable. Hemostatic powder is a relatively new tool in the endoscopic armamentarium for

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ASGE Journal Scan | Colon

Declines in Colorectal Cancer Incidence in Older Persons Are Slowing

This study used SEER (Surveillance, Epidemiology, and End Results) data to update colorectal cancer (CRC) incidence and mortality trends from 1992 to 2019. The well-known

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ASGE Journal Scan | Colon

Video-Based Feedback Improves Cold Snare Polypectomy Among Fellows but Learning Curve Is Long

Cold snare polypectomy (CSP) is the preferred resection method for colorectal lesions ≤10 mm. Competence in CSP can be assessed using the CSPAT (Cold Snare

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ASGE Journal Scan | Stomach and Small Bowel

Band and Biopsy: An Easier Way to Sample and Remove Small Subepithelial Lesions?

Diagnosis and resection of subcentimeter subepithelial tumors (SETs) can be challenging. One problem with endoscopic band ligation (EBL) and allowing the lesion to slough is

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ASGE Journal Scan | Colon

European Society of Gastrointestinal Endoscopy Issues Comprehensive Curriculum for Endoscopic Mucosal Resection in the Colon

Those performing endoscopic mucosal resection (EMR) in the colorectum should be aware of this remarkably comprehensive document from the European Society of Gastrointestinal Endoscopy that

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ASGE Journal Scan | Pancreas

Lessons Learned After Post-ERCP Mortality

ERCP is a vital endoscopic procedure for the management of pancreatobiliary disease but is associated with serious adverse events, including mortality. Although a central tenet

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ASGE Journal Scan | Pancreas

Effectiveness of EUS Gallbladder Drainage as Primary Therapy for Malignant Biliary Obstruction

ERCP is generally the first-line approach for palliation of distal malignant biliary obstruction (DMBO), but interest in the use of endoscopic ultrasound (EUS)-guided transmural drainage

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ASGE Journal Scan | Colon

More on Expanding ADR Measurement Beyond Screening

Current recommendations suggest measuring the adenoma detection rate (ADR) in first-time screening colonoscopies. Several studies have found that including surveillance and diagnostic colonoscopies in an

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ASGE Journal Scan | Pancreas

Fully Covered Self-Expanding Metal Stents Are Safe and May Be More Durable in Distal Malignant Biliary Obstruction

It is clear that metal stents are superior to plastic stents for palliation of distal malignant biliary obstruction (dMBO). Among self-expanding metal stents (SEMS), there

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ASGE Journal Scan | Colon

Tissue Is Often Retained in the Cap or Channel After EGD and Colonoscopy With Biopsy

This study looked at retained tissue in the endoscope after EGD and colonoscopy in which only cold forceps biopsies were performed. The study cases were

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ASGE Journal Scan | Colon

Retrieval Bag Allows Removal of ESD Specimens From Rectum Without Fragmentation

Very large specimens obtained by endoscopic submucosal dissection may fragment during retrieval through the anus. The Endo Carry Large Type (Hakko Co, Tokyo, Japan) is

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Colon

Submucosal Injection Unnecessary for 3- to 9-mm Polyps, per Randomized Controlled Trial Results

Cold snare resection is the treatment of choice for 4- to 9-mm polyps, yet some practitioners perform submucosal injection for polyps in this size range.

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ASGE Journal Scan | Colon

New AI Can Tell Normal From Abnormal Colon Biopsies, Would Reduce Pathology Workload

In some countries, pathologists and pathology departments are overworked. A number of artificial intelligence (AI) programs have shown substantial accuracy in interpretation of whole slide

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ASGE Journal Scan | Colon

ChatGPT Provides Good Answers to Patient Questions About Colonoscopy

This study examined the quality of answers provided by ChatGPT (OpenAI, San Francisco, Calif) to 8 common questions about colonoscopy, compared with answers to the

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ASGE Journal Scan | Colon

General Familial Adenomatous Polyposis Cancer Risks in Danish National Registries

Cancer incidence studies in national registries, such as that maintained in Denmark, are of interest because they reduce referral bias. A study used nationwide Danish

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ASGE Journal Scan | Stomach and Small Bowel

Does Eradication of Helicobacter pylori Lower the Chance of Gastric Cancer?

Helicobacter pylori eradication has been shown to decrease the risk of noncardia gastric adenocarcinoma (NCGA) in Asia; however, the data in the United States are limited.

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ASGE Journal Scan | Esophagus

Short POEM as Good as Long POEM for Achalasia Treatment

For the treatment of patients with achalasia, peroral endoscopic myotomy (POEM) has shown comparable effectiveness to surgery. During POEM, the typical length of the myotomy

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ASGE Journal Scan | Esophagus

Using AI To Identify Patients With Barrett’s Esophagus and Dysplasia From Pathology Reports

Natural language processing (NLP) is a computer technology that uses language cues and context to interpret findings and mine large databases to identify desired clinical

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ASGE Journal Scan | Colon

Simultaneous Population-Based Testing for Specific Cancer Genes, Including Lynch Syndrome, Found Conditionally Cost-Effective

According to data, 1.5% of the U.S. population has hereditary breast and ovarian cancer syndrome (0.72%), Lynch syndrome (0.35%), or familial hypercholesterolemia (FH; 0.43%). This

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ASGE Journal Scan | Colon

More on Mucus Production by Water Filling During Colonoscope Insertion

Water instillation is now commonly used for a variety of purposes during colonoscopy. Water filling during colonoscope insertion has been shown to decrease pain, reduce

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ASGE Journal Scan | Pancreas

Primary EUS Choledochoduodenostomy Is Safe and Efficacious in Malignant Biliary Obstruction

Palliation of malignant biliary obstruction is required to facilitate oncologic therapy and relief of symptoms. Although this is almost always performed with ERCP, biliary cannulation

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ASGE Journal Scan | Esophagus

Pneumatic Dilation Associated With Higher Complication and Readmission Rates in Patients With Achalasia

Data directly comparing treatment options for achalasia are limited, namely peroral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LHM), and endoscopic pneumatic dilation (PD). The current

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ASGE Journal Scan | Colon

Changing Advanced/High-Risk Adenoma Definition Would Reduce Colonoscopies With Limited Delay in CRC Diagnoses

Patients with advanced or high-risk adenomas are recommended to undergo surveillance earlier than patients with low-risk adenomas. In the U.S., the traditional high-risk group classification

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ASGE Journal Scan | Colon

Endoscopy Unit-Level Measures That Improve ADR: Report Cards and a Second Observer

In a systematic review and meta-analysis, 15 studies evaluating the impact of report cards on adenoma detection rate (ADR) were among the 34 studies that

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ASGE Journal Scan | Colon

Cesarean Delivery Associated With Early-Onset Colorectal Cancer in Women

Birth by cesarean delivery has been associated with intestinal dysbiosis in childhood. This study is a population-based, nationwide, case-control study from Sweden involving 564 cases

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ASGE Journal Scan | EUS

Relief of Gastric Outlet Obstruction: Is Endoscopy Treatment Better Than Surgery?

Malignant gastric outlet obstruction (mGOO) results in significant morbidity and decreased quality of life. Treatment options include surgical gastrojejunostomy (SGJ) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE).

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ASGE Journal Scan | Pancreas

Consensus Guidelines Recommend Monitored Anesthesia Care for Most ERCPs

Adequate patient sedation is essential for the successful completion of ERCP; however, delivery methods of anesthesia vary between providers, with most endoscopists favoring deep sedation

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ASGE Journal Scan | Esophagus

A Severity Index May Be Clinically Useful in the Management of Patients With EoE

The Index of Severity for EoE (I-SEE) is a new tool created by a multidisciplinary team to identify meaningful features of eosinophilic esophagitis (EoE) disease

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ASGE Journal Scan | Esophagus

Long-Term Exposure to Air Pollution Is a Risk Factor for Esophageal Cancer

Long-term exposure to PM2.5 (fine particulate matter) is a known risk factor for lung cancer. However, the evidence linking PM2.5 to esophageal cancer is sparse

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ASGE Journal Scan | Colon

Computer-Aided Diagnosis System Bombs in a Real-World Colon Polyp Histology Prediction Trial

In a prospective study from Singapore, the computer-aided diagnosis (CADx) program CAD EYE (Fujifilm, Tokyo, Japan) was assessed in 661 consecutive polyps of all sizes

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ASGE Journal Scan | Colon

Free Online 30-Minute Interactive Training Improves ADR and Lowers Interval Cancer Risk

This study from the Northern California Kaiser Permanente health care system evaluated the impact of a 30-minute online interactive training program collaboratively developed by endoscopists,

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ASGE Journal Scan | Colon

Endocuff Vision Enhances Detection in CADe-Assisted Colonoscopy

In a randomized trial, 1316 patients underwent colonoscopy with either computer-aided detection (CADe) assistance alone or CADe plus Endocuff Vision (ECV; Olympus America, Center Valley,

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ASGE Journal Scan | Colon

Predictors of Prolonged Rectal Endoscopic Submucosal Dissection

In a Japanese experience of endoscopic submucosal dissection (ESD) performed on 483 rectal lesions over 23 years, a prolonged ESD was considered longer than 120

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ASGE Journal Scan | Esophagus

Local Steroid Injection After Esophageal ESD Does Not Prevent Strictures in All Patients

Local triamcinolone (TA) therapy involves injecting approximately a 100-mg dose of TA into the ulcer immediately after an endoscopic submucosal dissection procedure to reduce the

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ASGE Journal Scan

Another Tool in the Endoscopic Closure Toolbox

Endoscopic closure techniques are essential for successful closure of resection sites and acute perforations. Initially largely limited to through-the-scope (TTS) clips, the armamentarium has evolved

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ASGE Journal Scan | Colon

If the Right Side of the Colon Deserves Double Examination, so Does the Rectum

This study used the World Endoscopy Organization classification of postcolonoscopy colorectal cancer (PCCRC) to assess 762 PCCRC cases that accumulated during 1995 to 2021. PCCRC

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ASGE Journal Scan | Colon

In U.S. Veterans, Advanced Adenomas, Not Nonadvanced Adenomas, Before Age 50 Associated With Higher CRC Risk

Adenomas are commonly diagnosed in patients younger than age 50 undergoing colonoscopy. Adenomas in young people often initiate surveillance at shorter than the recommended intervals,

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ASGE Journal Scan | Colon

Offering a Blood Test Increases CRC Screening in Patients Who Had Declined Colonoscopy and FIT

This was a randomized controlled trial in 359 veterans aged 50 to 75 years who had declined colonoscopy and a fecal immunochemical test (FIT) in

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ASGE Journal Scan | Pancreas

Papillary Morphology Predicts Difficult Biliary Cannulation

Successful and safe ERCP requires the endoscopist to cannulate the duct of interest successfully and efficiently. Although operator skill clearly influences procedure success, there is

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ASGE Journal Scan | Colon

Single U.S. Center Reports High Rates of Screening Colonoscopy in Older Patients With Low Life Expectancy: Low Yield and Very High Complication Rates

The U.S. Preventive Services Task Force recommends that the decision regarding whether to screen persons aged 75 to 85 years for colorectal cancer be individualized

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ASGE Journal Scan | Colon

There Is an Endoscopic Mucosal Transition Zone on the Ileocecal Valve

Experienced endoscopists are aware that the mucosa on the ileocecal valve (ICV) lips has a 3- to 10-mm-wide transition zone between normal colonic mucosa and

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ASGE Journal Scan | Colon

Colonoscopy Quality Appears To Be Good in U.S. Veterans Administration Hospitals

In a study of 29,877 patients with colorectal cancer (CRC) in the U.S. Veterans Affairs (VA) health care system, the rate of postcolonoscopy colorectal cancer

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ASGE Journal Scan | Esophagus

Not All Patients Require Radiotherapy After ESD for T1b Esophageal Cancer

Endoscopic resection (ER) plays a critical role in both treating and diagnosing superficial esophageal cancer. However, the incidence of lymph node metastasis in patients with

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ASGE Journal Scan | Stomach and Small Bowel

Can We Improve Quality in ERCP and EUS?

ERCP and EUS are essential in treating a variety of disease entities. Metrics exist to measure performance quality, but data are necessary to improve quality

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ASGE Journal Scan | Esophagus

Endoscopic Therapy Can Successfully Treat Post-POEM GERD

Peroral endoscopic myotomy (POEM) is increasingly being used as mainline therapy for patients with achalasia. After POEM, approximately 30% to 50% of patients experience abnormal

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ASGE Journal Scan | Colon

You Removed a Small Lesion With High-grade Dysplasia or Cancer Using a Cold Snare, Now What?

Cold snare polypectomy is now the resection method of choice for colorectal lesions ≤10 mm in size. The risk of resecting a cancerous lesion in

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ASGE Journal Scan | Colon

Combined EMR and Full-Thickness Resection for Large Nonlifting Colorectal Adenomas

Endoscopic submucosal dissection (ESD) is an option for scarred, large colorectal adenomas that do not lift well and/or contain a suspicious area of an advanced

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ASGE Journal Scan | Pancreas

True Rate of Post-ERCP Pancreatitis: Do Randomized Trials Provide the Answer?

Pancreatitis after ERCP is one of the most common and morbid adverse events following any gastrointestinal endoscopy procedure. It is imperative that the consent process

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ASGE Journal Scan | Colon

For American Patients Interested in Screening, Colonoscopy Resulted in Higher Adherence and Detection Than Annual Fecal Testing

In 3 U.S. centers, asymptomatic patients aged 50 to 69 years (or 40-69 if Black) were randomized to screening colonoscopy or annual sequential high-sensitivity guaiac

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ASGE Journal Scan | Stomach and Small Bowel

Just Because Something Is New, Does It Mean It Works?

The development of hemostatic powders has increased the tools in our armamentarium to treat GI bleeding. However, data on their utility in peptic ulcer bleeding

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ASGE Journal Scan | Esophagus

POEM Better Than Pneumatic Dilation in Treating Achalasia Symptoms After Surgical Myotomy

Research into peroral endoscopic myotomy (POEM) as a rescue therapy for patients with persistent or recurrent symptoms after laparoscopic Heller myotomy (LHM) is increasing. Although

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ASGE Journal Scan | Esophagus

Majority of At-Risk Patients Not Screened for Barrett’s Esophagus

The current screening model for Barrett’s esophagus (BE) has limitations because patients need to be identified by their primary care physician and then referred to

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ASGE Journal Scan | Colon

CADe Fails To Improve Polyp Detection in Community-Based Randomized Controlled Trial

The overwhelming majority of randomized trials testing the impact of computer-aided detection (CADe) programs have shown substantial benefits. In a randomized controlled trial in 4

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ASGE Journal Scan | Esophagus

Dietary Therapy Can Be Extremely Helpful for Patients With Eosinophilic Esophagitis

There are several elimination diet regimens available, including the 6-food elimination diet (SFED), 4-food elimination diet (FFED), one-food elimination diet (OFED), and targeted elimination diet

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ASGE Journal Scan | Colon

What Should You Photograph During Colonoscopy?

An expert colonoscopist recommends the following for photography during colonoscopy:  Cecal landmarks Terminal ileum, if intubated Bowel preparation quality Large lesions before and after endoscopic

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ASGE Journal Scan | Colon

Surveillance Colonoscopy Recommended Too Often in Older Patients With Limited Life Expectancy

Colonoscopists are advised to consider age, comorbidities, and colonoscopy findings before recommending surveillance. In a study of the New Hampshire Colonoscopy Registry, 9831 adults older

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ASGE Journal Scan | Colon

Uncontrolled Description of X-Tack Efficacy for Colonic EMR Defects

X-Tack (Apollo Endosurgery, Austin, Texas) is a through-the-scope suturing device that can be an alternative to through-the-scope clips. No controlled trial of X-Tack versus clips

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ASGE Journal Scan | Colon

Cold Snare Safer Than Hot Snare for 4- to 10-mm Colorectal Polyps in Pragmatic Randomized Controlled Trial

Cold snare polypectomy is now widely accepted as the treatment of choice for colorectal polyps 4 to 10 mm in size. Despite overwhelming evidence that

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ASGE Journal Scan | Colon

Another Real-World U.S. Trial of Computer-Aided Detection Fails To Impress

Randomized controlled trials (RCTs) have generally shown consistent improvements in adenoma detection rates (ADRs) with the use of computer-aided detection (CADe) during colonoscopy, but a

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ASGE Journal Scan | Colon

Can Artificial Intelligence Eliminate the Need for Postdiverticulitis Colonoscopy?

Colonoscopy is often recommended after an episode of acute diverticulitis, particularly complicated diverticulitis, and when no colonoscopy was performed the previous year. Colonoscopy in prior

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ASGE Journal Scan | Colon

Serrated Appendiceal Lesions Common in Serrated Polyposis but Not Clinically Important

Some previous work has suggested that the prevalence of advanced lesions in the appendix is high enough to warrant routine appendectomy in patients with serrated

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy Is Also Effective in Patients With Prior Achalasia Treatment

Some studies suggest that prior treatment may increase the difficulty and success of tunneling during a peroral endoscopic myotomy (POEM) procedure, but recent studies have

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ASGE Journal Scan | EUS

Does EUS-Guided Gastroenterostomy Improve Quality of Life in Patients With Malignant Gastric Outlet Obstruction?

Malignant gastric outlet obstruction (GOO) has a profound negative impact on quality of life (QoL). Options for palliation include surgical gastroenterostomy, enteral stent placement, and,

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ASGE Journal Scan | Esophagus

Time To Start Paying Attention to Postendoscopy Upper GI Cancers

Upper gastrointestinal cancers (UGICs) are typically diagnosed through endoscopy, but some cases may be missed and diagnosed later, known as postendoscopy UGICs (PEUGICs). PEUGICs are

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ASGE Journal Scan | Esophagus

Assessing Visualization During Upper Endoscopy

Esophagogastroduodenoscopy (EGD) requires clear visualization of the upper gastrointestinal (UGI) mucosa, but there is no standardized method to assess mucosal visualization. Lesions are often missed

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ASGE Journal Scan | Colon

Continuing Antithrombotics Substantially Increases Risk of Delayed Bleeding After Colorectal ESD

In this retrospective study from Japan, researchers compared delayed bleeding rates for 82 patients who underwent ESD while continuing antithrombotic medications versus 386 patients without

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ASGE Journal Scan | Esophagus

Optimum Barrett’s Inspection Time Is Critical for a High-Quality Endoscopy

Endoscopic surveillance of Barrett’s esophagus (BE) is recommended to reduce mortality and morbidity related to esophageal adenocarcinoma. A thorough endoscopic inspection of a BE segment

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ASGE Journal Scan | Colon

Synchronous Large Nonpedunculated Lesions Are Most Common With a Left-Sided Nongranular Index Lesion

Large (≥20 mm) colorectal lesions are often accompanied by synchronous lesions, including a high prevalence of synchronous advanced lesions. This study examined the relationship between

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ASGE Journal Scan | Colon

A New Treatment for Endoscopic Palliation of Colorectal Cancer

Patients with colorectal cancer (CRC) metastatic to the liver or lung often do not undergo surgical resection of their primary tumor. However, the primary tumor

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ASGE Journal Scan | Stomach and Small Bowel

Is Motorized Spiral Enteroscopy All That It Is Cut Out To Be?

In 2016, motorized spiral enteroscopy (mSe) was introduced to facilitate visualization for diagnosis and therapy of the small bowel. The primary aim of this review

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Colon

Cold Snare Resection, at Least Cold EMR, Looks Good for 10- to 19-mm Polyps, Including Adenomas

Cold snare polypectomy is the accepted treatment of choice for all colorectal polyps smaller than 10 mm and with no suggestion of cancer on endoscopic

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ASGE Journal Scan | Colon

No Metachronous Cancers Observed in MSH6 and PMS2 Carriers

Lynch syndrome is caused by germline mutations in MLH1, MSH2, MSH6, or PMS2 genes, but the most commonly affected genes are MLH1 and MSH2. Increasingly, surveillance recommendations are on a gene-specific basis, with

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ASGE Journal Scan | Colon

71% of U.S. ESD Patients in Study Were Discharged Without Hospital Admission

Endoscopic submucosal dissection (ESD) is frequently followed by hospital admission for multiple days in Asian countries. However, hospitalization is much more expensive in the U.S.,

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ASGE Journal Scan | Colon

Intravenous Acetaminophen Said To Distinguish Benign Postcolorectal EMR Pain From Pain Potentially Reflecting Complications

In an observational study of colorectal EMR, 67 of 336 patients (19.9%) experienced postprocedural pain. All EMRs were performed with electrocautery and adrenaline injection. Pain

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ASGE Journal Scan | Colon

Anticoagulant and Antiplatelet Agents Affect Fecal Immunochemical Test Performance

In a very large study, 11.8% of 77,007 patients receiving antithrombotic treatment had a positive fecal immunochemical test (FIT) result, compared with 6% of those

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ASGE Journal Scan | Esophagus

Patients With Superficial Esophageal Squamous Cell Cancer With Lymphovascular or Submucosal Invasion Need Additional Therapy After Endoscopic Resection

In patients with esophageal squamous cell carcinoma with invasion into the muscularis mucosa (pMM-ESCC) with lymphovascular invasion (LVI), the Japan Esophageal Society recommends additional treatment

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ASGE Journal Scan | Stomach and Small Bowel

Is Cold Snare Resection a Good Idea for Duodenal Adenomas?

Resection of duodenal adenomas (DAs) can be challenging, in part due to the thinness of the duodenal wall and its vascularity. Both postprocedural bleeding (PPB)

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ASGE Journal Scan | Colon

Should a Biopsy of Normal-Appearing EMR Scars Be Performed at Follow-up?

Traditionally, even if careful inspection of an EMR scar at follow-up shows no residual polyp, a biopsy should still be performed to rule out histologic

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ASGE Journal Scan | Colon

Should Older Adults With Adenomas Continue Surveillance Colonoscopy?

Although there are rules for when to stop colorectal cancer screening, there are no rules about when to stop surveillance colonoscopy in patients with precancerous

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ASGE Journal Scan | Colon

Colonoscopy Screening at Intervals Longer Than 10 Years Is Feasible

Case-control studies and cohort studies have found that colonoscopy prevents colorectal cancer (CRC) for 15 to 20 years or more. However, only a few small

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ASGE Journal Scan | Colon

The Strongest Predictor of Colonoscopy Completion After a Positive Stool Test Is a Multitarget Stool DNA Test

It is well known that the rates of follow-up colonoscopy after a positive fecal screening test are suboptimal, and delays in colonoscopy versus prompt colonoscopy

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ASGE Journal Scan | Colon

Trainees Often Look at Polyps and Don’t Recognize Them

This study used eye tracking of 7 endoscopy trainees to determine whether missed polyps had not been seen versus seen but not recognized.  Trainees identified

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ASGE Journal Scan | Esophagus

Endoscopic Presence of LA Grade B but Not Grade A Erosive Esophagitis Confirms GERD

Per the Lyon Consensus, endoscopic documentation of Los Angeles (LA) grade C or D esophagitis is conclusive evidence of GERD, whereas LA grades A and

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ASGE Journal Scan | Esophagus

Quality Indicators for Eosinophilic Esophagitis Management

Eosinophilic esophagitis (EoE) is a chronic condition increasingly encountered in clinical practice. The establishment of quality indicators (QIs) in EoE will lead to the standardization

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ASGE Journal Scan | Colon

Another CADx Program With Good but Limited Performance for Diminutive Colorectal Polyps

This study describes the prospective testing of a computer-aided diagnosis (CADx) system called POLyp Artificial Recognition (POLAR), developed for real-time diagnosis of diminutive colorectal polyps.

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ASGE Journal Scan | Colon

Does Appendectomy Increase Risk of Colorectal Cancer?

This systematic review and meta-analysis identified 22 studies from 3 continents that addressed the risk of colorectal cancer (CRC) after appendectomy in the general population.

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy Is Effective in Chronic Opioid Use-related Esophageal Motility Disorders

Chronic opioid use can lead to a variety of esophageal disorders, including type III achalasia, esophagogastric outflow obstruction (EGJOO), diffuse esophageal spasm (DES), and hypercontractile

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ASGE Journal Scan | Stomach and Small Bowel

Could Upper GI Eosinophilia Account for Abdominal Pain?

Eosinophilic gastrointestinal diseases (EGIDs) are rare inflammatory conditions of the GI tract characterized by tissue eosinophilia and chronic GI symptoms. EGIDs include eosinophilic gastritis (EoG)

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ASGE Journal Scan | Colon

FIT-Fecal DNA Test Had High Positive Predictive Value in Second-Round Screening

This study examined the positive predictive value (PPV) of a second round of screening with a fecal immunochemical test (FIT)-fecal DNA test (Cologuard, Exact Sciences).

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ASGE Journal Scan | Colon

Colorectal Cancer Screening Rates Increased During the COVID Pandemic, but With Stool-based Tests, Not Colonoscopy

This report is from the National Health Interview Survey, an annual survey of U.S. households covering a wide range of health topics. Response rates were

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ASGE Journal Scan | Colon

Two Doses of Linaclotide Replaced 1 Liter of Polyethylene Glycol-Electrolyte Lavage Solution in Bowel Preparation for Colonoscopy

In a study from China, 548 patients were randomized to receive 2 L of polyethylene glycol (PEG) on the day of colonoscopy or 290 µg

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ASGE Journal Scan | Esophagus

Artificial Intelligence Continues To Be Impressive for Characterization of Barrett’s Neoplasia

Barrett’s esophagus (BE)-related neoplasia is frequently missed during upper endoscopy, and characterization of mucosal changes may help in its detection. The primary aim of this

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ASGE Journal Scan | Colon

Randomized Trial of Endoscopic Retrograde Appendicitis Therapy Versus Appendectomy for Acute Uncomplicated Appendicitis

Increasingly, antibiotics are used to treat acute uncomplicated appendicitis. Successful antibiotic treatment can be followed by recurrence. An alternative nonoperative approach is endoscopic retrograde appendicitis

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ASGE Journal Scan | Colon

Second Proximal Colon Examination Produced Significant Rise in Adenoma Detection Rates

Many experts now routinely examine the proximal colon twice because colonoscopy is less protective against colorectal cancer in the proximal colon than in the distal

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ASGE Journal Scan | EUS

How Good Is Single-Incision Needle-Knife Biopsy in Diagnosing Gastrointestinal Subepithelial Tumors?

Tissue sampling of subepithelial lesions (SELs) is needed to determine the diagnosis, malignant potential, and management of these lesions. Endoscopic ultrasound-guided fine needle aspiration and/or

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ASGE Journal Scan | Esophagus

Artificial Intelligence Accurately Delineates the Extent of Early Esophageal Squamous Cell Cancer

Subtle surface changes associated with early-stage esophageal squamous cell cancer (ESCC) can be difficult to detect during standard endoscopy. The primary aim of this study

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ASGE Journal Scan | Colon

Computer-aided Detection Failed in Pragmatic Trial in Clinical Practice

Computer-aided detection (CADe) programs are expensive to implement in clinical practice; therefore, endoscopy groups often want to trial the programs before purchase or lease. In

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ASGE Journal Scan | Colon

Computer-aided Detection Said To Fail in Randomized Controlled Trial, but It Actually Performed Well

Artificial intelligence programs for highlighting or detecting polyps during colonoscopy are designated computer-aided detection (CADe) programs. In general, randomized controlled trials of CADe have been

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ASGE Journal Scan | Colon

Randomized Controlled Trial Shows Hemostatic Peptide Solution TDM-621 Reduces Need for Coagulation Forceps Treatment During ESD by 80%

Bleeding can be problematic during endoscopic submucosal dissection (ESD). The bleeding point may be difficult to identify, and coagulation may lead to muscle injury and

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ASGE Journal Scan | Colon

Artificial Intelligence for Adenoma Detection Rate: Simply the Best?

This study assessed 94 randomized controlled trials with 61,172 patients to determine how artificial intelligence (AI) impacts the adenoma detection rate (ADR). In short, AI

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ASGE Journal Scan | Esophagus

Obese Patients With Eosinophilic Esophagitis Have Lower Response to Therapy

Current treatment options for patients with eosinophilic esophagitis (EoE) include the use of topical corticosteroids. This study aimed to demonstrate whether outcomes of topical corticosteroids

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ASGE Journal Scan | Stomach and Small Bowel

Is There an Increased Risk of Proximal Gastrointestinal Cancer After a Positive Fecal Immunochemical Test?

The fecal immunochemical test (FIT) is a simple, noninvasive, at-home study that detects blood in the stool and is used for colon cancer (CRC) screening

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ASGE Journal Scan | Colon

Postcolonoscopy Cancer Still Mostly Associated With Missed Lesions, but Failed Resections Are Also Important

Postcolonoscopy colorectal cancer (PCCRC) is a dreaded event. Previous studies have found that PCCRC is associated with a lower adenoma detection rate (ADR), nongastroenterologist performance

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ASGE Journal Scan | Colon

Male Gender and Hot Avulsion Are Associated With Recurrence After Colorectal Endoscopic Mucosal Resection

Endoscopic mucosal resection (EMR) is the cornerstone of the treatment of large (≥20 mm) nonpedunculated colorectal lesions. This study from a Canadian expert center examined

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ASGE Journal Scan | Colon

Ampullary Adenomas Are Associated With Increased Colorectal Neoplasia Risk

Nonampullary adenomas are frequently associated with an increased risk of colorectal adenomas. There is less known about the association between ampullary adenomas and colorectal neoplasia.

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ASGE Journal Scan | EUS

Is EUS-guided Ablation Feasible To Treat Nonfunctioning Pancreatic Neuroendocrine Tumors Smaller Than 2 cm?

Although small (<2 cm), nonfunctioning pancreatic neuroendocrine tumors (PNETs) are typically followed, there are instances, such as patient anxiety, that prompt resection. Endoscopic ultrasound-guided ethanol

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ASGE Journal Scan | Esophagus

GERD: Atypical Symptoms and Endoscopic Therapy

Atypical GERD symptoms, including cough and hoarseness, can be difficult to treat, even with proton pump inhibitors and laparoscopic surgical fundoplication. Transoral incisionless fundoplication (TIF),

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ASGE Journal Scan | Esophagus

Artificial Intelligence Beats General Endoscopists for the Detection of Barrett’s Neoplasia

Barrett’s esophagus (BE) is a precancerous condition that can lead to the development of dysplasia and esophageal adenocarcinoma (neoplasia). Since neoplasia can present as subtle

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ASGE Journal Scan | Colon

Cold Snare Polypectomy Failed for 10- to 20-mm Colorectal Polyps

Cold snare is now considered the polypectomy method of choice for polyps <10 mm in size, and recent studies have extended the use of cold

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ASGE Journal Scan | Colon

Endoscopic Biopsy in Patients Exposed to Direct Oral Anticoagulants Is Claimed To Be Safe

Patients taking direct oral anticoagulants (DOACs) are often considered to be at increased risk for bleeding after therapeutic endoscopic procedures such as polypectomy and sphincterotomy. 

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ASGE Journal Scan | Colon

Update on Adverse Events With Colorectal Endoscopic Full-thickness Resection

This study updates complication rates associated with the full-thickness resection device (FTRD) from a combined Dutch and German registry, with 1892 procedures performed between July

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ASGE Journal Scan | Esophagus

Endoscopic Resection Plus Chemoradiotherapy Similar to Surgical Resection for 

High-risk Stage I Esophageal Cancer Traditionally, surgical resection has been the standard for the treatment of patients with clinical stage I T1a-bN0M0 esophageal squamous cell

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ASGE Journal Scan | Esophagus

Genetic Risk Loci, Biomarkers, and Lifestyle Risk Factors in Barrett’s Esophagus and Cancer

Genome-wide association studies (GWAS) involve scanning the DNA of a large cohort to identify any genetic variants associated with the disease in question. Previous GWAS

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ASGE Journal Scan | Colon

High Synchronous Neoplasia Burden in Patients With Large Pedunculated Colon Polyps

Previous studies have found that patients with large (≥20 mm) nonpedunculated colorectal polyps have a high prevalence of synchronous colorectal neoplasia. This study investigated synchronous

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ASGE Journal Scan | Colon

Online Yoga Good for Irritable Bowel Syndrome

Previous studies have found yoga as effective as other treatments for irritable bowel syndrome (IBS) symptoms. This study tested whether virtually delivered yoga improved IBS

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ASGE Journal Scan | Colon

Mental Illness Delayed Colorectal Cancer Diagnosis in England

This study evaluated 3766 patients with colon cancer in the U.K., of whom 16.5% had preexisting mental health morbidities (MHMs) recorded in their primary care

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ASGE Journal Scan | EUS

Prevention of Cholecystitis in Patients Undergoing ERCP for Malignant Distal Biliary Obstruction Involving the Cystic Duct: A Novel Technique

Cholecystitis following biliary drainage with a self-expandable metallic stent (SEMS) in patients with distal malignant biliary obstruction (MBO) and cystic duct orifice involvement is significant.

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ASGE Journal Scan | Esophagus

Favorable Long-Term Outcomes With ESD for Esophageal Squamous Cell Cancer

Endoscopic resection is a minimally invasive and curative treatment option for those with superficial esophageal squamous cell carcinoma (ESCC). Endoscopic submucosal dissection (ESD), although more

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ASGE Journal Scan | Colon

Evidence for Variation in the Number of Colonoscopies Required To Achieve a Clear Colon

Ideally, patients presenting for colonoscopy should have a complete examination and identification and resection of all precancerous polyps in a well-prepared colon, followed by assignment

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ASGE Journal Scan | Colon

Metabolic Syndrome Increases All-Cause and Disease-Specific Mortality in Colorectal Cancer

Metabolic syndrome (MS), diabetes mellitus, and obesity are all associated with an increased prevalence of precancerous colorectal polyps and incidence of colorectal cancer (CRC). This

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ASGE Journal Scan | Colon

Snare Tip Soft Coagulation Reduced Recurrence After EMR in Routine Practice

Thermal treatment of endoscopic mucosal resection (EMR) margin defects after complete resection of large (≥20 mm) nonpedunculated colorectal polyps has reduced the recurrence rate at

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ASGE Journal Scan | Esophagus

Potassium Competitive Acid Blocker Better Than Proton Pump Inhibitor in Healing Higher Grades of Erosive Esophagitis

Erosive esophagitis, a complication of chronic gastroesophageal reflux disease (GERD), is documented in 30% to 50% of GERD patients undergoing endoscopy. Current guidelines recommend proton

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ASGE Journal Scan | Colon

U.S. GI Societies Announce Strategic Plan to Promote and Support Sustainable Digestive Health Care

As a subspecialty, GI medicine is typically ranked in the top 3 for its high carbon footprint and production of plastic waste. The 4 U.S. GI

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ASGE Journal Scan | Colon

Randomized Controlled Trial Finds Lower Recurrence Rate With Underwater Versus Conventional Colorectal EMR

In a randomized controlled trial (RCT) performed in Brazil, 120 colorectal lesions with a mean size of 17.5 mm were randomized to underwater endoscopic mucosal

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ASGE Journal Scan | Colon

Colonoscopist Adenoma Detection Rate Predicts Advanced Neoplasia Risk After Polypectomy

Investigators evaluated 30,897 individuals with baseline polypectomy and at least 1 surveillance colonoscopy between 2004 and 2016 across 73 Veterans Administration sites in the U.S.,

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ASGE Journal Scan | Colon

Study Shows Margin Treatment Was Good but Not Perfect for Colorectal Laterally Spreading Lesions 40 mm or Larger

Thermal treatment of the margin after piecemeal endoscopic mucosal resection (EMR) of laterally spreading lesions (LSLs) ≥20 mm is now considered standard of care because

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ASGE Journal Scan | Esophagus

Wireless pH Monitoring Is Better at 96 Hours Than 48 Hours in Patients With GERD Unresponsive to PPI Therapy

A significant portion of patients with reflux-like symptoms do not have GERD and could potentially discontinue proton pump inhibitor (PPI) therapy. Although wireless pH monitoring

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ASGE Journal Scan | Stomach and Small Bowel

Is Juvenile Polyposis Syndrome Associated With a Significant Risk of Gastric Cancer?

Juvenile polyposis syndrome (JPS), in which patients develop juvenile polyps, is uncommon but is thought to be associated with an increased risk of gastrointestinal cancers.

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ASGE Journal Scan | Colon

GI Patients Like Telehealth

This is a survey of 5134 patients who participated in a telehealth visit in 1 year across 105 practices in the Digestive Health Physicians Association. 

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ASGE Journal Scan | Colon

Prediagnosis Obesity Eliminates Survival Advantage Associated With Aspirin Use in Stage IV Colorectal Cancer

This study divided 656 participants with stage IV colorectal cancer (CRC) into groups according to their prediagnosis body mass index (BMI): normal (38.3%), overweight (36.3%),

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ASGE Journal Scan | Colon

More on Withdrawal Time in Colonoscopy

Current recommendations are that minimum withdrawal times in screening colonoscopy that are negative should average at least 6 minutes.  In an analysis of a previously

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ASGE Journal Scan | Esophagus

Top Recommendations for the Diagnosis and Management of Esophagogastric Variceal Bleeding

The European Society of Gastrointestinal Endoscopy has released updated recommendations on the diagnosis and management of esophagogastric variceal hemorrhage. Of the 16 recommendations, all are

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ASGE Journal Scan | Colon

Combining CADe and a Mucosal Exposure Device Provides Best Detection During Colonoscopy

In a randomized controlled trial, 1245 participants aged 50 to 75 years were randomized to standard colonoscopy, standard colonoscopy plus an artificial intelligence (AI) detection

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ASGE Journal Scan | Colon

Large Tandem Study Shows 9-Minute Withdrawal Time Better Than 6 Minutes

In a randomized tandem study from China, 2 study arms compared the standard colonoscopy withdrawal time of 6 minutes versus 9 minutes. The colon was

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ASGE Journal Scan | Colon

Treat Traditional Serrated Adenomas as Advanced Lesions

Traditional serrated adenomas (TSAs) are rare lesions. They are predominantly in the left side of the colon, and unlike sessile serrated lesions, they can be

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ASGE Journal Scan | Colon

Fifteen-Year Benefits of Screening Sigmoidoscopy, Based on Pooled Results of 4 Randomized Controlled Trials

This is a pooled analysis of 4 randomized controlled trials of one-time sigmoidoscopy screening in patients aged 55 to 64 years. The trials were conducted

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ASGE Journal Scan | Esophagus

Increased Risk of Eosinophilic Gastritis and Enteritis in Families of Patients With Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is influenced by both genetic and environmental factors. The genetic risk of distal eosinophilic gastrointestinal diseases in patients with EoE is not

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ASGE Journal Scan | Colon

ADR Works in FIT-Positive Populations: Target ADR Must Be Substantially Higher Than Primary Screening ADR

It is well known that the prevalence of adenomas is higher in patients with a positive result from a stool test, including both the fecal

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ASGE Journal Scan | Colon

Review Indicates Colorectal Cancer Screening Guidelines Have Inadequate Reporting and Discussion of Screening Harms

Cancer screening can lead to patient-level harms from screening tests, diagnostic follow-up, and cancer treatment. This review examined U.S. screening guidelines on breast, cervical, colorectal,

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ASGE Journal Scan | Colon

Increasing Distance From Treatment Centers Associated With Advanced Stage Colorectal Cancer

In a study of the National Cancer Database, the distance of patients from their medical facility was found to be associated with a risk of

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ASGE Journal Scan | Colon

Wide Geographic Variation in Colorectal Cancer Screening Rates in the U.S. Associated With CDC’s Social Vulnerability Index

The Centers for Disease Control and Prevention (CDC) quantifies social vulnerability in the U.S. at the county level. The Social Vulnerability Index (SVI) reflects infrastructure,

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ASGE Journal Scan | Colon

The Impact of Different Bowel Preparation Approaches on Nocturnal Awakenings, Sleep Loss, and Travel Interruption

This is a subinvestigation of a randomized bowel preparation trial in 10 Canadian centers. Patients were divided into 2 groups and underwent colonoscopy either in

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Colon

Rare Causes of Abdominal Pain

Gastroenterologists commonly evaluate unexplained chronic or recurrent abdominal pain. In a review of overlooked causes of recurrent abdominal pain, some key points were: Chronic abdominal

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ASGE Journal Scan | Colon

Expert Endoscopists (>1000 Procedures) Can Generally Assess Their Own Competency Accurately; Those With Less Experience Can’t

This systematic review and meta-analysis identified 13 qualitative studies of the accuracy of GI endoscopist self-assessment and 3 studies for individual patient data meta-analysis. These

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ASGE Journal Scan | Esophagus

Artificial Intelligence Can Help Extract Dysplasia Diagnoses From Electronic Health Records

Natural language processing (NLP) is a branch of artificial intelligence (AI) systems that involves teaching computers the ability to understand written text like how humans

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ASGE Journal Scan | Colon

First Randomized Controlled Trial Comparing Colonoscopy With No Screening Finds Less Benefit Than Expected for Colonoscopy

In the first report of incidence and mortality results from a randomized controlled trial (RCT) comparing colonoscopy with no screening, 84,585 previously unscreened persons aged

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ASGE Journal Scan | Colon

GI Reimbursement Being Hammered by Medicare: 15-Year Trends

This study looked at reimbursement from Medicare for 10 commonly used EGD and colonoscopy codes as well as several inpatient and outpatient services over a

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ASGE Journal Scan | Esophagus

Dietary Therapy for Eosinophilic Esophagitis Unpopular Among Gastroenterologists

Recent studies have demonstrated that dietary elimination therapy is an effective nonprescription treatment for eosinophilic esophagitis (EoE), yet many providers are still hesitant about recommending

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ASGE Journal Scan | Stomach and Small Bowel

Refractory Celiac Disease: What to Do

Refractory celiac disease (RCD) is defined as celiac disease with persistent symptoms despite at least 12 months of a strict gluten-free diet. There are 2

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ASGE Journal Scan | Colon

Postcolonoscopy Symptoms Are Related to Gender, Mood, Prior Somatic Symptoms

There are few prospective, detailed studies on factors such as time lost from work and symptoms after colonoscopy. This study prospectively measured postcolonoscopy symptoms in

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ASGE Journal Scan | Colon

Dutch Describe Impact of Their National Biennial Fecal Immunochemical Test Screening Program

In 2014, the Netherlands instituted a national program of every-other-year fecal immunochemical test (FIT) screening for colorectal cancer (CRC). Since the start of screening, within

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ASGE Journal Scan | Esophagus

Trigger-Food Elimination Diets Are Effective for Patients With Eosinophilic Esophagitis

One treatment method for patients with eosinophilic esophagitis (EoE) is the six-food elimination diet (SFED), which removes milk, wheat, soy, egg, tree nuts/peanuts, and fish/shellfish

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ASGE Journal Scan | Colon

Risk-Stratified CRC Screening Using Fecal Immunochemical Test and Stool DNA

This is a post hoc analysis of a risk-stratification screening strategy based on the Asia-Pacific Colorectal Screening (APCS) scoring system. This score ranks patients as

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ASGE Journal Scan | Colon

Substantial Risk of Advanced Adenomas but No Colorectal Cancer in a Cohort of Patients With CDH1 Mutations

CDH1 mutations are associated with a very high risk of gastric cancer, early age of onset of gastric cancer, and a high risk of breast cancer

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ASGE Journal Scan | Esophagus

Healing of Mucosal Ablation Areas After Radiofrequency Ablation in Patients With Barrett’s Esophagus

Endoscopic therapy for patients with neoplastic Barrett’s esophagus (BE) involves resection followed by mucosal ablation. Radiofrequency ablation (RFA) of the flat BE mucosa leads to

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ASGE Journal Scan | Colon

Global Trends in Colorectal Cancer

Data on colorectal cancer (CRC) incidence and deaths were extracted from the GLOBOCAN database for 2020, and projections were made for 2040. Some of the

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ASGE Journal Scan | Esophagus

Decrease in Dietary Sugar Reduces GERD Symptoms and Esophageal Acid Exposure

Although dietary changes are recommended for patients with gastroesophageal reflux disease (GERD), randomized controlled trials (RCTs) supporting these management strategies are lacking. This RCT evaluated

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ASGE Journal Scan | Colon

Metachronous Adenomas Occur More Often in the Same Segment or a Proximal Segment Than in a Distal Segment

It is well-known that some clustering of adenomas occurs in the colorectum. In a single-center study in patients each with a single index adenoma, 61%

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ASGE Journal Scan | Colon

Second-Generation Endocuff Again Found to Be Effective in New Randomized Controlled Trial

The second-generation Endocuff (Olympus America, Center Valley, Penn, USA) is called Endocuff Vision (ECV). It differs from the original Endocuff by having only a single

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ASGE Journal Scan | Colon

Adherence to Low-Risk Adenoma Recommendations From 2020 U.S. Multi-Society Task Force Postpolypectomy Guideline Has Not Yet Caught On

The U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) creates postpolypectomy surveillance interval recommendations for the U.S. The main change to the 2020 guideline was

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ASGE Journal Scan | Colon

Artificial Intelligence Increased Fraction of Colonoscopy Patients Needing 3-Year Surveillance: Relative Increase of 35% and Absolute Increase of 2.9%

This study examined the fraction of patients undergoing colonoscopy with versus without artificial intelligence (AI) in 9 randomized controlled trials (6 parallel and 3 tandem)

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ASGE Journal Scan | Colon

Review Your Bowel Preparation Program Regularly

In an article published by Gastrointestinal Endoscopy in its new Top Tips section, Shaukat reviews methods to improve bowel preparation in the endoscopy unit: Map the bowel

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ASGE Journal Scan | Esophagus

Endoscopic Submucosal Dissection Plus Radiofrequency Ablation Exhibits High Eradication Rates in Patients With Barrett’s Esophagus

Current strategies for the endoscopic treatment of Barrett’s esophagus (BE) focus on resection of nodular lesions within BE and then the ablation of the flat

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ASGE Journal Scan | Colon

Interval Cancers Are More Deadly Than Screen-Detected Cancers but Are Not Different in Molecular Features

Previous studies have found that interval or postcolonoscopy cancers have molecular profiles that differ somewhat from those of cancers detected at a baseline colonoscopy, including

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ASGE Journal Scan | Colon

Do Patients With Young-Onset Colorectal Cancer Require More Frequent Surveillance Colonoscopy?

Current recommendations for sporadic colorectal cancer (CRC) are to perform surveillance colonoscopy 1 year after surgical resection, then at 3 years, and then at 5-year

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ASGE Journal Scan | Esophagus

Upper Endoscopy Is an Aerosol-Generating Procedure

It is unclear whether SARS-CoV-2 can be transmitted through the aerosol route during GI endoscopic procedures. As more hospitals and endoscopy units are resuming prepandemic

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ASGE Journal Scan | Colon

Deaths From GI Cancers Declined in the U.S. From 2003 to 2019 but Less So in Rural Areas

Based on the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research database, nationwide GI cancer age-adjusted mortality rates (AAMRs) per 100,000

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ASGE Journal Scan | Colon

Colonoscopy Every 10 Years Starting at Age 40 Modeled as Cost-Effective for Men With Body Mass Index ≥35

Obesity is a known risk factor for colorectal cancer (CRC) in both men and women. A previously developed decision analytic was used to model the

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ASGE Journal Scan | Colon

Steps To Consider in Deciding Whether To Incorporate a New Endoscopic Technique Into Your Practice

This interesting opinion piece provides advice regarding a process for deciding whether to incorporate a new endoscopic technique into your practice. The authors suggest you

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ASGE Journal Scan

What Is the Best Option for the Endoscopic Management of Malignant Gastric Outlet Obstruction?

Malignant gastric outlet obstruction (GOO) requires prompt surgical or endoscopic decompression. Surgery is associated with significant morbidity and mortality. Fortunately, with the evolution of endoscopic

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ASGE Journal Scan | Colon

Endoscopy Units Should Establish a Management Algorithm for Acute Iatrogenic Endoscopic Perforations

In this single-center study, 8 gastroenterology fellows and 20 practicing gastroenterologists answered a 10-question pretest regarding acute iatrogenic endoscopic perforation (AIEP) diagnosis and management. This

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ASGE Journal Scan | Colon

Observational Study Indicates Early Colonoscopy, Within 24 Hours of Admission, Benefits Patients With Shock Index ≥1, Performance Status ≥3

Randomized controlled trials of early versus late colonoscopy in acute lower GI bleeding suggest no or limited benefit from early colonoscopy, but some of these

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ASGE Journal Scan | Esophagus

Chronic Opioid Exposure Can Lead to a Higher Likelihood of Hypercontractile Esophagus and Distal Esophageal Spasm

Given a major increase (50%) in opioid prescriptions across the United States from 2000 to 2010, there is renewed interest in evaluating the effects of

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ASGE Journal Scan | Esophagus

Improving Quality in Upper Endoscopy

With more than 6.1 million EGDs performed in the United States annually, establishing quality measures is imperative. Having well-defined quality measures can ensure consistency for

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ASGE Journal Scan | Colon

Artificial Intelligence Increased Adenoma and Advanced Adenoma Detection Rates in Multicenter Randomized Controlled Trial

Artificial intelligence (AI) has been shown to increase adenoma detection rates (ADRs) by an average of about 10% in randomized controlled trials (RCTs). Meta-analyses of

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ASGE Journal Scan | Colon

Double Right-Sided Colon Examination Effective No Matter How You Do It

This study identified 5 randomized controlled trials that addressed the value of a second right-sided colon examination in the forward view versus no second examination.

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ASGE Journal Scan | Colon

ESGE and ESGENA Issue Position Statement on the Environmental Footprint of Endoscopy

Endoscopists interested in reducing their carbon and plastic footprints will find this set of recommendations from the European Society of Gastrointestinal Endoscopy and the European

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ASGE Journal Scan | Colon

Predicting Residual Neoplasia Risk After “Noncurative” Endoscopic Submucosal Dissection for Malignant Colorectal Lesions

This is a retrospective study from 15 Western centers performing colorectal endoscopic submucosal dissection (ESD) in Europe and Australia.  A curative resection was defined as

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ASGE Journal Scan | Colon

Liquid Biopsy Shows Promise for Early-Onset Colorectal Cancer

Early-onset colorectal cancer (EOCRC), or CRC occurring before age 50, is associated with advanced tumor stage at diagnosis, distal colon location, and signet ring histology.

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy for Achalasia Is Effective up to 4 Years

Recent guidelines have recommended peroral endoscopic myotomy (POEM) as first-line therapy for all subtypes of achalasia, given that POEM and laparoscopic Heller myotomy have comparable

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ASGE Journal Scan | Colon

New Recommendations on Anticoagulant and Antiplatelet Management During Acute GI Bleeding and the Periendoscopic Period

A new GRADE guideline from the American College of Gastroenterology and Canadian Association of Gastroenterology includes recommendations for the periendoscopic management of anticoagulants and antiplatelets

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ASGE Journal Scan | Colon

Impact of Preresection Biopsy on Subsequent Endoscopic Mucosal Resection

We often hear that physician-identified large nonpedunculated colorectal polyps (LNPCPs) that warrant referral to an advanced endoscopist for endoscopic mucosal resection (EMR) or endoscopic submucosal

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ASGE Journal Scan | Colon

Risk of Ileoanal Pouch Cancer Is Greater in Familial Adenomatous Polyposis Than in Ulcerative Colitis

This report identified 46 studies that included 19,964 patients with ulcerative colitis (UC) in whom 73 cases of pouch cancer occurred and 3741 patients with

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ASGE Journal Scan | Stomach and Small Bowel

Are Over-the-Scope Clips Superior to Other Methods of Hemostasis?

Nonvariceal upper gastrointestinal bleeding (NVUGIB) is potentially life-threatening and a common cause of hospitalization. Endoscopy is the procedure of choice for the evaluation and management

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ASGE Journal Scan | Colon

Breath Test for Colon Cancer Shows Promise

Patients with certain cancers expel volatile organic compounds (VOCs). VOCs are the basis of previous reports in which dogs were trained to identify patients with

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ASGE Journal Scan | Colon

Randomized Trial Finds Tip-In (Anchoring) EMR Superior to Conventional EMR for 10- to 25-mm Nonpedunculated Colorectal Polyps

“Tip-in” or “anchoring” endoscopic mucosal resection (A-EMR) involves submucosal injection followed by a small incision on the proximal side of the injection mound. The snare

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ASGE Journal Scan | Colon

Tip-in EMR Compared With ESD for 20- to 30-mm Nonpedunculated Colorectal Neoplasms

Tip-in endoscopic mucosal resection (EMR) involves submucosal injection, followed by an incision on the proximal side of the injection mound using a snare tip with

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ASGE Journal Scan | Stomach and Small Bowel

Are Proton Pump Inhibitors Truly Dangerous?

The use of proton pump inhibitors (PPIs) has continually increased over the past 20 to 30 years. As a result, interest has grown in the

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ASGE Journal Scan | Colon

Cap-Assisted EMR Produced Faster Resection Times and Lower Recurrence Rates Compared to Traditional EMR

Cap-assisted EMR (EMR-C) involves submucosal injection followed by resection using a stiff Olympus cap (MH-597, Olympus Optical Co, Ltd, Tokyo, Japan) with an outer diameter

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ASGE Journal Scan | Colon

Gender, Mood Among Factors Predicting Severe Symptoms With Bowel Preparation

In a study performed in 10 Italian centers, 1137 colonoscopy patients completed validated questionnaires prior to colonoscopy and had symptoms from bowel preparation tracked. Overall,

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ASGE Journal Scan | Colon

Ketogenic Diets and ß-Hydroxybutyrate May Suppress Colorectal Cancer

High-sugar diets and hyperglycemia have been associated with colorectal cancer (CRC). In this study, investigators showed that ketogenic diets both prevented and treated CRC induced

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ASGE Journal Scan | Stomach and Small Bowel

How Often Do Patients With Dyspepsia Have Pathology on Endoscopy?

Dyspepsia is a worldwide disease that interferes with quality of life. A 2010 systematic review investigated the prevalence of endoscopic findings in patients with dyspepsia;

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ASGE Journal Scan | Colon

Serrated Polyp Detection Predicted Interval Cancer Independent of Adenoma Detection Rate

The adenoma detection rate (ADR) is currently the recommended measure of the quality of mucosal inspection during colonoscopy. ADR does not include sessile serrated lesions

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ASGE Journal Scan | Colon

Hybrid Argon Plasma Coagulation Endorsed to Reduce Recurrence Rate After Colorectal EMR

Thermal coagulation of the normal-appearing margin using snare tip soft coagulation (STSC) treatment after endoscopic mucosal resection (EMR) has been shown to reduce recurrence rates

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ASGE Journal Scan | Colon

Badge Sign-in Plus Report Cards Increased First Case On-time Starts

At a single U.S. academic center with 20 endoscopists, including 13 academic and 7 voluntary, there were initial baseline measurements of first case on-time starts

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ASGE Journal Scan | Colon

Treating High-Grade Squamous Intraepithelial Lesions in HIV Prevents Anal Cancer

Anal cancer is 10 times more common in HIV-positive men than cervical cancer is in women in the general population; however, women with HIV are

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ASGE Journal Scan | Colon

Pilot Study Finds Submucosal Thickness Is Greater With Colorectal EMR Than ESD

Discussions of colorectal endoscopic mucosal resection (EMR) versus endoscopic submucosal dissection (ESD) usually focus on en bloc resection and recurrence rates. Little is known about

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ASGE Journal Scan | Esophagus

Artificial Intelligence Detects Dysplasia in Histopathology Slides From Patients With Barrett’s Esophagus

The degree of dysplasia in patients with Barrett’s esophagus (BE) is key to determining the application of BE endoscopic therapy and assigning surveillance intervals. Multiple

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ASGE Journal Scan | Stomach and Small Bowel

What Are the Risk Factors for Abdominal Pain Disorders of Gut-Brain Interaction?

Abdominal pain-related disorders of gut-brain interaction (AP-DGBI) affect a sizable portion of the population. Irritable bowel syndrome (IBS) is one of the most common forms

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ASGE Journal Scan | Colon

12 of 12 Patients With Mismatch Repair-Deficient, Locally Advanced Rectal Cancer Had Complete Response to Dostarlimab Alone

It is well known that mismatch repair-deficient colorectal cancer (CRC), also called microsatellite instability (MSI)-high CRC, fails to respond to traditional fluorouracil-based chemotherapy but has

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ASGE Journal Scan | Colon

Systematic Review and Meta-analysis Indicates Snare Tip Soft Coagulation of EMR Margins Is Likely Better Than Argon Plasma Coagulation

Thermal treatment of the margin of piecemeal endoscopic mucosal resection (EMR) defects is now considered an effective treatment for reducing recurrences. Some practitioners have adopted

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ASGE Journal Scan | Colon

Motorized Spiral Enteroscopy Effective for Previous Incomplete Colonoscopies Related to Redundant Colon

The motorized spiral enteroscope has been shown to be safe and effective for deep enteroscopy.  This study from a single center included 36 patients who

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ASGE Journal Scan | Pancreas

Might Biliary Radiofrequency Ablation Be Less Effective Than We Thought?

Most inoperable malignant biliary strictures are best treated with self-expanding metal stents (SEMS); however, a significant portion of patients develop stent occlusion from neoplastic or

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ASGE Journal Scan | Colon

Liquid Biopsy After Resection of Stage II Colon Cancer Reduced the Need for Adjuvant Chemotherapy

Patients with stage III (node-positive) colorectal cancer (CRC) benefit from adjuvant chemotherapy. Patients with stage II (invading muscularis propia or deeper and node-negative) CRC typically

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ASGE Journal Scan | Colon

Median Thickness of Submucosa in the Resected Specimen Is Less With Underwater Than Conventional EMR for Polyps <20 mm

The thickness of submucosal tissue resection can be important for predicting whether the resection margin and submucosal assessment will be adequate when there is suspicion

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ASGE Journal Scan | Esophagus

Benign Tight Esophageal Strictures Can Be Managed With Weekly Dilations

For patients with complex benign esophageal strictures, including tight, long, or tortuous strictures, endoscopic dilation is usually performed at 2- to 4-week intervals. The success

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ASGE Journal Scan | Colon

Adenoma Detection Rate Says It All in FIT-Positive Patients

This is a study of detection indicators in 13,067 fecal immunochemical test (FIT)-positive colonoscopies performed by 80 community gastroenterologists. The cutoff for FIT positivity was

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ASGE Journal Scan | Colon

Actual Impact of COVID-19 on CRC (8.7% Reduction) and Advanced Adenoma (26.9% Reduction) Diagnoses in a U.S. Health Care System

This study utilized the Kaiser Permanente Northern California (KPNC) health care system to evaluate the actual impact of the COVID-19 pandemic on colorectal cancer (CRC).

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ASGE Journal Scan | Colon

Again, No Need To Adjust Adenoma Detection Rate After Inclusion of 45- To 49-Year-Olds

This study looked at a large health care system’s first-time screening colonoscopies from the period October 2017 through December 2018, prior to the American Cancer

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ASGE Journal Scan | Stomach and Small Bowel

Does Eradication of Helicobacter pylori Really Decrease Gastric Cancer Incidence and Mortality?

Gastric cancer is the third most common cause of cancer-related death in the world. Through the intestinal metaplasia pathway, Helicobacter pylori is a class 1 carcinogen and

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ASGE Journal Scan | Colon

Fully Covered Metal Stents Are the Most Cost-Effective Option for Benign Biliary Strictures in Chronic Pancreatitis

Benign distal biliary strictures (BBS) are common sequelae of chronic pancreatitis. The usual treatment involves prolonged maximal-caliber stenting, using either serial exchange of multiple plastic

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ASGE Journal Scan | Colon

Computer-Aided Detection Improves Adenoma Detection Rate and Adenomas Per Colonoscopy in Fecal Immunochemical Test-Positive Patients

In parallel-arm randomized trials involving mostly primary screening and surveillance colonoscopy patients, computer-aided detection (CADe) has increased the adenoma detection rate (ADR) by about 10%.

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ASGE Journal Scan | Colon

ORISE Associated With Submucosal Fullness and Distortion at Follow-Up EMR

ORISE (Boston Scientific, Marlborough, Mass, USA) is a viscous gel for submucosal injection. When ORISE is used for endoscopic mucosal resection (EMR) or endoscopic submucosal

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ASGE Journal Scan | Colon

Gastroenterology Fellows Need More Training in Detection of Sessile Serrated Lesions

Detection skills by gastroenterology fellows are difficult to quantitate. One way to measure detection is to have the fellow perform a complete colonoscopy and clear

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ASGE Journal Scan | Colon

CADx Program Met PIVI Thresholds for Diminutive Rectosigmoid Polyps but Not in Proximal Colon

A computer-assisted diagnosis (CADx) program is artificial intelligence (AI) software that predicts histology. In a prospective evaluation of the Fujifilm CADx program (CAD EYE, Fujifilm

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ASGE Journal Scan | Colon

For Resection Without Injection, Histologic Study Indicates Underwater Gives Most Complete Resection

Previous studies have indicated that cold snare polypectomy effectively removes colorectal lesions up to 15 mm in size but cuts more superficially than hot snare

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ASGE Journal Scan | Colon

Complications of Colonoscopy Remain Stable During Surveillance in VA Cooperative Study 380

Most studies of colonoscopy complications examine adverse event rates at a single time point. The Department of Veterans Affairs Cooperative Study #380 was one of

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ASGE Journal Scan | Stomach and Small Bowel

Utility of Motorized Spiral Enteroscopy

Motorized spiral enteroscopy (MSE) is innovative technology designed to facilitate advancement of the enteroscope across the small bowel. Preliminary studies have shown MSE to be

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ASGE Journal Scan | Colon

More on Recurrence After Endoscopic Resection of T1 Colorectal Cancer: In Large Study, Only Rectal Location Predicted Recurrence

Widely accepted predictors of local recurrence after endoscopic resection of T1 cancers include rectal location, positive resection margin, poor differentiation (PD), lymphovascular invasion (LVI), high-grade

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ASGE Journal Scan | Colon

New Study Suggests T2 Colorectal Cancers Could Be Resected Endoscopically and Analyzed for Risk of Lymph Node Metastases Before Surgical Resection

T2 colorectal cancers (CRCs) are almost invariably treated by surgical resection, but only 25% have lymph node metastases (LNM). An alternative approach in selected cases

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ASGE Journal Scan | Colon

New Distal Attachment Combines Hood and Finger Features

Distal attachments that utilize fingers include the Endocuff Vision (Olympus America, Center Valley, Penn, USA) and AmplifEYE (Medivators Inc, Minneapolis, Minn, USA). An alternative approach

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ASGE Journal Scan | Colon

Multi-Society Task Force Issues New Recommendations for Management of Hamartomatous Polyposis Syndromes

The hamartomatous polyposis syndromes include Peutz-Jeghers syndrome, juvenile polyposis syndrome, PTEN hamartoma tumor syndrome (Cowden’s and Bannayan-Riley-Ruvalcaba syndromes), and hereditary mixed polyposis syndrome. This document is a

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ASGE Journal Scan | Colon

Randomized Controlled Trial Finds Cold Forceps Are Equally Effective and Faster Than Cold Snare for Colorectal Polyps ≤3 mm

Previous studies have found that a cold snare is more effective than cold forceps for polypectomy of polyps ≥4 mm in size, but data are

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ASGE Journal Scan | Colon

Cold Snare Polypectomy of Pedunculated Polyps ≤10 mm: Choking Stalk for ≥10 Seconds Before Resection Reduces Immediate Bleeding

Cold snare polypectomy is now accepted as safer than hot resection of lesions ≤10 mm in size, though it is still widely believed that electrocautery

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ASGE Journal Scan | Colon

T1 Colorectal Cancer With Free Resection Margins Between 0.1 and 1 mm: High-Grade Tumor Budding Makes the Difference in Recurrence Risk

A free resection margin, often interpreted as >1 mm between cancer and the resection line, is an independent predictor of low risk for recurrent cancer

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ASGE Journal Scan | Colon

Large Japanese Real-World Experience Suggests Self-Expandable Metal Stents Are Beneficial in Obstructive Colorectal Cancer

Randomized controlled trials (RCT) of emergency surgery versus colonic stent placement using self-expandable metal stents (SEMS) have mostly suggested limited or no benefits from SEMS.

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ASGE Journal Scan | Colon

Hang Some Pictures of Sessile Serrated Lesions in Your Endoscopy Unit

The first requirement in detecting subtle colorectal lesions during colonoscopy is to know what they look like. In this study from Minneapolis, a poster with

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ASGE Journal Scan | Stomach and Small Bowel

What Are the Long-Term Outcomes of Gastric Peroral Endoscopic Myotomy Performed for Gastroparesis?

Refractory gastroparesis (RG) negatively impacts the quality of life, and treatments to date have worked variably. Gastric peroral endoscopic myotomy (G-POEM), first performed in 2013,

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ASGE Journal Scan | Colon

Systematic Review and Meta-analysis of Adenoma Detection Rates in FIT-positive Patients

The U.S. Multi-Society Task Force on Colorectal Cancer recommends minimally acceptable adenoma detection rates (ADRs) in primary screening colonoscopy of 30% in men and 20%

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ASGE Journal Scan | Colon

Artificial Intelligence Detection Program Assessment by a High Detector: Improved Adenoma Detection Rate, but Some Misses of Large, Flat Lesions

Artificial intelligence (AI) programs for computer-aided detection (CADe) of colorectal polyps have increased adenoma detection rates (ADR) by about 10% in parallel randomized trials and

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ASGE Journal Scan | Colon

Prophylactic Clipping to Prevent Postpolypectomy Bleeding After Oral Anticoagulants

Prophylactic clipping is generally considered effective for endoscopic mucosal resection (EMR) defects of lesions ≥20 mm removed with electrocautery and proximal to the splenic flexure. 

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ASGE Journal Scan | Colon

Endoscopic Submucosal Dissection of Lesions at the Dentate Line Compared With Rectal Lesions Above the Dentate Line

This systematic review and meta-analysis sought to quantify the differences in outcomes after endoscopic submucosal dissection (ESD) of rectal lesions at the dentate line versus

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ASGE Journal Scan | Pancreas

Empiric Prophylactic Plastic Stenting for Disconnected Pancreatic Duct After Necrosectomy Is Not Uniformly Beneficial

Pancreatic necrosis often results in main pancreatic duct injury and eventual discontinuity, or so-called disconnected pancreatic duct syndrome (DPDS), with recurrent symptoms from duct obstruction

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ASGE Journal Scan | Colon

Linked Color Imaging Improves Sessile Serrated Lesion Detection

Linked color imaging (LCI) emphasizes red color and is available on Fujinon endoscopes (Fujifilm Corp, Tokyo, Japan). Previous studies found LCI improved adenoma detection and

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ASGE Journal Scan | Colon

Real-world Efficacy of Fecal Microbiota Transplantation for All C difficile Infection Subtypes: 81% for Recurrent, 78% for Refractory, 71% for Severe

This report describes a 4-year prospective, observational assessment of fecal microbiota transplantation (FMT) performed in 681 health care facilities across 50 U.S. states and 7

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ASGE Journal Scan | Colon

Smartphone Apps on Bowel Preparation for Colonoscopy Improve Bowel Prep and Increase Adenoma Detection Rate

This is a meta-analysis of 12 eligible randomized controlled trials with a total of 4165 patients that compared the effect of education using a smartphone

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ASGE Journal Scan | Esophagus

Expert Review Advises Personalized Approach to GERD Diagnosis and Treatment

GERD, manifested by typical symptoms of heartburn as well as regurgitation and additional extraesophageal symptoms, such as chronic cough, sore throat, and globus sensation, affects

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ASGE Journal Scan | Colon

Continuing Clopidogrel Increases Intraprocedural Bleeding and Clip Use After Cold Snare Polypectomy, but Not Delayed Bleeding

Guidelines have often recommended the continuation of clopidogrel for diagnostic colonoscopy but discontinuation for polypectomy, which is impractical because polypectomy rates are so high during

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ASGE Journal Scan | Colon

Advanced Adenoma Findings at Screening Colonoscopy Associated With Noncolorectal Cancer Mortality

This study used the VA Cooperative Screening Colonoscopy Study, one of the pivotal trials that led to federal legislation directing the Centers for Medicare and

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ASGE Journal Scan | Colon

Declining Colectomy Rates for Benign Colorectal Polyps in an Integrated Health Care System in the U.S.

Population-based studies have found no decline in colectomy rates for benign colorectal polyps over the past 10 to 15 years, even though a recent study

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ASGE Journal Scan | Colon

Chronic Physical and Mental Comorbidities Decrease Colonoscopy Uptake After Positive Fecal Blood Test

This study evaluated 168,701 individuals with a positive fecal occult blood test (FOBT) result, of whom 80.5% underwent colonoscopy within 12 months. Compared with patients

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ASGE Journal Scan | Pancreas

ASGE Guideline on Screening for Pancreatic Cancer in High-Risk Cohorts

Pancreatic ductal adenocarcinoma (PDAC) continues to have a dismal prognosis at the time of presentation. Survival is improved with diagnosis at an early stage, but

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ASGE Journal Scan | Endoscopic techniques

How to Manage Anticoagulants and Antiplatelets During Endoscopic Procedures

The increasing use of anticoagulant and antiplatelet agents has made the management of these medications during and around the time of endoscopy for GI bleeding

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ASGE Journal Scan | Colon

American Gastroenterological Association Updates Diet Recommendations for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) can be managed with a variety of treatments but commonly with diet and medications. This document from the American Gastroenterological Association

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ASGE Journal Scan | Colon

Detection Measures Other Than Adenoma Detection Rate Predict Postcolonoscopy Cancer

The adenoma detection rate (ADR) predicts the incidence of interval cancer after colonoscopy. Although ADR correlates in retrospective studies with other detection measures, it is

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ASGE Journal Scan | Colon

CMS Reduction in RVU Payment for Endoscopy With Anesthesia Slowed but Did Not Stop Growth in Anesthesia Use

In 2017, the Centers for Medicare and Medicaid Services (CMS) instituted a small relative value unit (RVU) reduction in the professional fee payment for endoscopy

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ASGE Journal Scan | Colon

Cold Snaring Effective for Colorectal Lesions Up to 15 mm

Cold snare resection is well established as comparably effective to and safer than hot snare resection for lesions ≤10 mm in size.  In a study

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ASGE Journal Scan | Colon

Randomized Tandem Study Shows Artificial Intelligence Decreases Adenoma Miss Rate

In a randomized tandem study of 230 patients, the adenoma miss rate (AMR) was lower at 15.5% when colonoscopy with artificial intelligence (AI) was performed

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ASGE Journal Scan | Colon

Prospective Comparison of Needle Knives With Scissor Knives for Colorectal Endoscopic Submucosal Dissection

This is a post-hoc propensity score-matched analysis of 2498 colorectal lesions removed with needle-type or scissor-type knives for endoscopic submucosal dissection (ESD) in 11 Japanese

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ASGE Journal Scan | Colon

Salvage Endoscopic Submucosal Dissection After Chemoradiation for Locally Advanced Rectal Cancer

Patients with locally advanced rectal cancer who undergo neoadjuvant chemoradiation sometimes have remarkable responses to treatment. These may include evidence of no residual disease or

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ASGE Journal Scan | Colon

Green Tea Does Not Prevent Recurrent Adenomas in Females, but It Might in Males

Green tea contains catechins, which have anticancer properties and reduce the incidence of polyps in mouse models with a mutation in the Adenomatous polyposis coli gene.  In

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ASGE Journal Scan | Colon

The Veterans Health Administration Instituted a National Policy Converting Screening Colonoscopy to FIT During the COVID Pandemic: Was the Policy Followed?

During the COVID-19 pandemic, the Veterans Health Administration (VHA) instituted a national policy converting screening colonoscopy to fecal immunochemical testing (FIT) to manage reduced access

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ASGE Journal Scan | Esophagus

Screening Endoscopy Should Be Considered in Patients With Head and Neck Cancer to Identify a Second Primary Esophageal Tumor

Individuals diagnosed with head and neck squamous cell carcinoma (HNSCC) are known to have an increased risk of developing a second primary tumor in the

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ASGE Journal Scan | Stomach and Small Bowel

When Proton Pump Inhibitors Should Be Discontinued: American Gastroenterological Association Clinical Practice Update

Proton pump inhibitors (PPIs) are prescribed for various indications, sometimes with clear evidence-based benefit and sometimes with little to no proven benefit. The purpose of

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ASGE Journal Scan | Colon

Small Tubular Adenomas Plus Small Serrated Polyps Equals Higher Risk of Metachronous Advanced Neoplasms

Recent studies have added complexity to our understanding of postpolypectomy surveillance risk, such as the risk of metachronous advanced neoplasia is higher with 6- to

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ASGE Journal Scan | Colon

Frequency of Splenic Injury in U.S. Inpatients

A previous study of U.S. inpatients suggested that the frequency of splenic injury was about 1 in 6000.  The current study utilized 2012-2018 data from

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ASGE Journal Scan | Colon

Rectal Lesions Really Are, Well, Different

Previous studies have indicated that the rectosigmoid colon location is an independent risk factor for cancer in large nonpedunculated colorectal polyps. Surgical procedures for cancer

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ASGE Journal Scan | Esophagus

Poor Squamous Regeneration After Barrett’s Endoscopic Therapy Increases Risk for Treatment Failure and Disease Progression

A small subset of patients who undergo Barrett’s endoscopic therapy (BET) using radiofrequency ablation (RFA) will have evidence of poor mucosal healing (mucosal edema, ulcers,

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ASGE Journal Scan | Esophagus

Robotic Endoscopy Improves Efficacy and Safety of Endoscopic Submucosal Dissection

Endoscopic submucosal dissection (ESD) is technically difficult and relies on appropriate countertraction and visibility to safely remove lesions of interest. Robot-assisted endoscopy has been under

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ASGE Journal Scan | Colon

Adenoma Detection Rate in 45- to 49-year-olds in the GIQuIC Registry

According to 2014-2020 data from the GI Quality Improvement Consortium (GIQuIC) Registry, 2.81 million screening colonoscopies were performed by 814 endoscopists in patients aged 45

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ASGE Journal Scan | Colon

Hemorrhoids Are Associated With Diverticulosis Not Constipation or Dietary Fiber Intake

This was a case-control study of patients undergoing screening colonoscopy between 2013 and 2015. Patients completed a detailed diet and bowel habit questionnaire, and a

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ASGE Journal Scan | Colon

Endoscopic Intermuscular Dissection for Deep Submucosal Invasion in Rectal Cancer

Endoscopic submucosal dissection (ESD) for T1 rectal cancer can leave positive margins, particularly for lesions invasive to the middle or deep thirds of the submucosa.

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ASGE Journal Scan | Colon

Impact of Simethicone During Bowel Preparation on Colonoscopy Quality: Systematic Review and Meta-analysis of 38 Randomized Controlled Trials

Many endoscopists utilize simethicone (SIM) in their bowel preparations for colonoscopy. This systematic review and meta-analysis identified 38 randomized controlled trials relevant to SIM impact

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ASGE Journal Scan | Colon

Formal Training in Endoscope Handling and Care Reduces Repair Costs

In the current study, a medical center in Thailand instituted a formal educational program focused on personal awareness of endoscope handling and manipulation, the correct

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ASGE Journal Scan | Esophagus

The Functional Lumen Imaging Probe Can Be Used to Assess Response to Peroral Endoscopic Myotomy

Clinical response after peroral endoscopic myotomy (POEM) is subjectively assessed using the Eckardt score (ES) or objectively tested using high-resolution manometry (HRM) or barium esophagram.

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ASGE Journal Scan | Colon

Stopping Direct Oral Anticoagulants on the Day of Colonoscopy Was Enough to Prevent Bleeding After Cold Snare Polypectomy

Direct oral anticoagulants (DOACs) are often stopped a couple of days before colonoscopy and resumed one or more days after the procedure, depending on thromboembolism

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ASGE Journal Scan | Colon

Colonoscopy Without Bowel Preparation for Acute Lower GI Bleeding

Colonoscopy for acute lower GI bleeding is usually performed after bowel purge. In a retrospective study with clinical diverticular bleeding, 266 patients received bowel preparation

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ASGE Journal Scan | Stomach and Small Bowel

Does a Low FODMAP Diet Help Patients With Celiac Disease?

The incidence of celiac disease has been increasing over time and is commonly encountered in GI practice. Although a gluten-free diet leads to pathologic disease

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ASGE Journal Scan | Colon

Endoscopic Submucosal Dissection for Early Colorectal Cancer and High-Risk Surgery: Okay to Not Operate

This study investigated outcomes in patients who underwent endoscopic submucosal dissection (ESD) for T1 colorectal cancer (CRC) and then had adverse histologic features that predict

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ASGE Journal Scan | Colon

Cold Snare Polypectomy Failed to Achieve Complete Resection in 11% of 4- to 9-mm Polyps

In a randomized controlled trial (RCT) performed at 8 hospitals in 4 countries, patients with nonpedunculated polyps ranging in size from 4 to 9 mm

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ASGE Journal Scan | Colon

Oral Microbiome Therapy Made of Purified Firmicutes Spores Effective for Treatment of Recurrent C difficile Infection

This study was a double-blind, randomized, placebo-controlled trial. It included patients with ≥3 episodes of C difficile infection (CDI) within 12 months, including the qualifying acute episode.

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ASGE Journal Scan | Esophagus

Progression in Barrett’s Esophagus Score Can Be Used for Estimating Neoplastic Progression

Barrett’s esophagus (BE) is a known precancerous lesion for esophageal dysplasia and adenocarcinoma (EAC); however, it is unclear who will progress to high-grade dysplasia (HGD)

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ASGE Journal Scan | Colon

American College of Physicians Endorses No Antibiotics for Most Uncomplicated Acute Diverticulitis

The American College of Physicians (ACP) has issued a clinical guideline regarding acute left-sided diverticulitis. There are 3 recommendations, which were developed using the GRADE

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ASGE Journal Scan | Colon

American College of Physicians Issues Guideline on Colonoscopy and Interventions to Prevent Recurrence After Acute Left-sided Diverticulitis

This guideline from the American College of Physicians appears with a summary of the supporting literature review and has 3 recommendations: Colonoscopy should be performed

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ASGE Journal Scan | Pancreas

Examining Cost-Utility Data for Interventions to Prevent Infection Transmission by Duodenoscopes

Transmission of multidrug-resistant organisms between patients undergoing ERCP prompted the U.S. Food and Drug Administration to issue guidance for endoscopy departments to adopt intensified reprocessing

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ASGE Journal Scan | Stomach and Small Bowel

Is Cold Snare Piecemeal EMR Adequate in Treating Duodenal Adenomas?

Traditionally, nonampullary small-bowel adenomas ≥10 mm in diameter are resected utilizing cautery. Unfortunately, since the small bowel is thin-walled and highly vascular, adverse events are

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ASGE Journal Scan | Esophagus

Empiric Esophageal Dilation Is Not Useful for Nonobstructive Dysphagia

Empiric esophageal dilation often is performed for patients presenting with dysphagia who have no evidence of an anatomic obstruction or lesion. However, there is little

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ASGE Journal Scan | Colon

Clip Closure Did Not Reduce Delayed Hemorrhage After Resection of Large Sessile Serrated Lesions Using Electrocautery, Even From the Proximal Colon

Recent large randomized controlled trials have demonstrated that clip closure reduces the risk of delayed hemorrhage after endoscopic mucosal resection (EMR) using electrocautery if the

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ASGE Journal Scan | Colon

Proving What We All Know: Hot Snare Polypectomy Causes More Delayed Bleeding Than Cold Snare

This was a retrospective analysis of bleeding after cold snare polypectomy (CSP) and hot snare polypectomy (HSP) for colorectal lesions with a diameter <10 mm.

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ASGE Journal Scan | Colon

Artificial Intelligence False Positives in Colonoscopy Are Not Time Consuming

Computer-aided detection (CADe), or artificial intelligence (AI), programs are now commercially available and have been shown to increase the adenoma detection rate. These AI programs

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Colon

Cutting Plane Between Underwater and Conventional EMR Is Similar

Randomized controlled trials (RCT) show that underwater EMR (UEMR) is more likely than conventional EMR (CEMR) to result in en bloc and R0 resection for

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ASGE Journal Scan

Guideline on Informed Consent for Endoscopic Procedures

Informed consent is mandatory before an endoscopic procedure. Its purpose is to educate the patient about the procedure and review the associated risks, benefits, and

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ASGE Journal Scan | Colon

Second-Generation Endocuff Versus Distal Cap Versus Standard High-Definition White-Light: No Overall Difference but More Detected Adenomas and Shorter Withdrawal Times in Screening Exams With Endocuff

This study from 3 U.S. centers is the first to compare the second-generation Endocuff Vision (Olympus America, Center Valley, Penn, USA) to distal cap (Reveal;

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ASGE Journal Scan | Esophagus

Endoscopic Submucosal Dissection Use Changes Histologic Diagnosis in More Than Half of All Patients With Visible Barrett’s Esophagus Neoplasia

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have emerged as important treatment techniques for patients with visible lesions in Barrett’s esophagus (BE). Whereas

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ASGE Journal Scan | Pancreas

Electrohydraulic Lithotripsy Safe and Effective for Clearing Obstructive Pancreatic Stones Near the Duodenum

Electrohydraulic lithotripsy (EHL) and laser lithotripsy are both well-established methods for the treatment of biliary and genitourinary stones. Several retrospective series have described successful pancreatoscopy-guided

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ASGE Journal Scan | Stomach and Small Bowel

Endoscopic Submucosal Dissection Enough to Cure Early Gastric Cancer?

Over the past decade, with advances in endoscopic resection (ER) techniques, there has been a trend toward removing early gastric cancer (EGC) with ER, especially

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ASGE Journal Scan | Colon

Cancer Risk in Serrated Polyposis Syndrome and Sporadic Sessile Serrated Lesion Patients and Their Relatives

This study used the Utah Cancer Registry to examine cancer risk in patients with serrated polyposis syndrome (SPS) and their relatives as well as patients

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ASGE Journal Scan | Colon

A Way Forward for Side-Viewing Colonoscopy?

Previous attempts to improve polyp detection during colonoscopy using extreme wide-angle or side-viewing optics have been unsuccessful, largely because of issues with diminished image resolution

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ASGE Journal Scan | Colon

Exploring Panendoscopy With a Colon Capsule: Issues of Bowel Preparation, Transit, Completion, Acceptance

This study looked at issues of technical success and acceptance of panendoscopy with a colon capsule in 451 generally healthy adults aged 50 to 75

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ASGE Journal Scan | Colon

Dye-based Chromoendoscopy Added Nothing to Prediction of Cancer in Colorectal Nonpedunculated Lesions

In a prospective study, 2 experts independently assessed the surfaces of 400 large, laterally spreading colorectal lesions (median size, 35 mm) for predictors of submucosal

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ASGE Journal Scan | Colon

Epinephrine Caused Increased Postprocedural Pain When Used for Colorectal EMR

Including epinephrine in the submucosal injectate for endoscopic mucosal resection (EMR) varies among endoscopists – some endoscopists prefer epinephrine, whereas others do not. Of those

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ASGE Journal Scan | Colon

Rivaroxaban Again Shown to Cause More GI Bleeding Than Other Direct Oral Anticoagulants

In a study from Iceland, investigators compared GI bleeding rates among 3217 patients receiving rivaroxaban, 2157 receiving apixaban, and 494 receiving dabigatran. Patients were excluded

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ASGE Journal Scan | Colon

Impact of Colonoscopy on Patients’ Work Productivity

The impact of colonoscopy on work productivity was assessed prospectively in 1137 employed patients in 10 Italian centers, utilizing a diary for 7 days after

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ASGE Journal Scan | Colon

Asking Patients With Colorectal Cancer to Help Get Their Siblings Screened Is Not That Helpful

We often tell our patients with colorectal cancer (CRC) or advanced adenomas that guidelines indicate their siblings are at increased risk of developing CRC or

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Esophagus

Barrett’s Endoscopic Therapy Using Hybrid-Argon Plasma Coagulation Is Safe and Effective

Endoscopic therapy for Barrett’s esophagus (BE) usually involves resection of visible lesions by endoscopic mucosal resection followed by mucosal ablation using radio frequency ablation. Hybrid

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ASGE Journal Scan | Colon

Should We Mark the Margins Before EMR?

One approach sometimes used in endoscopic mucosal resection (EMR) to improve complete resection is to use cautery to mark the normal tissue at the margins

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ASGE Journal Scan | Colon

Transferring Endoscopic Submucosal Dissection Skills From Hands-on to Human Cases

This report from The Netherlands describes the results of a survey of 118 participants in an endoscopic submucosal dissection (ESD) training workshop using live porcine

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ASGE Journal Scan | Colon

Study Suggests Computer-Aided Quality Assurance More Important Than Computer-Aided Detection in Polyp Detection

Artificial intelligence (AI) that highlights lesions seen at endoscopy is called computer-aided detection (CADe) or detection software. Computer-aided quality (CAQ) programs assess the completeness of

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ASGE Journal Scan | Stomach and Small Bowel

How Best to Treat Collagenous Gastritis?

Collagenous gastritis (CG) is an uncommon disorder characterized by subepithelial collagen deposition in the stomach. Symptoms vary depending on the phenotype (pediatric-onset vs adult-onset). Treatment

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ASGE Journal Scan | Colon

Too Much Forceps Removal of Small Polyps, but It Could Be Modified

Anecdotally, many colonoscopists still use forceps to remove small and diminutive colorectal polyps that are more effectively and efficiently removed by snare polypectomy. In 2

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ASGE Journal Scan | Colon

Randomized Controlled Trial of Thin Versus Thick Cold Snare Polypectomy for Small Polyps: Not Much Difference

Cold snare polypectomy is now considered the resection method of choice for colorectal lesions ≤10 mm in size. Dedicated snares with a wire diameter about

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ASGE Journal Scan | Colon

Randomized Controlled Trial Confirms Clipping Is Effective in Prevention of Right-Sided Colon Bleeding After EMR With Electrocautery

Previous randomized controlled trials (RCTs) have indicated that prophylactic clip closure is effective in preventing delayed hemorrhage after EMR of colonic lesions that are ≥20

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ASGE Journal Scan | Colon

Evacuation Problems? Check the RED Test

The balloon expulsion test (BET) is a screening tool for rectal evacuation disorders. BET is often performed in conjunction with anorectal manometry. In this report,

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ASGE Journal Scan | Colon

Gluten Intake Not Associated With GI Cancer Risk

Gluten exposure triggers an immune reaction in celiac disease that is associated with an increased risk of GI cancers. In this study, the effect of

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ASGE Journal Scan | Esophagus

Endoscopic Resection for Early Esophageal Squamous Cell Carcinoma Invading the Muscularis Mucosae Without Lymphovascular Invasion

Superficial esophageal squamous cell carcinoma (ESCC) involving the epithelium and lamina propria is treated with endoscopic resection (ER) due to negligible risk of lymph node

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ASGE Journal Scan | Colon

U.S. Multi-Society Task Force Endorses Colorectal Cancer Screening in Average-Risk Persons at Age 45

In a recommendation characterized as “weak recommendation; low-quality evidence,” the U.S. Multi-Society Task Force on Colorectal Cancer (MSTF) now recommends initiating screening for colorectal cancer

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ASGE Journal Scan | Colon

Laterally Spreading Lesions With Focus of T1 Cancer Treated by Hybrid EMR and EFTR

Patients with laterally spreading lesions and endoscopic evidence of T1 cancer (usually of morphologic change combined with NBI International Colorectal Endoscopic classification 3 or Kudo

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ASGE Journal Scan | Colon

Management of Large Polyps in a French Colorectal Cancer Screening Program Using Fecal Immunochemical Testing Suboptimal, With Widely Varying Endoscopic Resection Rates

In a study of fecal immunochemical test-positive patients in France, 1256 large polyps (LPs), defined as polyps ≥20 mm, were detected by 102 community gastroenterologists.

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ASGE Journal Scan | Esophagus

Single Dose of Intravenous Antibiotics Before Peroral Endoscopic Myotomy Is Sufficient for Infection Prevention

Peroral endoscopic myotomy (POEM) is an endoscopic procedure that exposes the contents of the esophagus to the sterile mediastinum during the myotomy. This allows microbial

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ASGE Journal Scan | Stomach and Small Bowel

Key to Optimal Pathology Reporting for Endoscopic Gastric Cancer Resection Specimens

Endoscopic resection (ER) of early gastric neoplasia is being performed with increasing frequency by endoscopists. Complete and accurate reporting of pathology is imperative to provide

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ASGE Journal Scan | Pancreas

Cholecystectomy Optimally Performed Within 8 Weeks for Necrotizing Biliary Pancreatitis

Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to

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ASGE Journal Scan | Colon

Predicting Diverticulitis and Surgery for Diverticulitis Based on Endoscopic and Clinical Features: DICA and CODA Scoring

The Diverticular Inflammation and Complication Assessment (DICA) endoscopic scale is a scoring system that predicts diverticulitis and related surgery. Briefly, this scale takes into account

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ASGE Journal Scan | Colon

There Are Now 5 Randomized Controlled Trials of Flexible Sigmoidoscopy Screening, and They All Show It Works

Four previous randomized controlled trials of flexible sigmoidoscopy (FS) have shown reductions in at least distal colorectal cancer (CRC) incidence and mortality after FS screening. 

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ASGE Journal Scan | Esophagus

Cryoballoon Ablation Has Similar Efficacy to but Higher Stricture Rates Than Radiofrequency Ablation in Barrett’s Endoscopic Therapy

Radiofrequency ablation (RFA) is widely utilized in the treatment of neoplastic Barrett’s esophagus (BE) after endoscopic resection of all visible lesions. Cryotherapy is another form

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ASGE Journal Scan | Colon

European Society of Gastrointestinal Endoscopy Issues Guideline on Lower GI Tract Endoscopic Tissue Sampling

These evidence-based recommendations from the European Society of Gastrointestinal Endoscopy (ESGE) cover principles of tissue sampling and removal in the lower GI tract. Some points

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ASGE Journal Scan | Colon

Endocuff Vision Effective in “Real-World” Experience

Endocuff Vision (ECV; Olympus America, Center Valley, Pa) has produced adenoma detection rate (ADR) gains in randomized controlled trials, but it has not received widespread

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ASGE Journal Scan | Colon

Do We Keep Measuring and Measuring and Measuring Adenoma Detection Rate?

The adenoma detection rate (ADR), first recommended by the U.S. Multi-Society Task Force on Colorectal Cancer in 2002, is a validated predictor of colorectal cancer

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ASGE Journal Scan | Colon

U.S. GI Endoscopy Volumes: Biggest Change Is Increases in Upper Endoscopic Ultrasound

This article uses data from multiple sources to estimate gastrointestinal, liver, and pancreatic health care expenditures, ambulatory visits, and hospitalizations, as well as endoscopic procedural

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ASGE Journal Scan | Colon

Birth Cohort Effects in Colorectal Cancer Impacting 50- to 54-Year-Olds

As birth cohorts younger than age 50 become progressively younger, the relative increase in colorectal cancer (CRC) risk compared to past decades becomes progressively greater.

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ASGE Journal Scan | Colon

Constipation Is Not a Risk Factor for Colorectal Cancer

Patients are often concerned that chronic constipation will put them at risk for colorectal cancer (CRC), and previous data on this topic have been mixed.

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ASGE Journal Scan | Stomach and Small Bowel

Refractory Gastroparesis: Expert Recommendations

Gastroparesis is a vexing problem and often has overlapping symptoms with functional dyspepsia. In this update from the American Gastroenterological Association, medically refractory gastroparesis is

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ASGE Journal Scan | Esophagus

A Negative Upper Endoscopy in Patients With GERD Reduces Incidence and Mortality From Upper GI Cancers

Gastroesophageal reflux disease (GERD) is the most common reason for referral for upper endoscopy. This study sought to determine whether there is a relationship between

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ASGE Journal Scan | Pancreas

Further Validation for a Motorized Endoscopic Necrosectomy Device

Many patients with walled-off pancreatic necrosis (WON) require debridement following minimally invasive drainage. This often entails serial procedures with cumulative expense and risk. These authors

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ASGE Journal Scan | Colon

Systematic Review and Meta-Analysis Finds That 9-Minute Withdrawal Is Indeed Better Than 6 Minutes

Very large retrospective studies of withdrawal time and colonoscopy yield have indicated that interval cancer prevention levels out with a withdrawal time of 8 to

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ASGE Journal Scan | Colon

Meta-Analysis of Full-Thickness Resection in the Colorectum

In a meta-analysis of 14 studies of colorectal endoscopic full-thickness resection (EFTR) involving 1936 patients, 76% of lesions were in the colon and the remainder

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ASGE Journal Scan | Colon

World Gastroenterology Organisation Reports on Gastroenterology, Climate Change, and Nonrecyclable Waste

This report from the World Gastroenterology Organisation (WGO) reviews the potential health impact of climate change on GI disease, but it also calls on gastroenterology

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ASGE Journal Scan | Pancreas

Surveillance Rather Than Immediate Resection Appears Advisable for Most Familial Adenomatous Polyposis-Related Ampullary Adenomas

Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk

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ASGE Journal Scan | Colon

Predictors of Endoscopy Procedure Volume During Fellowship: Male Gender and Private (vs Academic) Program

The American Society for Gastrointestinal Endoscopy recommends that gastroenterology fellows complete a minimum of 130 EGDs and 275 colonoscopies before assessing competency.  In a survey

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ASGE Journal Scan | Colon

Genetic Testing for Everyone With 10 or More Adenomas? It’s Low Yield

Germline genetic testing for inherited colorectal cancer syndromes often is recommended in patients with ≥10 cumulative adenomas. However, the evidence to support this recommendation is

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ASGE Journal Scan | Esophagus

Barrett’s Esophagus-Specific Training Improves Adherence to Diagnosis and Treatment Guidelines

The accurate diagnosis and management of patients with Barrett’s esophagus (BE) are important for the early recognition and minimally invasive treatment of BE neoplasia. Despite

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ASGE Journal Scan | Esophagus

Artificial Intelligence Similar to Expert Endoscopists at Differentiating Between Mucosal and Submucosal Barrett’s Cancer

Artificial intelligence (AI) systems using convolutional neural networks have been developed to differentiate between esophageal cancer (EAC), high-grade dysplasia, and nondysplastic Barrett’s esophagus. However, until

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ASGE Journal Scan | Colon

Oral Sulfate Solution and 2-Liter Polyethylene Glycol-Ascorbic Acid Are Both Safe and Effective in Older Patients

In a trial of 199 patients aged 65 to 80 years, standard oral sulfate solution (OSS) was compared with 2-L polyethylene glycol with ascorbic acid

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ASGE Journal Scan | Colon

Current Rates of Colorectal Cancer in Average-Risk Screening Are About 1 in 500

Older studies have suggested that the prevalence of cancer detected with average-risk screening colonoscopy is 0.5% to 1% or about 1 cancer per 100 to

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ASGE Journal Scan | Colon

Multi-Society Task Force Said to Repeat Colonoscopy Within One Year for Inadequate Preparation, but a Lot of Colonoscopists Aren’t

In 2015, the U.S. Multi-Society Task Force (MSTF) on Colorectal Cancer, composed of members of the 3 luminal GI societies, recommended that patients with inadequate

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ASGE Journal Scan | Colon

Cap-Assisted Endoscopic Mucosal Resection Effective for Flat and Fibrotic Colorectal Polyps

Everyone performing EMR in the colorectum encounters flat or fibrotic polyp tissue that resists standard snaring.  In a multicenter European study, 70 nonlifting polyps with

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ASGE Journal Scan | Pancreas

Incision Improves Success and Safety for Difficult Biliary Access Compared With Wire- or Stent-Guided Entry

A variety of techniques have been described for achieving deep biliary cannulation, a necessary prelude to most endoscopic retrograde cholangiographic (ERCP) procedures. The rate of

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ASGE Journal Scan | Stomach and Small Bowel

Does Hemostatic Powder Lessen Bleeding After Endoscopic Submucosal Dissection?

Bleeding after endoscopic submucosal dissection (ESD) is one of the most common adverse events, but the risk of post-ESD bleeding varies, depending on antiplatelet or

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ASGE Journal Scan | Colon

How Much Will Screening 45- to 49-Year-Olds Affect ADR?

With the advent of screening average-risk persons beginning at age 45, many are wondering whether minimum acceptable adenoma detection rate (ADR) thresholds will need adjustment,

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ASGE Journal Scan | Colon

Endoscopic Full-Thickness Resection for T1 Colorectal Cancers: Update on Short-Term Outcomes

Endoscopic full-thickness resection (eFTR) can be used for lesions <30 mm in size, and when used for early colorectal cancer (CRC), it provides a histologic

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ASGE Journal Scan | Colon

Perioperative Antibiotics Did Not Prevent Postendoscopic Submucosal Dissection Coagulation Syndrome in Study

Postendoscopic coagulation syndrome (PECS) is common after endoscopic submucosal dissection (ESD), and prior data have indicated that perioperative antibiotics reduced the syndrome.  In this Japanese

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ASGE Journal Scan | Colon

Artificial Intelligence for Detection During Colonoscopy Works in the U.S. Too

Artificial intelligence programs that detect lesions are called computer-aided detection (CADe) systems. Randomized controlled trials of CADe for colonoscopy have, thus far, mostly been performed

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ASGE Journal Scan | Esophagus

Smoking, Obesity, Alcohol, and GERD Continue To Be Common, Modifiable Risk Factors for Upper GI Cancers

Among upper gastrointestinal (UGI) cancers, gastric and esophageal cancers rank third and sixth, respectively, as the most common cause of death due to cancer worldwide.

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ASGE Journal Scan | Esophagus

Upper GI Screening Endoscopy in Individuals With a Family History of Barrett’s Esophagus or Esophageal Cancer

The incidence of esophageal adenocarcinoma (EAC) continues to increase and is still associated with a poor prognosis with a 5-year survival rate of 20%. The

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ASGE Journal Scan | Esophagus

Endoscopic Septotomy Is Safe and Effective for the Treatment of Zenker’s Diverticulum

Zenker’s diverticulum (ZD) can lead to dysphagia to both solids and liquids and can be treated endoscopically or surgically. This retrospective, single-center, observational study evaluated

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ASGE Journal Scan | Colon

Pericolonoscopy Antibiotics Associated With Postcolonoscopy Irritable Bowel Syndrome

Experienced colonoscopists have seen occasional patients date the onset of irritable bowel syndrome (IBS) to colonoscopy (and, occasionally, patients who date improvement of digestive symptoms

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ASGE Journal Scan | Stomach and Small Bowel

Diagnosis and Management of Atrophic Gastritis: Clinical Practice Update From the American Gastroenterological Association

Patients with atrophic gastritis (AG) are at increased risk for gastric cancer; however, the diagnosis and surveillance of AG are not well-defined. Algorithms for the

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ASGE Journal Scan | Stomach and Small Bowel

PEG Placement: Is the Radiologic, Surgical, or Endoscopic Technique Safest?

The optimal technique for gastrostomy tube placement remains undefined. This retrospective study used the Nationwide Readmissions Database and the International Classification of Diseases Procedure Coding

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ASGE Journal Scan | Pancreas

On Balance, Benefit of Sphincterotomy for Biliary Stenting Appears to Outweigh the Risk

Limited reports have suggested that endoscopic biliary sphincterotomy (ES) at the time of transpapillary biliary stent placement may reduce the risk of post-ERCP pancreatitis (PEP).

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ASGE Journal Scan | Colon

Problems With Colorectal EMR Training for Some GI Fellows

In a 2019-2020 academic year survey of all 1730 GI fellows in the U.S. regarding endoscopic mucosal resection (EMR) training and knowledge, the response rate

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ASGE Journal Scan | Colon

Maternal Obesity and Pregnancy Weight Gain and Colorectal Cancer Risk in Offspring

This study utilized a database of women and their prenatal care between 1959 and 1966, involving 18,751 live births and 14,507 mothers. Sixty-eight offspring developed

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ASGE Journal Scan | Colon

Cold Snare Polypectomy Without Submucosal Injection May Be the Treatment of Choice for Sessile Serrated Lesions 10 mm or Larger

In a multicenter, multinational study, retrospectively obtained data for 379 patients showed 615 sessile serrated lesions ≥10 mm in size resected by cold snare polypectomy

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Colon

Are Gastroenterologists Better at Colonoscopy Than Other Specialists? Yep

Numerous studies have found that colonoscopies performed by nongastroenterologists are associated with lower rates of polyp detection and higher rates of interval cancer than colonoscopies

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ASGE Journal Scan | Esophagus

Artificial Intelligence During Barrett’s Endoscopy Is Accurate for Reporting Prague Criteria

During endoscopy, the extent of Barrett’s esophagus (BE) is quantified by endoscopists using the widely accepted Prague C&M (circumferential and maximal lengths) criteria. Prague C&M

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy Is Effective and Safe for Spastic Esophageal Motility Disorders

Spastic esophageal motility disorders (SEMDs) include a group of esophageal dysmotility conditions that are difficult to treat and often refractory to nonsurgical and/or endoscopic measures.

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ASGE Journal Scan | Colon

Endo-SPONGE Analysis Shows Device Effective in Treating Colorectal Anastomotic Leaks

Anastomotic leak after low anterior resection is a dreaded complication. Patients with generalized peritonitis must undergo surgery, and treatment of localized walled-off leaks is not

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ASGE Journal Scan | Colon

Sessile Serrated Lesions, Unspecified Serrated Polyps, and Colorectal Cancer Risk

This study examined the risk of colorectal cancer (CRC) associated with serrated polyp subtypes in patients undergoing their first colonoscopy between 2006 and 2016. There

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ASGE Journal Scan | Colon

Updated Guideline on Endoscopy and Antiplatelet or Anticoagulant Therapy From British and European Gastroenterology Organizations

This guideline from the British Society of Gastroenterology and the European Society of Gastrointestinal Endoscopy relies on the traditional division of procedures into low risk

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ASGE Journal Scan | Colon

Does Better Sleep Prevent Colon Cancer?

In this study from Sweden, 58,657 persons aged 50 years and older prescribed melatonin were matched with 175,971 nonusers of melatonin. The adjusted hazard ratio

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ASGE Journal Scan | Pancreas

Are There Signs or Symptoms That Predate the Diagnosis of Pancreatic Cancer?

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer mortality since most cancers are advanced at diagnosis. Early identification of these cancers is

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ASGE Journal Scan | Esophagus

Neoplasia Detection Rate Can Be Used as a Quality Indicator for Endoscopy in Barrett’s Esophagus

Standardized quality metrics evaluating the performance of a high-quality examination in patients with Barrett’s esophagus are lacking. The neoplasia detection rate (NDR), defined as the

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ASGE Journal Scan | Colon

Underwater EMR Outperforms Conventional EMR for 20- to 40-mm Nonpedunculated Polyps in Randomized Controlled Trial

In a single-center randomized controlled trial from Germany, 148 nonpedunculated lesions 20 to 40 mm in size were included in a per-protocol analysis and randomized

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ASGE Journal Scan | Colon

Incompletely Resected Polyps Associated With Subsequent Neoplasia and Advanced Neoplasia in Observational Study

Interval cancers are thought to result primarily from missed lesions, with a smaller component in the 10% to 30% range arising from incomplete polyp resection.

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ASGE Journal Scan | Colon

Summary of Evidence: Overweight and Obesity Are Both Associated With Early-Onset Colorectal Cancer Incidence

Intense ongoing investigation has suggested a number of risk factors for early-onset colorectal cancer (EOCRC), defined as CRC in persons younger than aged 50 years

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ASGE Journal Scan | Stomach and Small Bowel

Removing Duodenal Epithelial Lesions: Does Underwater Endoscopic Resection Work?

Underwater endoscopic mucosal resection (UEMR) has been increasingly utilized in the resection of colonic and duodenal mucosal lesions. Its use for resection of nonpolypoid superficial

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ASGE Journal Scan | Colon

Computer-Based Measurement of Polyp Size Getting Closer

Polyp size measurements by endoscopists during colonoscopy are notoriously inaccurate, with both over-measurements and under-measurements. Computerized assessments of polyp size are promising for more accurate

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ASGE Journal Scan | Esophagus

Narrow-Band Imaging Is a Good Screening Modality for Esophageal Squamous Cell Cancer for Expert and General Endoscopists

Those at high risk or with a prior history of esophageal squamous cell cancer (SCC) are recommended to undergo screening or surveillance using dye-based chromoendoscopy.

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ASGE Journal Scan | Colon

Tip-In EMR Increases En Bloc Resection Rate for 15- to 25-mm Colorectal Lesions

Tip-in EMR is a method of anchoring the snare tip in the submucosa before snare resection. First, a mound of submucosal injection is created. Then,

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ASGE Journal Scan | Colon

Is a Second Right-Side Colon Examination Needed When Using Mucosal Exposure Devices? Yes

Double right-sided colon examination has been advocated as a way to reduce interval cancers, which are more common in the proximal colon. Mucosal exposure devices,

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ASGE Journal Scan | Colon

Patients Live a Healthier Lifestyle After Endoscopic Screening

Previous studies have been inconclusive as to whether endoscopic screening contributes to patients leading a healthier or unhealthier lifestyle. For example, patients with normal examinations

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ASGE Journal Scan | Colon

Protein Assays Added to the Fecal Immunochemical Test Improve Sensitivity for Advanced Adenomas

The fecal immunochemical test (FIT) is widely chosen by organized colorectal cancer (CRC) screening programs as the screening test of choice. FIT detects about 80%

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ASGE Journal Scan | Esophagus

Only 80% Eradication Rates of Barrett’s Esophagus With Long-Term Follow-Up of Endoscopic Therapy Studies

Patients with high-grade dysplasia and/or early cancer in Barrett’s esophagus (BE) are treated with endoscopic therapy (BET), with the goal of complete eradication of all

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ASGE Journal Scan | Colon

New Data Indicate That Surgery Rates for Benign Polyps Might Be Finally Declining

Several recent studies have collectively reported that surgery rates for benign colorectal polyps in the U.S. have continued to increase even though surgery results in

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ASGE Journal Scan | Colon

Low Vitamin D Intake Associated With Early Onset Colorectal Cancer in Nurses’ Health Study

Many investigators are trying to understand the increasing risk of colorectal cancer (CRC) developing before age 50, or so-called early-onset CRC.  The Nurses’ Health Study

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ASGE Journal Scan | Colon

Diet High in Processed Meats and Low in Mixed Vegetables and Legumes Associated With Early-Onset Adenomas

This study utilized the Nurses’ Health Study II data to evaluate a sulfur microbial diet (high intake of processed meats and low intake of vegetables

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ASGE Journal Scan | Colon

No Increase in Adenomas in Microscopic Colitis

Although ulcerative colitis and Crohn’s colitis are associated with an increased risk of colorectal cancer (CRC), chronic inflammation associated with microscopic colitis (MC) has not

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ASGE Journal Scan | Pancreas

DNA Methylation Studies of Biliary Brush Cytology Samples Likely to Aid in Diagnosis of Cholangiocarcinoma

Establishing a firm diagnosis for indeterminate biliary strictures is often challenging. The current standard of practice is fluoroscopic and cholangioscopic characterization with brush and biopsy

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ASGE Journal Scan | Colon

Practice Patterns for Stopping Surveillance in Older Patients Are Highly Variable Among Endoscopists

The U.S. Multi-Society Task Force on Colorectal Cancer recommends individualizing the decision to stop surveillance colonoscopy in patients aged 75 years and older.  This is

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ASGE Journal Scan | Colon

Randomized Controlled Trial in Patients With Failed Bowel Preparation

When a patient is compliant with bowel preparation instructions, but the preparation is inadequate, there are little data from controlled trials to guide the bowel

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ASGE Journal Scan | Colon

Artificial Intelligence Improves Detection, Regardless of Endoscopist Experience

Five randomized controlled trials (4 from China and 1 from Europe and the U.S.) have demonstrated that artificial intelligence (AI) increases the adenoma detection rate

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ASGE Journal Scan | Colon

Strong Evidence That Long-Term Proton Pump Inhibitor Use Increases Colorectal Cancer Risk

Data vary regarding whether hypergastrinemia and proton pump inhibitor (PPI) use increase adenoma progression and risk of colorectal cancer (CRC).  The current study from the

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy Is Safe and Effective: A 10-Year Follow-Up of Patients

Peroral endoscopic myotomy (POEM), an endoscopic modality for managing major esophageal motility disorders, has gained popularity in the last decade. Multiple controlled studies and systematic

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ASGE Journal Scan | Stomach and Small Bowel

Endoscopic Management of Perforations: AGA Clinical Practice Update

A practice update from the American Gastroenterological Association used expert review and focus on methodologies to develop best practice recommendations for the management of endoscopic

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ASGE Journal Scan | Colon

Amoxicillin-Clavulanate Favored Over Fluoroquinolone-Metronidazole for Outpatient Diverticulitis

A combination of fluoroquinolone (ciprofloxacin, levofloxacin) and metronidazole is the most commonly used antibiotic treatment for outpatient diverticulitis. However, the U.S. Food and Drug Administration

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ASGE Journal Scan | Colon

Average U.S. Adenoma Detection Rate Hits 40%

Currently recommended minimum thresholds for adenoma detection rates (ADRs), defined as the fraction of patients undergoing first-time screening colonoscopy who have one or more conventional

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ASGE Journal Scan | Esophagus

Esophageal Dilation Is Safe and Effective in Patients With Difficult-to-Treat Eosinophilic Esophagitis

The phenotypes of eosinophilic esophagitis (EoE) range from mild inflammation to severe fibrostenotic disease. Although current therapies (diet, proton pump inhibitors, and steroids) have shown

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ASGE Journal Scan | Colon

Skinny Scopes Better for Women Requesting Unsedated Colonoscopy

On average, colonoscope insertion is considered more difficult in women than men, and most colonoscopists meet patients, including women, who request an attempt at unsedated

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ASGE Journal Scan | Colon

Is Leaving the Rectum in Place in Familial Adenomatous Polyposis Still Okay?

In this study from a French hospital, 296 patients with familial adenomatous polyposis (FAP) underwent either proctocolectomy with ileoanal anastomosis (IAA; 31.1%) or abdominal colectomy

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ASGE Journal Scan | Colon

Microbiome Predicts Metachronous Colorectal Adenomas

This Chinese study examined 367 patients in a retrospective cohort and 238 in a prospective group for the amount of fecal Fusobacterium nucleatum, quantitated by

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ASGE Journal Scan | Stomach and Small Bowel

Do Individuals With Celiac Disease Really Have an Increased Risk of Cancer?

Diagnosis of celiac disease has increased significantly over the past decade. The risk of cancer in this patient population is thought to be increased, although

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ASGE Journal Scan | Colon

Estimating Cancer Risk in Serrated Polyposis Syndrome

In a meta-analysis involving 36 studies and 2788 patients with serrated polyposis syndrome (SPS), the overall risk of colorectal cancer (CRC) was 19.9%. However, most

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ASGE Journal Scan | Colon

Colorectal Cancer Rates Increasing in Younger People Since 1980: What About Before Then?

Many U.S. cancer registries extend back to only a few years before cancer incidence in younger people began to rise, but the Connecticut Tumor Registry

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ASGE Journal Scan | Stomach and Small Bowel

Does Ranitidine Use Increase Risk of Bladder Cancer?

In 2020, the U.S. Food and Drug Administration and other similar bodies recalled all ranitidine products, secondary to a possible increased association with several types

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ASGE Journal Scan | Colon

New European Society of Gastrointestinal Endoscopy Guideline on Acute Lower GI Bleeding

These are highlights of the European Society of Gastrointestinal Endoscopy’s new guideline on the diagnosis and management of acute lower GI bleeding: In cases of

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ASGE Journal Scan | Esophagus

Adverse Events Are Uncommon After Peroral Endoscopic Myotomy, Score Predicts Those at Risk

Peroral endoscopic myotomy (POEM) is a widely accepted, effective endoscopic procedure for the management of achalasia. Although POEM is considered a relatively safe procedure, studies

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ASGE Journal Scan | Colon

Predicting Recurrence After Cold Endoscopic Mucosal Resection

Cold EMR is increasingly popular because of its low risk of complications. However, there do seem to be more recurrences after cold EMR.  In a

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ASGE Journal Scan | Colon

Turn up the Lights During Colonoscopy

Traditionally, room lights are turned down quite low during endoscopy. In a single-center retrospective study, 498 colonoscopies were performed by 9 gastroenterologists in low light

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ASGE Journal Scan | Colon

How Things Have Changed: Management of Colonoscopic Perforations

Fifteen years ago, tools to close acute perforations during colonoscopy became available, beginning with hemostatic clips, followed by over-the-scope clips and suturing.  To examine the

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ASGE Journal Scan | Colon

Updated Colorectal Cancer Screening Recommendations From the U.S. Preventive Services Task Force: Some of the Details

The U.S. Preventive Services Task Force (USPSTF) recommendations are key for screening because they influence the policies of the Centers for Medicare and Medicaid Services

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ASGE Journal Scan | Colon

Cancer Can Be Accurately Predicted Endoscopically in Flat Colorectal Lesions; Nodular and Bulky Lesions, Not so Much

Before endoscopic resection, large nonpedunculated colorectal lesions should be thoroughly inspected for evidence of submucosal invasive cancer (SMIC). The features to look for are disruption

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ASGE Journal Scan | Colon

Surgery for Benign Colorectal Polyps

This report from the U.S. evaluated 144 patients undergoing surgical resection for benign colorectal polyps. There were 118 referred patients without an attempt at endoscopic

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ASGE Journal Scan | Esophagus

Oral Budesonide Suspension Is Effective in Patients With Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE), a chronic inflammatory disorder, can be treated with steroids, proton pump inhibitors, and dietary modifications. There have been advances in the formulations

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ASGE Journal Scan | Stomach and Small Bowel

Is There a Method to Improve Examination of the Small Bowel With Capsule Endoscopy?

The ability of video capsule endoscopy (VCE) to detect small-bowel (SB) pathology is dependent on adequate visibility and motility. This single-center, prospective, randomized, controlled trial

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ASGE Journal Scan | Colon

Does Endoscopic Resection of High-Risk T1 Colorectal Cancer Cause Adverse Oncologic Outcomes?

High-risk T1 colorectal cancer means there are adverse histologic features associated with an increased risk of lymph node metastases (LNM). The features are typically deep

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ASGE Journal Scan | Colon

Ileocecal Valve Lesions No Longer Defy Endoscopic Resection

Laterally spreading lesions on the ileocecal valve (ICV) have traditionally been among the most challenging to resect endoscopically, and some centers refer them for surgical

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ASGE Journal Scan | Esophagus

Endoscopic GERD Treatment With Full-Thickness Plication Is Safe and Effective

Gastroesophageal reflux disease (GERD), a relatively common condition impacting up to 40% of the adult population, can be treated with proton pump inhibitors (PPIs), laparoscopic

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ASGE Journal Scan | Colon

Stalk Injection and Prophylactic Clipping of Pedunculated Polyps Increase Delayed Bleeding

In this Japanese study from 5 institutions, 1147 pedunculated (stalk length of ≥5 mm) colorectal polyps were evaluated for predictors of immediate bleeding after being

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ASGE Journal Scan | Pancreas

BILE Criteria to Assess ERCP Need in Cholangitis May Be More Sensitive, Less Cumbersome Than Others

Biliary obstruction with associated cholangitis usually is managed with the use of endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction or stent decompression of the bile

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ASGE Journal Scan | Esophagus

Nonendoscopic Detection of Barrett’s Esophagus Using Methylated DNA Markers

Currently, an upper GI endoscopy with biopsies of the columnar-lined distal esophagus is necessary to diagnose Barrett’s esophagus (BE). Easier, noninvasive, nonendoscopy-based testing techniques have

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ASGE Journal Scan | Colon

Up to 4% of Colorectal Cancers Have Unexplained Positive Immunohistochemistry

Universal screening of colorectal cancers (CRCs) is recommended to increase the diagnosis of Lynch syndrome. Tumor screening can be done by microsatellite instability (MSI) testing,

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ASGE Journal Scan | Colon

Colonoscopy More Effective Than the Fecal Immunochemical Test in Case-Control Study

Randomized controlled trials comparing the use of colonoscopy to the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening are underway.   A case-control study from

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ASGE Journal Scan | Stomach and Small Bowel

Pancreatic Cystic Lesions: Is Fluid Glucose Better Than Carcinoembryonic Antigen?

Differentiating pancreatic mucinous from nonmucinous cysts can be challenging, and the pancreatic cyst fluid (PCF) carcinoembryonic antigen (CEA) level has suboptimal accuracy. Adjunct tests, such

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ASGE Journal Scan | Colon

Using Family History to Guide Surveillance of “Other” Cancers in Lynch Syndrome: Does That Work?

The “other” cancers in Lynch syndrome include small-bowel, pancreatobiliary, urinary tract, and brain cancers, as well as sebaceous neoplasms. Routine screening for many of these

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ASGE Journal Scan | Pancreas

Covered Metal Stents Equal to Multiple Plastic Stents for Treatment of Biliary Strictures From Chronic Pancreatitis but Require Fewer Procedures

Compression of the distal bile duct within a fibrotic pancreas is one complication of chronic pancreatitis (CP), which can lead to chronic cholestasis, cholangitis, and

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ASGE Journal Scan | Colon

Germline Testing for Cancer Genes in Everyone With Colorectal Cancer?

Current guidelines recommend universal screening of patients with newly diagnosed colorectal cancer (CRC) for tumor features of Lynch syndrome. This is usually done by immunohistocompatibility

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ASGE Journal Scan | Colon

New Test for “Leaky Gut” Proposed

We often hear about the idea of “leaky gut,” which refers to intestinal permeability resulting from medications or certain diets, and that this condition may

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ASGE Journal Scan | Colon

What Is the Prevalence of Sessile Serrated Lesions Anyway?

In a systematic review and meta-analysis of 280,370 screening colonoscopies in the literature, the pooled prevalence of sessile serrated lesion (SSL) detection was 2.5%. The

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ASGE Journal Scan | Colon

Liquid Biopsy Assay Predicts Lymph Node Metastases in T1 Colorectal Cancer

When patients have T1 colorectal cancer (CRC) resected, histologic features, such as deep submucosal invasion, poor differentiation, lymphovascular invasion, and high-grade tumor budding, are used

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ASGE Journal Scan | Colon

Tattoos Claimed Unnecessary for Finding EMR Scars

Referring physicians sometimes tattoo large nonpedunculated lesions before referral, and resectionists sometimes tattoo the resection site for easy identification of the scar later. Neither practice

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ASGE Journal Scan | Colon

Modeling Suggests Later Starting Age and 3-Year Intervals for Colonoscopy in MSH6 and PMS2

Lynch syndrome is associated with increased cancer risk, particularly in the colorectum, as a result of germline mutations in any of 4 mismatch repair genes

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ASGE Journal Scan | Esophagus

POEM and Surgical Myotomy for Achalasia Show Comparable Functional Luminal Imaging Probe Measurement Results at 1 Year

The functional luminal imaging probe (FLIP) measures the distensibility index (DI) at the gastroesophageal junction (GEJ). This is a measure of GEJ compliance, which has

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ASGE Journal Scan | Colon

Cold EMR for Large Nonpedunculated Colon Polyps Dominates Hot EMR in Cost-Effectiveness Analysis

Cold EMR is becoming increasingly popular for large nonpedunculated colorectal lesions, particularly sessile lesions and adenomas without major 1s or pseudodepressed components. These researchers performed

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ASGE Journal Scan | Colon

Multicenter International Study Confirms That Snare-Tip Soft Coagulation of EMR Margin Dramatically Lowers Recurrence Rate

A previous randomized controlled trial showed that thermal ablation of a normal-appearing EMR margin after complete polyp resection reduced the recurrence rate from 21% to

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ASGE Journal Scan | Colon

Bad Outcomes for Patients Not Undergoing Colonoscopy After Positive Fecal Immunochemical Test

In an Italian study using a fecal immunochemical test (FIT)-positivity cutoff of 20 µg Hb/g feces, 88,013 FIT-positive patients (79%) underwent colonoscopy, and 23,410 (21%)

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ASGE Journal Scan | Pancreas

Transpapillary Gallbladder Stent Placement Usually Successful as Destination Therapy

Severe acute cholecystitis (AC) often is palliated with percutaneous or endoscopic drainage 6 to 12 weeks prior to preplanned interval cholecystectomy. Many patients with severe

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ASGE Journal Scan | Esophagus

Antireflux Surgery Is Associated With a Low 90-Day Mortality Rate in Patients With GERD

Laparoscopic antireflux surgery (ARS) is an effective treatment for patients with well-documented gastroesophageal reflux disease (GERD). In this retrospective cohort study, investigators used national databases

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ASGE Journal Scan | Colon

Don’t Refer Large Nonpedunculated Colorectal Lesions to Surgeons After Failed EMR Attempts

In clinical practice, colonoscopists sometimes think that patients with large nonpedunculated colorectal lesions should be referred to surgery after one or two attempts at resection

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ASGE Journal Scan | Colon

Adherence To Colonoscopy After Positive Fecal Immunochemical Testing Is Related To Patient Navigation and Distance From Center

In a comparison of colonoscopy adherence after positive fecal immunochemical testing (FIT) in 2017 without patient navigation (PN) versus 2018 with navigation, overall completion of

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ASGE Journal Scan | Stomach and Small Bowel

Management of Bariatric Complications: An American Gastroenterological Association Clinical Practice Update

More than 200,000 bariatric surgeries took place in 2018. Of these, 95% were either a sleeve gastrectomy or Roux-En-Y gastric bypass. Although the 90-day mortality

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ASGE Journal Scan | Colon

Selective Serotonin Reuptake Inhibitors Reduce Colorectal Cancer Risk, and the Effect Is Additive to Aspirin

In a nationwide Swedish registry study, 24,786 colorectal cancer (CRC) cases and 74,358 randomly matched controls for birth year and sex were evaluated to determine

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Colon

Brits Evaluate Their New Postpolypectomy Surveillance Guidelines

The UK revised its postpolypectomy surveillance guidelines to reduce the use of surveillance colonoscopy. According to the guidelines, patients considered to be high risk for

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ASGE Journal Scan | Esophagus

Pneumatic Dilation Is Ineffective for Postfundoplication Dysphagia

Persistent dysphagia (ie, symptoms for more than 3 months) after fundoplication surgery is reported in up to 25% of patients. After anatomical causes of dysphagia

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ASGE Journal Scan | Colon

“Step-Clipping” Technique Reported as Effective for Endoscopic Localization of Colonic Diverticular Bleed

Colonic diverticular bleeding (CDB) often stops spontaneously, and a meticulous colonoscopic search of the colon for the bleeding diverticulum is often unsuccessful. The “step-clipping” method

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ASGE Journal Scan | Colon

Individual Patient Data Meta-Analysis of Randomized Trials Fails To Show Benefit of Chromoendoscopy in Lynch Syndrome

An individual patient data meta-analysis, which was performed for this study, utilizes the individual data from separate studies rather than summary data. However, this study

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ASGE Journal Scan | Pancreas

Radiofrequency Ablation Plus Stent Placement for Extrahepatic Cholangiocarcinoma Shows Benefit Over Stenting Alone

The optimal treatment for cholangiocarcinoma (CCA) or ampullary carcinoma (AC) is surgery. When deemed unresectable and not amenable to neoadjuvant therapy followed by liver transplantation,

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ASGE Journal Scan | Colon

Want To Take Out Polyps in Anticoagulated Patients? New Data Indicate Apixaban Is the Drug To Be On

This retrospective cohort study evaluated postpolypectomy bleeding and thromboembolism risks with warfarin, apixaban, dabigatran, and rivaroxaban use in Hong Kong public hospitals between January 2012

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ASGE Journal Scan | Colon

Three Minutes of Verbal Instructions Improved Bowel Preparation in Mobile Inpatients

Clinicians everywhere struggle with colonoscopy bowel preparation in inpatients. In a randomized trial performed in 4 cities, 300 patients (180 mobile and 120 bedridden) received

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ASGE Journal Scan | Esophagus

Linked Color Imaging Improves Neoplasia Detection

Image-enhanced endoscopy is aimed at improving the detection of neoplastic lesions in the luminal GI tract during standard white-light endoscopy (WLE). Linked color imaging (LCI)

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ASGE Journal Scan | Pancreas

Better, but Insufficient Results From Duodenoscope Reprocessing With Double Wash and High-Level Disinfection or Liquid Chemical Sterilization

The potential for interpatient transmission of infections by contaminated duodenoscopes is a significant concern in the practice of ERCP. Pending further understanding and development of

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ASGE Journal Scan | Colon

Adenoma Detection Rate Can Be Measured in Combined Screening, Surveillance, and Diagnostic Examinations

When the adenoma detection rate (ADR) was originally proposed as a quality measure in 2002, the recommendation did not constrain its indication to screening colonoscopies

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ASGE Journal Scan | Colon

High Success Rates for Endoscopic Submucosal Dissection in Prospective North American Study

There are limited data on success rates of endoscopic submucosal dissection (ESD) in North America. In this study, 10 centers in the United States and

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ASGE Journal Scan | Colon

Virtual Reality for Colonoscopy Sedation?

In this study, a virtual reality program playing nature and animal scenes was tested in 27 patients who had previously undergone moderate sedation for colonoscopy

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ASGE Journal Scan | Stomach and Small Bowel

Is Gastroparesis Truly Different From Functional Dyspepsia?

Patients with functional dyspepsia (FD) and gastroparesis are commonly seen, diagnosed, and treated in gastroenterology clinics. Though we think of these diseases as two separate

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ASGE Journal Scan | Esophagus

Endoscopic Features for Recognizing Buried Barrett’s Esophagus

Buried Barrett’s esophagus (BE) mucosa, or subsquamous intestinal metaplasia, is defined as intestinal metaplasia that is present under a lining of endoscopically intact squamous epithelium.

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ASGE Journal Scan | Colon

Endocuff Vision Raises Adenoma Detection Rate by 7% in Randomized Controlled Trial in FIT-Positive Patients

Recent analyses suggest that colonoscopy with the original Endocuff or newer Endocuff Vision (EV) is superior to standard colonoscopy but that Endocuff has a greater

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ASGE Journal Scan | Colon

Europeans Report Japanese-Like en Bloc and R0 Colonic Endoscopic Submucosal Dissection Rates Using Double-Clip Traction

Colonic endoscopic submucosal dissection (ESD) is generally considered more challenging than esophageal, stomach, or rectal ESD.  The authors have previously described a double-clip traction (DCT)

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ASGE Journal Scan | Colon

Off-Label Use of Multitarget Stool DNA Test Is Common in Primary Care

In a retrospective analysis of all multitarget stool DNA (mt-sDNA) tests ordered at a single center over one year by 62 primary care providers (50

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ASGE Journal Scan | Colon

Cancer Incidence and Mortality Risk After Index Colonoscopies Showing Low-Risk Adenomas, High-Risk Adenomas, or No Adenomas

Postpolypectomy surveillance recommendations are based on observational studies, often using advanced adenomas at follow-up as their primary outcome.  A new meta-analysis focused on the risk

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ASGE Journal Scan | Colon

Screening With Fecal Immunochemical Test More Impactful for Distal Than Proximal Cancers

In a nationwide biennial fecal immunochemical test (FIT) screening program in Taiwan, more than 5.4 million individuals were invited to undergo screening between 2004 and

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ASGE Journal Scan | Esophagus

Endoscopic Screening Reduces Mortality From Esophageal Cancer in High-Risk Population

Although esophageal adenocarcinoma (EAC) is the most common type of esophageal cancer in the Western world, esophageal squamous cell carcinoma (ESCC) is the dominant type

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ASGE Journal Scan | Stomach and Small Bowel

Are Proton Pump Inhibitors Associated With Increased Mortality?

There has been significant media attention on the risks of proton pump inhibitors (PPIs) noted in observational studies, including associated risks of pneumonia, Clostridium difficile,

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ASGE Journal Scan | Colon

WASP Optical Classification Criteria Are Not So Good for Diminutive Sessile Serrated Lesions

The optical features of sessile serrated lesions (SSLs) identified in narrow-band imaging are a cloud-like surface, indistinct borders, irregular shape, and dark spots. In a

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ASGE Journal Scan | Colon

Is Endocuff Vision As Good As the Original Endocuff?

The original Endocuff (EC) had two rows of fingers, whereas the currently marketed Endocuff Vision (ECV) has a single row of longer fingers. Although EC

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ASGE Journal Scan | Pancreas

Cholecystectomy Before Dismissal Confirmed as Optimal in Large Population of Veterans With Biliary Pancreatitis

Multiple guidelines recommend performing cholecystectomy (CCy) before hospital dismissal for patients with mild gallstone pancreatitis that is not complicated by infection or necrosis. In this

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ASGE Journal Scan | Colon

Colorectal cancer screening occurs broadly in two settings, termed “organized” and “opportunistic.” Organized programs are typically run by nations or health care systems and usually

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ASGE Journal Scan | Colon

Colon Capsule Gives CT Colonography Another Drubbing

In a prospective randomized trial including 320 average-risk screenees, polyps ≥6 mm were found more often with colon capsule endoscopy than with CT colonography (CTC;

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ASGE Journal Scan | Esophagus

Artificial Intelligence Accurately Identifies Esophageal Lesions

Artificial intelligence (AI) studies for detecting and differentiating gastrointestinal lesions are on the rise. Various groups have developed a multitude of machine-learning algorithms to accurately

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ASGE Journal Scan | Stomach and Small Bowel

Does Ranitidine Use Increase Cancer Risk?

Ranitidine is a widely used H2-receptor antagonist used to treat reflux and peptic ulcer disease. Recently, the U.S. Food and Drug Association (FDA) discontinued sales

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ASGE Journal Scan | Colon

Lower Back, Neck, and Left Thumb Injuries Most Common Types of Injuries Among Colonoscopists

In a survey of primarily UK endoscopists (72% of all respondents) that included endoscopists from 45 countries and had an overall 20.2% response rate, the

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ASGE Journal Scan | Colon

Diverticulitis Not Associated With Constipation

In this study, researchers evaluated the Nurses’ Health Study (NHS) and Health Professional Follow-up Study (HPFS) databases to examine the association of diverticulitis with bowel

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ASGE Journal Scan | Colon

Risks of Recurrence and Mortality After Local Endoscopic Resection of T1 Colorectal Cancer

In a meta-analysis of 71 studies involving 5167 endoscopically treated T1 colorectal cancers (CRCs), the cumulative recurrence rate was 3.3%, the local recurrence rate was

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ASGE Journal Scan | Colon

Yes, Early Onset Colorectal Adenocarcinoma Rates Are Increasing, But Rectal Carcinoid Rates Are Increasing Faster

There is now widespread recognition that there are increasing rates of colorectal cancer in persons under age 50 (early-onset colorectal cancer), that most of the

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ASGE Journal Scan | Colon

Depressed Lesions Are Different at a Histologic and Molecular Level

In a study from Japan, T1 colorectal cancers and adenomas were classified as “depressed,” “flat,” or “protruded” subtypes. Depressed lesions constituted only 1.2% of all

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ASGE Journal Scan | Stomach and Small Bowel

Can We Decrease Lesion Recurrence After Duodenal Endoscopic Mucosal Resection?

Laterally spreading lesions (LSLs) of the duodenum are increasingly being diagnosed and treated endoscopically. Although endoscopic resection of the thin and vascular duodenal wall is

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ASGE Journal Scan | Esophagus

Recurrence of Intestinal Metaplasia in the Cardia After Barrett’s Endoscopic Therapy: What To Do?

In patients undergoing Barrett’s endoscopic therapy (BET), complete eradication of intestinal metaplasia (CE-IM) is the final goal. However, studies have reported recurrence of IM, specifically

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ASGE Journal Scan | Colon

Predicting Complete Closure of EMR Sites

Clip closure of endoscopic mucosal resection (EMR) defects ≥20 mm located proximal to the splenic flexure and removed by electrocautery is associated with a reduction

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ASGE Journal Scan | Colon

Patients With Multifocal Cancer: Evidence for Intraluminal Spread of Tumor

In various series, 2% to 7% of patients with colorectal cancer (CRC) have either synchronous or metachronous second cancer. Second CRCs have generally been considered

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ASGE Journal Scan | Pancreas

Hydrogen Peroxide, One Way or Another, Appears Beneficial During Endoscopic Necrosectomy

Management of walled-off pancreatic necrosis often benefits from direct transmural endoscopic necrosectomy. This retrospective chart review assessed the utility of hydrogen peroxide (H2O2) lavage as

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ASGE Journal Scan | Colon

New Expert Review From the American Gastroenterological Association on Managing Colonic Diverticulitis

The American Gastroenterological Association has issued a clinical practice update on the management of colonic diverticulitis. The recommendations are as follows: Physicians should order a

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ASGE Journal Scan | Colon

Positive Incidental Colorectal PET/CT: Sometimes Serious Lesions, Sometimes Not

There is general agreement that when positron emission tomography (PET) incidentally lights up the colon, there is a substantial positive predictive value for cancer and

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ASGE Journal Scan | Esophagus

Reflux Monitoring Can Reduce the Inappropriate Use of Proton Pump Inhibitors in Patients With GERD

Proton pump inhibitors (PPIs) are the main treatment for gastroesophageal reflux disease (GERD). However, 30% to 50% of patients with GERD fail to achieve adequate

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ASGE Journal Scan | Esophagus

Diaphragmatic Breathing Can Help Reduce GERD

Upright gastroesophageal reflux disease (GERD), also known as upright reflux, is thought to be a result of increased intragastric pressure. In turn, increases in intragastric

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ASGE Journal Scan | Colon

Appendicitis Treatments: Large Randomized Controlled Trial Compares Antibiotics With Appendectomy

Antibiotic treatment is now widely recognized as an option for appendicitis therapy. In a nonblinded randomized trial of 1552 adults, including 414 with an appendicolith,

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ASGE Journal Scan | Colon

When Is Clip Closure of EMR Defects Cost-Effective?

Randomized controlled trials demonstrate that prophylactic clip closure of endoscopic mucosal resection (EMR) defects of large (≥20 mm) nonpedunculated colorectal lesions effectively prevents delayed hemorrhage.

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ASGE Journal Scan | Pancreas

Best Conformation for Hilar Self-Expanding Metal Stents Remains Undefined

Bilateral placement of metal stents for malignant hilar strictures (MHS) can be challenging. Two approaches have been used, each with potential benefits and challenges.  In

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ASGE Journal Scan | Colon

Multi-Society Task Force Issues Malignant Polyp Management Recommendations

The U.S. Multi-Society Task Force on Colorectal Cancer, which consists of experts from the 3 luminal GI societies, has issued recommendations on the management of

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ASGE Journal Scan | Colon

Oral Sulfate Tablets for Bowel Preparation Are Effective and Safe

This study compared a new formulation of oral sulfate in tablet form to polyethylene glycol with ascorbate (PEG-EA). Both types of preparation were given in

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ASGE Journal Scan | Pancreas

Updated Criteria for Prediction of Choledocholithiasis Add Specificity

A variety of recommendations have been proposed for predicting choledocholithiasis based upon presenting signs, symptoms, initial laboratory studies, and imaging. In this retrospective study, the

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ASGE Journal Scan | Stomach and Small Bowel

Endoscopic Management of Gastroduodenal Obstruction

Gastric outlet obstruction (GOO) can result in significant morbidity. Symptoms include early satiety, nausea, vomiting, and abdominal pain, which are frequently associated with weight loss.

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ASGE Journal Scan | Stomach and Small Bowel

Is Gastric Electric Stimulation Cost-Effective in Patients With Refractory Vomiting?

Medication-refractory nausea and vomiting, which is often due to gastric dysmotility, is a challenging problem. High-frequency gastric electrical stimulation (GES), which was approved by the

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ASGE Journal Scan | Colon

Non-White Race and Low Socioeconomic Status Associated With Longer Wait for Treatment After Colorectal Cancer Diagnosis

The time between diagnosis of colorectal cancer (CRC) and initiation of treatment is associated with mortality. In this study of 330,988 CRC cases in the

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ASGE Journal Scan | Colon

Sessile Serrated Lesions That Are 10 mm or Larger: No Need To Inject

Cold resection of sessile serrated lesions (SSLs) ≥10 mm in size is increasingly accepted as effective and, compared to electrocautery, is safer. Many experts prefer

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ASGE Journal Scan | Colon

Poor Compliance With Antithrombotic Guidelines Associated With Bad Outcomes

Rates of polypectomy in colonoscopy are high for all indications; therefore, clinicians usually stop antiplatelet and antithrombotic agents other than aspirin prior to colonoscopy and

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ASGE Journal Scan | Colon

Lynch Syndrome Colonoscopy: Quality Matters

In the U.S., colonoscopy is usually performed at 1- to 2-year intervals in Lynch syndrome. This multicenter study evaluated the relationship of adenoma detection and

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ASGE Journal Scan | Colon

Colonoscopy Performance Produces Force Levels and Durations of Force Elevation That Are Associated With Upper Extremity Injury

Musculoskeletal injuries are common in endoscopists. This study used surface electromyography of wrist flexors and extensors as well as pressure transducers on the thumbs to

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ASGE Journal Scan | Colon

Colon Capsule Endoscopy Scorches CT Colonography in Fecal Immunochemical Test-Positive Trial

Comparative trials in patients with prior incomplete colonoscopy suggest that colon capsule endoscopy (CCE) detects polyps with higher sensitivity than CT colonography (CTC). In the

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ASGE Journal Scan | Colon

Postcolorectal Endoscopic Mucosal Resection Follow-up Is Essential

There is a well-known risk of adenoma recurrence after piecemeal endoscopic mucosal resection (EMR).  In a single-center study of 2411 nonpedunculated lesions ≥20 mm in

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ASGE Journal Scan | Colon

Polish Study Calls for Using Adenoma Detection Rate to Stratify Screening and Surveillance Recommendations

In this study, the risk of interval cancer was compared between doctors with high (≥20%) versus low (<20%) adenoma detection rates (ADRs) in the Polish

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ASGE Journal Scan | Esophagus

Achalasia Patients at Increased Risk for Esophageal Cancer

Achalasia can cause food retention, leading to bacterial overgrowth, irritation, and chronic inflammation, a proposed pathophysiological process that may lead to squamous cell carcinoma (SCC).

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ASGE Journal Scan | Stomach and Small Bowel

Should We Be Treating Postsurgical Leaks Endoscopically?

Postoperative leaks are difficult to treat; however, the evolution of therapeutic endoscopy has allowed less-invasive repair techniques in an attempt to avoid repeat surgery. This

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ASGE Journal Scan | Pancreas

Further Evidence Supporting Early, Primary Use of Precut Sphincterotomy for Duct Access

Deep access to the bile duct or the pancreatic duct is required in order to complete all subsequent therapeutic ERCP maneuvers. Precut sphincterotomy (PCS) refers

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ASGE Journal Scan | Esophagus

Cryoballoon Ablation Can Be Used for Barrett’s Esophagus Endoscopic Therapy

Cryotherapy involves the application of a cryogen by way of spraying liquid nitrogen to the esophageal mucosa or by surface contact with a nitrous oxide-filled

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ASGE Journal Scan | Colon

Anesthesia and Pathology Charges Lead to Surprise Billing in Commercially Insured Colonoscopy

This study reviewed colonoscopies identified in a claims database from a large national insurer in the United States. The database was queried for commercially insured

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ASGE Journal Scan | Colon

Kaiser Achieved Greater Than 80% Screening Adherence; How Did They Do It?

Organized screening, in which a nation or health care system systematically offers colorectal cancer screening for eligible patients, usually by fecal immunochemical testing (FIT), is

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ASGE Journal Scan | Colon

Symptoms are Common After Total Proctocolectomy With Ileal Pouch Creation in Patients With Familial Adenomatous Polyposis

Pouch symptoms are typically considered to occur less frequently after total proctocolectomy and ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP) compared to after

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ASGE Journal Scan | Colon

New Clinical Model Predicts Need for Screening Colonoscopy

A risk-stratified approach to colorectal cancer screening within the average-risk population is seldom used. In this approach, patients whose prescreening predicted prevalence of advanced neoplasia

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ASGE Journal Scan | Colon

Which Rectal Neuroendocrine Tumors are Dangerous?

In this study of 309 rectal neuroendocrine tumors (NETs), often called rectal carcinoids in the past, endoscopic factors were studied to understand their association with

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ASGE Journal Scan | Stomach and Small Bowel

How Safe Is Endoscopic Gastrostomy Tube Placement?

The invasive nature of the endoscopic placement of a gastrostomy tube is associated with higher morbidity and mortality compared to other routine endoscopic procedures. Alternative

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ASGE Journal Scan | Colon

Negative Colonoscopy for FIT-Positive Patients: Should We Keep Doing FIT?

In this study from Taiwan, patients with a negative colonoscopy after a positive fecal immunochemical test (FIT) during the interval 2004 through 2009 were followed

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ASGE Journal Scan | Colon

Chemoprevention for Colorectal Cancer: What Works and What Doesn’t?

This was a systematic review of 80 meta-analyses of colorectal cancer prevention with medications, vitamins, supplements, and dietary factors.  Of the factors found to be

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ASGE Journal Scan | Pancreas

Endoscopic Approaches to Drainage for Acute Cholecystitis Are Optimal in Nonoperative Patients

Gallbladder removal or drainage is a key component of treatment for acute cholecystitis. When the risk of urgent cholecystectomy is considered prohibitive, the optimal alternative

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ASGE Journal Scan | Colon

Even Expert Pathologists Have Only Moderate Agreement Regarding Differentiating Sessile Serrated Lesions From Hyperplastic Polyps

Current recommendations for measurement of the adenoma detection rate (ADR) recommend that sessile serrated lesions (SSLs; also called sessile serrated adenomas and sessile serrated polyps)

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ASGE Journal Scan | Colon

Artificial Intelligence System Outperforms Guideline Predictive Criteria for Lymph Node Metastasis in T1 Cancers

In a study from 7 centers in Japan, a deep learning artificial intelligence (AI) program trained on 3134 T1 colorectal cancers (CRCs) from 6 Japanese

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ASGE Journal Scan | Esophagus

Relapse in Eosinophilic Esophagitis Occurs Despite Treatment With Swallowed Topical Corticosteroids

Swallowed topical corticosteroids (STC) are effective as initial treatment in patients with eosinophilic esophagitis (EoE) and in achieving histological remission. However, their role in the

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ASGE Journal Scan | Pancreas

First Single-Use Duodenoscope Measures up in Direct Comparison for Low-Complexity Procedures

The development of single-use (disposable) endoscopes is one approach to eliminating infection transmission between sequential patients during endoscopy. This single-center study randomized patients undergoing endoscopic

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ASGE Journal Scan | Esophagus

Neoplasia Detection Rate in Barrett’s Esophagus: A Measure of High-Quality Upper Endoscopy

Studies have reported that up to 25% of esophageal adenocarcinomas (EACs) are detected within 1 year of index endoscopy (missed cancer), emphasizing the need for

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ASGE Journal Scan | Colon

ESGE Issues Comprehensive Training Curriculum on Optical Diagnosis

The extent to which optical diagnosis is used in routine endoscopy in the United States to improve treatment decisions in endoscopy is virtually unknown.  The

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ASGE Journal Scan | Colon

More Evidence That Negative Screening Colonoscopy Can Be Followed by Intervals of More Than 10 Years

This study compared the incidence of advanced neoplasms in 2456 German screening colonoscopy patients who had a previous colonoscopy without polyps to the results from

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ASGE Journal Scan | Colon

Computerized Imaging of Vessels in EMR Defects Predicts Postprocedural Bleeding

Recent studies indicate that prophylactic clip closure of postendoscopic mucosal resection defects from colonic lesions >20 mm in size and proximal to the splenic flexure

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ASGE Journal Scan | Colon

Monoallelic NTHL1 Loss of Function Not Associated With Colorectal Cancer

NTHL1 encodes endonuclease III-like protein 1, an enzyme involved in base-excision repair that identifies and removes oxidized pyrimidines. Biallelic loss-of-function mutations of base-excision repair genes, such

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ASGE Journal Scan | Colon

Optical Character Recognition Combined With Natural Language Processing to Improve Extraction of Quality Parameters From Colonoscopy Reports

Measurement and improvement of colonoscopy quality measures, such as the adenoma detection rate (ADR), are critical to optimizing colorectal cancer prevention by colonoscopy. The process

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ASGE Journal Scan | Stomach and Small Bowel

Is Endoscopic Sleeve Gastroplasty the Solution?

The prevalence of obesity in the United States has reached an epidemic level and is associated with conditions such as insulin resistance (IR) and nonalcoholic

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ASGE Journal Scan | IBD

Ileal and Rectal Ulcers Heal Slower and May Be More Refractory to Therapy Than Colonic Lesions in Crohn’s Disease

Researchers performed a post hoc analysis of endoscopic outcomes in participants of the pivotal SONIC trial that compared the efficacy of azathioprine, infliximab, and the

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ASGE Journal Scan | Esophagus

Budesonide Can Be Used for Maintaining Long-Term Remission in Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic antigen-mediated immunological disorder that has a high relapse rate of >80% with cessation of therapy. Although corticosteroids (both topical

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ASGE Journal Scan | Pancreatobiliary System and Liver

Discovering Adverse Events By Phone – the Sweet Spot is 7 Days After ERCP

Identification of adverse events following gastrointestinal endoscopy can be challenging due to patient reticence to present for mild to moderate problems and dispersed follow-up among

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ASGE Journal Scan | Colon

Most Primary Care Physicians Not Following the American Cancer Society’s Recommendation to Screen at Age 45

The American Cancer Society (ACS) recommended in 2018 that all Americans should undergo colorectal cancer (CRC) screening beginning at age 45. Thus far, other major

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ASGE Journal Scan | Colon

American Gastroenterological Association Issues Guidelines on GI Evaluation of Iron Deficiency Anemia

The American Gastroenterological Association (AGA) has issued the following recommendations regarding GI evaluation of iron deficiency anemia (IDA): In patients with anemia, IDA should be

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ASGE Journal Scan | Esophagus

Implementing a Standardized Protocol Helps to Increase Diagnosis of Eosinophilic Esophagitis

The incidence of eosinophilic esophagitis (EoE), a condition characterized by esophageal eosinophilia and dysfunction, has been reported in about 5 to 10 per 100,000 individuals.

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ASGE Journal Scan | Colon

What Are Cold Snare Protrusions and Are They a Bad Thing?

During cold snare polypectomy, removal of larger lesions and/or larger specimens sometimes results in a cold snare protrusion (CSP), appearing as a white cord in

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ASGE Journal Scan | Pancreas

Large-Caliber Dilation Without Sphincterotomy Is Efficacious and Safe for Stones >10 mm

Endoscopic biliary sphincterotomy (ES) is the standard prelude to duct stone removal; however, it carries moderate risk for both pancreatitis and bleeding and can be

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ASGE Journal Scan | Colon

Hemostasis Peptide Reduces Need for Electrocoagulation of Bleeding Points During ESD

Bleeding is common during endoscopic submucosal dissection (ESD). It can obscure dissection planes and often requires electrocoagulation that could injure the muscularis propria. PuraStat (3D-Matrix,

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ASGE Journal Scan | Colon

Risk of Death From Colonoscopy in the Italian FIT Screening Program

Organized fecal immunochemical test (FIT)-based screening programs offer the opportunity to prospectively assess adverse events of colonoscopy. A recent large study from the Netherlands found

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ASGE Journal Scan | Colon

All That Time That Cannot Be Billed

Previous data found that primary care physicians and some specialists spend about an hour on electronic health records (EHRs) for each hour they are scheduled

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ASGE Journal Scan | Esophagus

Motility Disorders Can Exist in Patients With Eosinophilic Esophagitis, Specifically in Those Not Responding to Therapy

Eosinophilic esophagitis (EoE) is characterized by the presence of esophageal dysfunction along with histological evidence of ≥15 eosinophils per high-power field from esophageal biopsies. Recent

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ASGE Journal Scan | Pancreas

Pancreatic Extracorporeal Shock Wave Lithotripsy: Efficient and Effective in Gastroenterologists’ Hands

Extracorporeal shock wave lithotripsy (ESWL) has become the dominant therapy for the treatment of symptomatic pancreatic duct stone obstruction in chronic calcific pancreatitis. In the

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ASGE Journal Scan | Colon

Risk of Death From Colonoscopy in a FIT-Positive Program

In any screening program, it is important to know the benefits and harms of screening. Patients who have a positive fecal immunochemical test (FIT) result

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IBD

Low Incidence of Colorectal Cancer After Endoscopic Dysplasia Resection in Patients With IBD

Given the paucity of high-quality outcome data, the optimal management of polypoid and/or nonpolypoid colonic lesions in IBD is an ongoing debate. Guidelines recommend that

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ASGE Journal Scan | Stomach and Small Bowel

Should Asian Americans Be Routinely Screened for Gastric Cancer With Endoscopy?

There are no current guidelines in the United States for gastric cancer screening, even with a high population of immigrants from Asian-Pacific countries. Studies have

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ASGE Journal Scan | Colon

Early Colorectal Cancer Screening in African Americans: High Uptake and High Yield

Recommendations from GI societies to screen African Americans for colorectal cancer (CRC) starting at age 45 were based largely on age-related incidence and mortality data

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ASGE Journal Scan | Colon

Granular Laterally Spreading Tumors With Nodule: Rectal Location and at Least 4-cm Size Warrant en Bloc Resection

Granular laterally spreading tumors (G-LST) in the colorectum are more common than nongranular lesions, less likely to have cancer, and in general, easier to remove

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ASGE Journal Scan | Esophagus

Dysphagia Is Common After Bariatric Surgery

Symptoms of dysphagia due to obstruction (mechanical or functional) can be caused by a noncompliant gastric pouch after bariatric surgery and, theoretically, could lead to

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ASGE Journal Scan | Pancreatobiliary System and Liver

When Draining Walled-Off Pancreatic Necrosis, Attention to Disconnected Pancreatic Duct Syndrome Guides Terminal Steps in Therap

Internal drainage using large-caliber lumen-apposing metal stents (LAMS) is now a dominant therapy for acute fluid collections and walled-off pancreatic necrosis associated with acute pancreatitis.

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ASGE Journal Scan | PANCREATOBILIARY | Pancreas

Video Auditing of Duodenoscope Reprocessing Contributes to High Performance in a Tertiary Care Center

Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients.  The

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ASGE Journal Scan | Colon

Acetic Acid and Blue Light Highlight Sessile Serrated Lesions

This case study demonstrates how acetic acid in combination with blue-light imaging (BLI), a relatively new mode of chromoendoscopy technology, highlights sessile serrated lesions (SSLs).

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ASGE Journal Scan | Esophagus

Nonendoscopic Screening for Barrett’s Esophagus: Are We There?

Upper endoscopy (EGD) with biopsy remains the gold standard for the diagnosis of Barrett’s esophagus (BE). Several nonendoscopic techniques (sponge, capsule) have utilized biomarkers, such

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ASGE Journal Scan | Stomach and Small Bowel

Hope for Those Suffering From Gastroparesis?

Gastroparesis is a chronic medical condition that can cause unpleasant and refractory symptoms that adversely affect quality of life. Unfortunately, metoclopramide, which can cause serious

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ASGE Journal Scan | Esophagus

Peroral Endoscopic Myotomy Can Be Safe and Effective for Persistent Symptoms After Heller Myotomy

Persistent and recurrent symptoms have been reported in up to 20% of patients with achalasia after surgical treatment with Heller myotomy. The aim of this

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ASGE Journal Scan | IBD

Recycled Precolectomy Anti-Tumor Necrosis Factor Does Not Work for Chronic Pouchitis

Following total proctocolectomy with restorative ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC), about one-third of patients develop chronic pouchitis. Treatment of antibiotic-refractory and Crohn’s

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ASGE Journal Scan | Colon

Delayed Start Times Associated With Reduced Adenoma Detection

Previous studies have shown that the adenoma detection rate (ADR) is sometimes lower in colonoscopies performed in the afternoon versus the morning, though the results

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ASGE Journal Scan | Colon

Surgery Not Needed After Complete Endoscopic Resection of Intramucosal Colorectal Cancer

Intramucosal cancer (IMC) refers to dysplasia in the lamina propria of the mucosa with or without invasion of the muscularis mucosa. Such lesions are usually

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ASGE Journal Scan | Colon

Initial Experience With EndoRotor Tissue Resection Device

The EndoRotor nonthermal powered endoscopic debridement (PED) instrument (Interscope, Inc., Whitinsville, Mass) is a new tissue resection device that can be passed through endoscopes. There

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ASGE Journal Scan | PANCREATOBILIARY

Fully Covered Metal Stents Provide Respectable Efficacy for Posttransplant Strictures

Biliary leaks and strictures are among the most common adverse events after liver transplantation. Anastomotic strictures are generally managed using endoscopic balloon dilation and stenting

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ASGE Journal Scan | Esophagus

Is Barrett’s Esophagus Thickness a Marker for Response to Radiofrequency Ablation Therapy?

Radiofrequency ablation (RFA) is a widely used modality for treating flat Barrett’s esophagus (BE) dysplasia, with the goal of achieving complete eradication of intestinal metaplasia

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ASGE Journal Scan | IBD

Relapse Half as Likely With Ulcerative Colitis in Clinical and Endoscopic Remission Than Clinical Remission with Mild Endoscopic Disease Activity

The current treatment target in ulcerative colitis (UC) is clinical and endoscopic remission, defined by patient-reported outcomes and a Mayo endoscopic subscore of 0 or

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ASGE Journal Scan | Colon

ESGE Expands the Postpolypectomy Cohort With No Recommended Surveillance

The European Society of Gastrointestinal Endoscopy (ESGE) has issued its first update of postpolypectomy surveillance recommendations since 2013. Key recommendations include the following: Patients with

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ASGE Journal Scan | Colon

Adding Time for Inspection During Colonoscope Insertion Does Not Work

There remain occasional advocates of dedicated time during colonoscope insertion to look for polyps as a way of increasing detection. In this analysis of 7

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ASGE Journal Scan | Stomach and Small Bowel

Endoscopic Submucosal Dissection Outcomes for Early Gastric Lesions in North America

There are sufficient data in Asia to demonstrate that endoscopic submucosal dissection (ESD) has equivalent outcomes to surgical intervention for early gastric cancer (EGC). Moreover,

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ASGE Journal Scan | Esophagus

Is Obesity a Risk Factor for Barrett’s Esophagus?

While the role of obesity in gastroesophageal reflux disease (GERD) and the role of GERD in Barrett’s esophagus (BE) are independently well established, there is

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ASGE Journal Scan | Colon

Prophylactic Clipping Ineffective for Polyps Less Than 20 mm in Size

Analyses of randomized trials indicate that prophylactic clipping of EMR sites ≥20 mm in size in the proximal colon reduces the risk of delayed hemorrhage.

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ASGE Journal Scan | Colon

Dutch Endoscopic Full-Thickness Resection Experience in Colorectum

This report summarizes a prospectively acquired experience using the endoscopic full-thickness resection device (FTRD) in the colorectum. Among 367 procedures performed between July 2015 and

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ASGE Journal Scan | Stomach and Small Bowel

Familial Adenomatous Polyposis: Should Routine Ampulla Biopsies Be Performed?

Duodenal and ampullary cancers are the most common causes of death in patients with familial adenomatous polyposis (FAP) who have undergone colectomy. Current guidelines recommend

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ASGE Journal Scan | Colon

Adenomas in the Young: What Do They Mean?

The incidence of colorectal cancer (CRC) is increasing in persons under age 50 in much of the world. Endoscopists commonly encounter sporadic adenomas when performing

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ASGE Journal Scan | Colon

Sarcopenia (Loss of Skeletal Muscle Mass) Associated With Metachronous Adenomas

Sarcopenia is a progressive loss of skeletal muscle mass in relation to aging. Sarcopenia is associated with metabolic syndrome, diabetes, and nonalcoholic steatohepatitis and has

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ASGE Journal Scan | Colon

Negative Colonoscopy Predicts Reduced Risk of Colon Cancer for 17 Years

Previous studies in symptomatic populations have found that a negative colonoscopy predicts a reduction in colorectal cancer (CRC) incidence for greater than 20 years. The

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ASGE Journal Scan | Colon

Malpractice Trends in Colon Cancer

This study identified 240 malpractice cases related to colorectal cancer (CRC) between 1988 and 2018 by using a legal database called VerdictSearch. This database is

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ASGE Journal Scan | Colon

Randomized Controlled Trial of Fellow Impact on Detection

There is widespread acceptance of a second-observer effect in improving adenoma detection in colonoscopy and general acceptance that this effect extends, in some regard, to

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ASGE Journal Scan | Colon

Lynch Syndrome Testing on Preoperative Biopsy Specimens Is Accurate

In this study, there were 96 patients with matched preoperative and postoperative immunohistochemistry (IHC) and micro