Featured
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World View |
Women in endoscopy: leading the way
Despite the paucity of women in endoscopy holding leadership roles, inroads are being made as more female endoscopists are promoted within this exciting field in gastroenterology. There are many benefits from increasing diversity in the workplace, including boosting morale, minimizing gender bias, providing role models and improving patient outcomes.
- Uzma D. Siddiqui
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Perspective |
SFED recommendations for IBD endoscopy during COVID-19 pandemic: Italian and French experience
The COVID-19 pandemic has resulted in changes to the management of patients with inflammatory bowel disease, including major disruptions to endoscopy. This Perspective provides a guide and recommendations for inflammatory bowel disease endoscopy during a global health emergency based on expert experience in Italy and France.
- Federica Furfaro
- , Lucine Vuitton
- & Laurent Peyrin-Biroulet
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Comment |
Medical and gastroenterological education during the COVID-19 outbreak
The outbreak of coronavirus disease 2019 has undeniably affected modalities of medical and gastroenterology training in all endemic areas. Indeed, the adoption of various distance-learning techniques has been mandatory to facilitate education and enhance skills such as problem-solving, self-directed learning, open communication and also holistic non-cognitive attributes such as adaptability and collaboration.
- Brigida Barberio
- , Davide Massimi
- & Edoardo V. Savarino
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Comment |
COVID-19 and endoscopy: implications for healthcare and digestive cancer screening
The coronavirus disease 2019 (COVID-19) pandemic is affecting and changing the daily practice of gastrointestinal endoscopy worldwide. To protect patients and endoscopy unit personnel, endoscopy units have had to postpone a large proportion of endoscopic procedures. These delays might have an effect on the screening for and surveillance of digestive cancers.
- Ian M. Gralnek
- , Cesare Hassan
- & Mario Dinis-Ribeiro
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In Brief |
Endoscopic myotomy non-inferior to surgical myotomy for idiopathic achalasia
- Jordan Hindson
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News & Views |
Artificial intelligence — upping the game in gastrointestinal endoscopy?
Artificial intelligence (AI) has the potential to change many aspects of health-care practice. Two newly published trials explore the potential applications of AI to improve polyp detection and mucosal visualization in gastrointestinal endoscopy — both show the benefits of AI to improve detection in gastrointestinal endoscopy.
- Colin J. Rees
- & Sara Koo
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Review Article |
Gastrointestinal diagnosis using non-white light imaging capsule endoscopy
The introduction of white light imaging capsule endoscopy has motivated research to improve its diagnostic capabilities through integration with other sensing modalities. In this Review, the authors summarize studies on non-white light imaging devices, such as those using optical coherence tomography, ultrasonography or biophysical measurements
- Gerard Cummins
- , Benjamin F. Cox
- & Anastasios Koulaouzidis
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Consensus Statement
| Open AccessThe potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
Environmental enteric dysfunction (EED) is an important cause of impaired development and stunting in children in the developing world. In this Consensus Statement, the authors assess the potential of optical biopsy technologies to facilitate the study and diagnosis of this global burden.
- Alex J. Thompson
- , Michael Hughes
- & Guang-Zhong Yang
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Review Article |
A guide to multimodal endoscopy imaging for gastrointestinal malignancy — an early indicator
Imaging and endoscopy remains key to the diagnosis of gastrointestinal malignancies, especially for early disease detection. Here, the authors describe multimodal imaging techniques and how they can be applied along the gastrointestinal tract, in particular for the identification of pre-malignant lesions in the oesophagus, stomach and colon.
- Arthur Hoffman
- , Henrik Manner
- & Ralf Kiesslich
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News & Views |
Chromoendoscopy in IBD: indispensable in real-life screening
Long-standing IBD is associated with an increased risk of neoplasia. Chromoendoscopy was proven to be the most sensitive modality for dysplasia detection in several clinical trials, but a new study has now shown it to be an effective screening strategy in a routine clinical setting, further warranting its implementation into real-world practice.
- Raja Atreya
- & Markus F. Neurath
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Review Article |
Role of endoscopy in early oesophageal cancer
Endoscopy is vital for detection and treatment of early oesophageal cancer. Here, Ragunath and Mannath discuss current and emerging imaging technologies that might improve detection of oesophageal lesions. Endotherapy techniques, including ablation therapy, endoscopic resection and endoscopic submucosal dissection, are also explored.
- Jayan Mannath
- & Krish Ragunath
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Review Article |
Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps
Most colorectal polyps can now be resected endoscopically using either mucosal resection or submucosal dissection. Although the former is an established technique, the latter has seen slow adoption in the West. In this Review, the authors summarize the indications for both procedures and discuss new advances in endoscopic polyp surgery.
- Brian P. Saunders
- & Zacharias P. Tsiamoulos
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News & Views |
Diagnostic yield of paediatric lower gastrointestinal endoscopy
In a recent study, Kawada et al. conducted a retrospective analysis of paediatric patients who had undergone lower gastrointestinal endoscopy to evaluate its use as a diagnostic tool. This under-studied area deserves critique within a modern framework of expectation for the routine yield for this invasive investigation in standard paediatric gastroenterology practice.
- Mike Thomson
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Year in Review |
Emerging trends in endoscopic imaging
Several key papers published in 2015 highlight important emerging trends in endoscopic imaging that promise to improve patient diagnosis and guidance of therapy. These studies reflect the future role for 'smart' contrast agents and fluorescence endoscopes to provide a molecular basis for disease detection, identify precancerous lesions and determine optimal choice of therapy.
- Bishnu P. Joshi
- & Thomas D. Wang
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News & Views |
An intravenous probe for colorectal cancer screening
Early detection of colorectal lesions is the cornerstone of cancer prevention. Intravenous administration of a novel fluorescent peptide probe now enables the screening of the whole colorectal area using near-infrared fluorescence colonoscopy, an approach that was documented as safe, well-tolerated and specific in its detection of colorectal polyps.
- Yanqing Li
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Opinion |
Optimizing early upper gastrointestinal cancer detection at endoscopy
Upper gastrointestinal cancer is often missed during examinations and survival outcomes are still poor among patients in the Western world. As discussed in this Perspectives, following the Japanese example, an improved gastroscopy technique, advanced training for endoscopists and optimized screening procedures for risk stratification will be necessary to elicit a change in clinical practice and improve diagnosis and treatment.
- Andrew M. Veitch
- , Noriya Uedo
- & James E. East
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Review Article |
Serrated neoplasia—role in colorectal carcinogenesis and clinical implications
Colorectal cancer (CRC) arises from precursor lesions that, contrary to a long-standing belief, are not always adenomas. In particular, the serrated neoplasia pathway is attracting more and more attention as an alternative route to CRC development. This Review provides a current perspective on the serrated neoplasia pathway, combining detailed descriptions of its characteristics and biological mechanisms with clinical observations.
- Joep E. G. IJspeert
- , Louis Vermeulen
- & Evelien Dekker
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Review Article |
Software for enhanced video capsule endoscopy: challenges for essential progress
Video capsule endoscopy has revolutionized the diagnostic work-up in the field of small bowel diseases and could be applied to screening the entire gastrointestinal tract. This Review focuses on computational methods that can be implemented in software to enhance video capsule endoscopy procedures in terms of time efficiency and diagnostic performance.
- Dimitris K. Iakovidis
- & Anastasios Koulaouzidis
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Research Highlight |
A window into the gut—real-time visualization of the effects of food intolerance using confocal laser endomicroscopy
- Katrina Ray
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Review Article |
Optimal bowel preparation—a practical guide for clinicians
High-quality bowel preparation is essential for effective colonoscopy. The modern colonoscopist considers efficacy, tolerability and safety when selecting bowel preparations. In this Review, Doug Rex presents his perspective in describing elements of a bowel preparation programme that enhance high-quality colon cleansing with acceptable tolerability.
- Douglas K. Rex
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News & Views |
Gastrointestinal endoscopy reporting: time for standardization?
With the increased emphasis on quality and standardization in gastrointestinal endoscopy, a need exists for minimum standardized information to be provided in endoscopy reports. A group of international colleagues provide a consensus document of standardized endoscopy reporting, including nomenclature and imaging, which is an important framework for all endoscopists, especially trainees.
- Todd H. Baron
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Year in Review |
The reality and the potential
2013 saw several advances in small bowel endoscopy: new 3D visualization software, increased battery life, side-viewing cameras and higher frame rate. Studies on prokinetics for patient preparation, safety in the elderly, rebleeding after negative capsule endoscopy and defining optimum training requirements for fellows were encouraging. Procedure time and small bowel length evaluated by double-balloon and spiral endoscopy were shown to be comparable.
- Uday C. Ghoshal
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News & Views |
Measuring what counts—endoscopic assessment in IBD
Endoscopic assessment in IBD provides direct visualization of the affected bowel mucosa. There is an important need for the meaningful measurement of these endoscopic images at the correct time point for medical decision-making and for clinical trials. European guidelines on endoscopy in IBD have recently been published.
- Reena Khanna
- , Barrett G. Levesque
- & William J. Sandborn
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News & Views |
EGD for children with abdominal pain: the jury is still out
Reports from a large, prospective study in paediatric patients suggest that oesophagogastroduodenoscopy is valuable for diagnosis in children with chronic abdominal pain. Nonetheless, the vast majority of children with chronic abdominal pain will have a functional gastrointestinal disorder, and no test is needed to achieve this diagnosis.
- Carlo Di Lorenzo
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Review Article |
Microscopic imaging in endoscopy: endomicroscopy and endocytoscopy
Endomicroscopy and endocytoscopy not only enable prediction of histology, but actual visualization of microscopic tissue details in real time. The authors of this Review discuss these microscopic imaging devices, outlining potential indications for their use and future directions for this technology.
- Martin Goetz
- , Nisar P. Malek
- & Ralf Kiesslich
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Review Article |
Molecular imaging in gastroenterology
This Review summarizes advances in molecular imaging approaches and provides an overview of molecular beacons and targets, as well as endoscopic devices for imaging. Studies on detection and characterization of lesions are put in perspective along with current challenges for this innovative approach.
- Raja Atreya
- & Martin Goetz
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Research Highlight |
New molecular probe for targeted imaging of oesophageal neoplasia in Barrett oesophagus
- Katrina Ray
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Research Highlight |
Diminutive colorectal polyps—is narrow-band imaging ready for prime time?
- Isobel Leake
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News & Views |
Sliding into the depths of sedation—is this what we want?
The risk of severe complications during colonoscopy is very low. This risk should be kept low when changing strategies to reduce discomfort during the examination. The increased use of deep sedation from <10% in 2000 to 35% in 2009 might have its downsides in years to come if the trend continues.
- Geir Hoff
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Review Article |
Surgical management of IBD—from an open to a laparoscopic approach
Surgery is a key feature of IBD management. Here, the authors present an overview of IBD surgical management, focusing on the potential benefits and drawbacks of laparoscopy compared with open surgery.
- Léon Maggiori
- & Yves Panis
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Research Highlight |
Tethered capsule endomicroscopy of the oesophagus—an easy pill to swallow
- Katrina Ray
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Year in Review |
A new focus for CRC prevention—more serration, less inflammation
Knowledge of colorectal cancer (CRC) risks has been rebalanced in 2012. The 'serrated pathway' to CRC, exemplified by serrated polyposis syndrome, emphasizes the importance of serrated lesions. The dogma that patients with IBD are at high risk of CRC, however, might be overstated; optimizing CRC prevention needs to focus on patients at increased risk.
- James E. East
- & Evelien Dekker
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News & Views |
UCCIS—a reproducible tool to assess mucosal healing
In an attempt to better characterize mucosal healing in ulcerative colitis, various endoscopic scoring systems have been introduced. However, most have limited interobserver agreement. A recent study has validated the ulcerative colitis colonoscopic index of severity and found that this new scoring system provides reproducible results among gastroenterologists.
- Helmut Neumann
- & Markus F. Neurath
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Research Highlight |
A surface maturation score to diagnose oesophageal squamous cell intraepithelial neoplasia
- Isobel Franks