New Techniques in Gastrointestinal Endoscopy

As result of progress, endoscopy has became more complex, using more sophisticated devices and has claimed a special form. In this moment, the gastroenterologist performing endoscopy has to be an expert in macroscopic view of the lesions in the gut, with good skills for using standard endoscopes, with good experience in ultrasound (for performing endoscopic ultrasound), with pathology experience for confocal examination. It is compulsory to get experience and to have patience and attention for the follow-up of thousands of images transmitted during capsule endoscopy or to have knowledge in physics necessary for autofluorescence imaging endoscopy. Therefore, the idea of an endoscopist has changed. Examinations mentioned need a special formation, a superior level of instruction, accessible to those who have already gained enough experience in basic diagnostic endoscopy. This is the reason for what these new issues of endoscopy are presented in this book of New techniques in Gastrointestinal Endoscopy

Combining Science with Art to Educate and Motivate Patients Prior to Colorectal Cancer Screening

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US despite wide use of colonoscopy to prevent CRC and CRC-related mortality. Colonoscopy is used to identify and remove lesions that will lead to cancer, however, most deaths occur because lesions are not detected or completely removed during the procedure. Patients play a crucial role in the detection component of colonoscopy: the better the colon is prepared, the higher the chance of detection of all polyps and cancers. In general, patients are instructed to clean the colon by way of a paper or web-based form that lists the objective (scientific) steps involved; unfortunately this too often does not result in a well-prepared colon. Behavior is known to be heavily influenced by emotion. As the first phase of a smart education research project we created an artistic and instructional documentary in which patients engage with the educational content through emotional responses; i.e., we motivate patients to follow instructions by combining scientific with emotional aspects of CRC prevention including preparation of the colon prior to colonoscopy. In the second research phase we will test whether use of the documentary results in improved colon preparation

No more hide and seek:strategies to optimize diagnosis and endoscopic treatment of complex colorectal neoplasms

Large non-pedunculated colorectal polyps and the occurrence of post-colonoscopy colorectal cancer are the subjects of the thesis “No more hide and seek”. The thesis shows that non-pedunculated colorectal cancers consist of a morphologically heterogeneous group (a group with high variety in tissue characteristics), with a different risk of cancer cells at diagnosis for each subtype. Accurate prior assessment of this risk could prevent suboptimal treatment. Furthermore, this thesis shows that patients with large flat polyps develop more polyps in the future than patients with other polyp types. Flat polyps are harder to detect than other polyps. It is suggested that they can be more easily missed during colonoscopy with the risk of malignant transformation afterwards, which should be prevented by colonoscopy. This could result in the occurrence of so-called post-colonoscopy colorectal cancer. Faster growth by different mutations was hypothesized as another factor in post-colonoscopy colorectal cancer occurrence. This thesis examined the genetic profile of post-colonoscopy colorectal cancers in comparison with common colorectal cancer. The results showed no unique mutations in post-colonoscopy colorectal cancers, but they did show more often the features as seen in a more subtle and flat category of flat bowel polyps. Improvements in detection of these polyps remain important in post-colonoscopy colorectal cancer prevention

Improving Colorectal Cancer Screening in a Rural Community During a Global Pandemic

Colorectal cancer is a leading cause of death in North Carolina and the United States. Colorectal cancer is detectable and preventable through screening, including visualization tests or stool-based testing. One county in Eastern North Carolina, colorectal cancer has been identified as a leading cause of cancer death and the county has a high mortality rate from colorectal cancer. During the COVID-19 pandemic in 2020, the number of screenings performed at the local cancer center had declined, as they did nationwide. This project was implemented to improve colorectal cancer education and screenings in this county during the pandemic by utilizing virtual appointments and mailout stool-based screening kits, as well as the development of an educational video that was posted on the site’s social media page. The project was implemented over 12 weeks from September to December 2020 and resulted in one screening appointment and 184 full views of the educational video.D.N.P