The Endoscopy News Podcast Bjorn Rembacken

Bu Hayee at Kings College tells us about what we can do to reduce the environmental impact of endoscopy.

Professor Mark Pritchard, has a simple plea; when you are dealing with gastric NET's, make sure that you know what you are doing!  In this Podcast he highlights the pitfalls and provides us with Endoscopy Gold !!! 

This time our Podcast is full of both important and interesting studies.  We present new evidence on how to treat pancreatic pseudocysts with hydrogen peroxide, the benefit of PPI's on EoE, an large study of endoscopic treatment of appendicitis, and find that our trusty indigo carmine dye spray is still going strong!  Then we have an interesting paper on the appalling effect of mountain sickness on the stomach, transplantation on the risk of polyps and when to stop Barrett's surveillance. Thanks to our Partners at Pentax medical for your Support !
References reviewed includes; 
Laserna MEJ et.al. Efficacy of Therapy for Eosinophilic Esophagitis in Real-World Practice.
Clinical Gastroenterology & Hepatology. 18(13):2903-2911.e4, 2020 12.
Greuter T et.al. Effectiveness and Safety of High- vs Low-Dose Swallowed Topical Steroids for Maintenance Treatment of Eosinophilic Esophagitis: A Multicenter Observational Study.
Clinical Gastroenterology & Hepatology. 2020 Aug 13.
Ding W et.al. Endoscopic retrograde appendicitis therapy (ERAT) for management of acute appendicitis. Surgical Endoscopy. 2021 May 13.
Becq A et.al. ERCP within 6 or 12 h for acute cholangitis: a propensity score-matched analysis. Surgical Endoscopy. 2021 May 11.
Ashkar MH et.al. Increased Risk of Advanced Colonic Adenomas and Timing of Surveillance Colonoscopy Following Solid Organ Transplantation. Digestive Diseases & Sciences. 2021 May 10.
Chandrasekhara V et.al. Predicting the need for step-up therapy after EUS-guided drainage of pancreatic fluid collections with lumen-apposing metal stents. Clinical Gastroenterology & Hepatology. 2021 May 06.
Messallam AA et.al. Endoscopic Necrosectomy With and Without Hydrogen Peroxide for Walled-off Pancreatic Necrosis: A Multicenter Comparative Study. American Journal of Gastroenterology. 116(4):700-709, 2021 Apr.
Shiroma S et.al. Timing of bleeding and thromboembolism associated with endoscopic submucosal dissection for gastric cancer in Japan. Journal of Gastroenterology & Hepatology. 2021 May 07
Yasuda T et.al. Benefits of linked color imaging for recognition of early differentiated-type gastric cancer: in comparison with indigo carmine contrast method and blue laser imaging. Surgical Endoscopy. 35(6):2750-2758, 2021 Jun.
Kim JW et.al. Narrowband imaging with near-focus magnification for discriminating the gastric tumor margin before endoscopic resection: A prospective randomized multicenter trial. Journal of Gastroenterology & Hepatology. 35(11):1930-1937, 2020 Nov.
Surek A et.al. Risk factors affecting failure of colonoscopic detorsion for sigmoid colon volvulus: a single center experience. International Journal of Colorectal Disease. 36(6):1221-1229, 2021 Jun.
Clark G et.al. Transition to quantitative faecal immunochemical testing from guaiac faecal occult blood testing in a fully rolled-out population-based national bowel screening programme. Gut. 70(1):106-113, 2021 Jan.
Gachabayov M et.al. Performance evaluation of stool DNA methylation tests in colorectal cancer screening: a systematic review and meta-analysis. Colorectal Disease. 23(5):1030-1042, 2021 05.
Forbes N et.al. Association Between Endoscopist Annual Procedure Volume and Colonoscopy Quality: Systematic Review and Meta-analysis. Clinical Gastroenterology & Hepatology. 18(10):2192-2208.e12, 2020 09.
Fruehauf H et.al. Evaluation of Acute Mountain Sickness by Unsedated Transnasal Esophagogastroduodenoscopy at High Altitude. Clinical Gastroenterology & Hepatology. 18(10):2218-2225.e2, 2020 09.
Goverde A et.al. Yield of Lynch Syndrome Surveillance for Patients With Pathogenic Variants in DNA Mismatch Repair Genes. Clinical Gastroenterology & Hepatology. 18(5):1112-1120.e1, 2020 05.
Lamba M et.al. Associations Between Mutations in MSH6 and PMS2 and Risk of Surveillance-detected Colorectal Cancer. Clinical Gastroenterology & Hepatology. 18(12):2768-2774, 2020 11.
Omidvar AH et.al. The optimal age to stop endoscopic surveillance of Barrett's esophagus

Artificial Intelligence (AI) will soon be touching all areas of medicine. The first is already affecting lesion detection and characterisation.  Hot on the heels of radiology and histopathology comes endoscopy ... 

Today we are reviewing 15 recent endoscopy publications ranging from the effect of Covid on our endoscopy service and training, a Delphi review of water immersion vs exchange, AI and scoring colitis, adrenaline and pancreatitis.  We are asking if gastric GIST’s are not better removed laparoscopically after all. Finally, a reminder about the new WHO criteria for the diagnosis of SSPS.
Rutter M. Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection: a National Endoscopy Database Analysis. GUT 2020, July 20 (http://dx.doi.org/10.1136/gutjnl-2020-322179 )
Lantinga MA. Impact of the COVID-19 pandemic on gastrointestinal endoscopy in the Netherlands: analysis of a prospective endoscopy database. Endoscopy 2020, Oct 20
Clarke K. Impact of COVID-19 Pandemic on Training: Global Perceptions of Gastroenterology and Hepatology Fellows in the USA. Digestive Diseases & Sciences.  2020 Oct 19
Sonnenberg A. Digestive Diseases & Sciences. 2020 Oct 21 (https://doi.org/10.1007/s10620-020-06661-0)
Maclean W. Adoption of Faecal Immunochemical Testing for two-week wait colorectal patients during the COVID-19 pandemic: An observational cohort study reporting a new service at a regional centre. Colorectal Disease. 2020 Oct 17
McSorley ST. Yield of colorectal cancer at colonoscopy according to faecal haemoglobin concentration in symptomatic patients referred from primary care. Colorectal Disease.  2020 Oct 16
Pin-Vieito N. Risk of gastrointestinal cancer in a symptomatic cohort after a complete colonoscopy: Role of faecal immunochemical test. World Journal of Gastroenterology 2020 26(1):70-85, 2020
Ebigbo A. Cost-effectiveness analysis of SARS-CoV-2 infection-prevention strategies including pre-endoscopic virus testing and use of high-risk personal protective equipment.. Endoscopy.  2020 Oct 20
Cadoni S. Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations. Gastrointestinal Endoscopy. 2020 Oct 15.
Bhambhvani HP. Deep learning enabled classification of Mayo endoscopic subscore in patients with ulcerative colitis. European Journal of Gastroenterology & Hepatology.  2020 Oct 16
Luo H. Rectal Indomethacin and Spraying of Duodenal Papilla with Epinephrine Increases Risk of Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography. Clinical Gastroenterology & Hepatology. 17(8):1597-1606.e5, 2019 07
Dong X. Laparoscopic resection is better than endoscopic dissection for gastric gastrointestinal stromal tumor between 2 and 5 cm in size: a case-matched study in a gastrointestinal center. Surgical Endoscopy. 34(11):5098-5106, 2020 Nov
Ezaz G. Association Between Endoscopist Personality and Rate of Adenoma Detection. Clinical Gastroenterology & Hepatology. 17(8):1571-1579.e7, 2019 07
Lee JY. Association Between Cigarette Smoking and Alcohol Consumption and Sessile Serrated Polyps in Subjects 30 to 49 Years Old. Clinical Gastroenterology & Hepatology. 17(8):1551-1560.e1, 2019 07
Dekker E. Update on the World Health Organization Criteria for Diagnosis of Serrated Polyposis Syndrome. Gastroenterology 2020, January 23 (https://doi.org/10.1053/j.gastro.2019.11.310)

Today I am talking to Dr Nick Burr, one of our Rising Stars in Gastroenterology, working in Leeds.  You may recognise his name from some of the most influential papers written on the topic of ADR and PCCRC in the recent past.  I’ve decided to ambush him with some difficult questions about our unhealthy obsession with ADR and see if I can convince him that the PCRCR rate is irrelevant to individual colonoscopists.  I am armed with the references below to support my argument ! 
Karminski MF. Quality Indicators for Colonoscopy and the Risk of Interval Cancer. NEJM 2010;362:1795-803
Eide T. Risk of CRC in adenoma bearing individuals. Intern J Cancer 1986;38;173–6
Stryker S. Natural history of untreated colonic polyps. Gastroenterology 1987;93:1009–13
Pickhart PJ. Assessment of volumetric growth rates of small colorectal polyps with CT colonography: a longitudinal study of natural history.  Lancet Oncol. 2013;14(8):711–20
Kuntz KM.  A Systematic Comparison of Microsimulation Models of Colorectal Cancer: The Role of Assumptions about Adenoma Progression.  Medical Decision making 2011;31(4):530-9 https://doi.org/10.1177/0272989X11408730
Djinbachian R. Rates of Incomplete Resection of 1- to 20-mm Colorectal Polyps: A Systematic Review and Meta-Analysis.  Gastroenterology 2020;159(3):904-14   https://doi.org/10.1053/j.gastro.2020.05.018