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World Journal of Gastroenterology Dec 2014Imaging studies are a major component in the evaluation of patients for the screening, staging and surveillance of colorectal cancer. This review presents commonly... (Review)
Review
Imaging studies are a major component in the evaluation of patients for the screening, staging and surveillance of colorectal cancer. This review presents commonly encountered findings in the diagnosis and staging of patients with colorectal cancer using computed tomography (CT) colonography, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT colonography. CT colonography provides important information for the preoperative assessment of T staging. Wall deformities are associated with muscular or subserosal invasion. Lymph node metastases from colorectal cancer often present with calcifications. CT is superior to detect calcified metastases. Three-dimensional CT to image the vascular anatomy facilitates laparoscopic surgery. T staging of rectal cancer by MRI is an established modality because MRI can diagnose rectal wall laminar structure. N staging in patients with colorectal cancer is still challenging using any imaging modality. MRI is more accurate than CT for the evaluation of liver metastases. PET/CT colonography is valuable in the evaluation of extra-colonic and hepatic disease. PET/CT colonography is useful for obstructing colorectal cancers that cannot be traversed colonoscopically. PET/CT colonography is able to localize synchronous colon cancers proximal to the obstruction precisely. However, there is no definite evidence to support the routine clinical use of PET/CT colonography.
Topics: Colonography, Computed Tomographic; Colorectal Neoplasms; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Multimodal Imaging; Neoplasm Invasiveness; Neoplasm Staging; Positron-Emission Tomography; Predictive Value of Tests
PubMed: 25493009
DOI: 10.3748/wjg.v20.i45.16964 -
F1000Research 2019Colonoscopy continues to evolve as equipment and techniques improve. Traditionally, colonoscopy has focused on adenoma detection, characterisation and resection as the... (Review)
Review
Colonoscopy continues to evolve as equipment and techniques improve. Traditionally, colonoscopy has focused on adenoma detection, characterisation and resection as the primary aims, and there has certainly been considerable activity over the last few years in terms of addressing these important issues. This review article not only will discuss progress made in these areas but also will focus on when to colonoscope in terms of introduction of faecal immunochemical testing, how to insert with the advent of water-assisted insertion, and how to withdraw using a bundle of evidence-based techniques to improve adenoma detection. In addition, the ramifications of failing to discover polyps and of post-colonoscopy colorectal cancer are highlighted.
Topics: Adenoma; Colonoscopes; Colonoscopy; Colorectal Neoplasms; Humans; Water
PubMed: 31431823
DOI: 10.12688/f1000research.18503.1 -
CA: a Cancer Journal For Clinicians 1992Colonoscopy is an accepted technique for investigation of the colon. No portion of the large bowel is inaccessible to the diagnostic and therapeutic approach by flexible... (Review)
Review
Colonoscopy is an accepted technique for investigation of the colon. No portion of the large bowel is inaccessible to the diagnostic and therapeutic approach by flexible colonoscopy. The technical aspects of instrumentation have yielded to progress, with a small television chip currently incorporated into the tip of endoscopes transmitting an excellent image of the colon. Primary colonoscopy is being performed for selected indications, and, as facility with the technique increases, there will be a greater tendency for the performance of primary colonoscopy. Interruption of the adenoma-carcinoma sequence by techniques of snare-polypectomy may serve to markedly decrease the incidence of colon cancer over the next generation.
Topics: Barium Sulfate; Colonic Diseases; Colonoscopes; Colonoscopy; Enema; Forecasting; Humans
PubMed: 1393743
DOI: 10.3322/canjclin.42.6.350 -
World Journal of Gastrointestinal... Jul 2023During endoscopy, an endoscopist is inevitably faced with the occasional "difficult colonoscopy," in which the endoscopist finds it challenging to advance the endoscope... (Review)
Review
During endoscopy, an endoscopist is inevitably faced with the occasional "difficult colonoscopy," in which the endoscopist finds it challenging to advance the endoscope to the cecum. Beyond optimization of technique, with minimized looping, minimal insufflation, sufficient sedation, and abdominal splinting when needed, sometimes additional tools may be needed. In this review, we cover available techniques and technologies to help navigate the difficult colonoscopy, including the ultrathin colonoscope, rigidizing overtube, balloon-assisted colonoscopy and the abdominal compression device.
PubMed: 37547242
DOI: 10.4253/wjge.v15.i7.491 -
Saudi Journal of Gastroenterology :... 2018
Topics: Aged; Colonoscopes; Colonoscopy; Equipment Design; Humans
PubMed: 29637912
DOI: 10.4103/sjg.SJG_137_18 -
Endoscopy International Open Nov 2021Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human...
Limited evidence suggests that endoscopy capacity in sub-Saharan Africa is insufficient to meet the levels of gastrointestinal disease. We aimed to quantify the human and material resources for endoscopy services in eastern African countries, and to identify barriers to expanding endoscopy capacity. In partnership with national professional societies, digestive healthcare professionals in participating countries were invited to complete an online survey between August 2018 and August 2020. Of 344 digestive healthcare professionals in Ethiopia, Kenya, Malawi, and Zambia, 87 (25.3 %) completed the survey, reporting data for 91 healthcare facilities and identifying 20 additional facilities. Most respondents (73.6 %) perform endoscopy and 59.8 % perform at least one therapeutic modality. Facilities have a median of two functioning gastroscopes and one functioning colonoscope each. Overall endoscopy capacity, adjusted for non-response and additional facilities, includes 0.12 endoscopists, 0.12 gastroscopes, and 0.09 colonoscopes per 100,000 population in the participating countries. Adjusted maximum upper gastrointestinal and lower gastrointestinal endoscopic capacity were 106 and 45 procedures per 100,000 persons per year, respectively. These values are 1 % to 10 % of those reported from resource-rich countries. Most respondents identified a lack of endoscopic equipment, lack of trained endoscopists and costs as barriers to provision of endoscopy services. Endoscopy capacity is severely limited in eastern sub-Saharan Africa, despite a high burden of gastrointestinal disease. Expanding capacity requires investment in additional human and material resources, and technological innovations that improve the cost and sustainability of endoscopic services.
PubMed: 34790551
DOI: 10.1055/a-1551-3343 -
World Journal of Gastroenterology Jun 2015Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasingly popular. They were originally designed to reduce colonic... (Review)
Review
Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasingly popular. They were originally designed to reduce colonic spasms, facilitate cecal intubation, and lower patient discomfort and the need for sedation. These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon. Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water. In addition, since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning, this method has the potential to be the favored insertion technique because it promotes patient safety without sedation. Recently, this water-immersion method has not only been used for colonoscope insertion, but has also been applied to therapy for sigmoid volvulus, removal of lesions, lower gastrointestinal bleeding, and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome. Although a larger sample size and prospective head-to-head-designed studies will be needed, this review focuses on the usefulness of water-immersion colonoscopy for diagnostic and therapeutic applications.
Topics: Colectomy; Colon; Colonic Diseases; Colonic Neoplasms; Colonoscopy; Gastrointestinal Hemorrhage; Humans; Immersion; Intestinal Volvulus; Predictive Value of Tests; Risk Factors; Treatment Outcome; Water
PubMed: 26074684
DOI: 10.3748/wjg.v21.i21.6451 -
Canadian Medical Association Journal Mar 1974Sigmoidoscopy is the most important gastrointestinal procedure and is essential for the correct interpretation of lower bowel symptoms. The indications are many and...
Sigmoidoscopy is the most important gastrointestinal procedure and is essential for the correct interpretation of lower bowel symptoms. The indications are many and there are no contraindications. If done with care it is safe and inexpensive and within the capability of all practising physicians.Consideration for the patient's comfort and dignity, correct positioning, and advancement of the instrument only under direct vision should ensure a satisfactory examination.
Topics: Adult; Age Factors; Aged; Anus Diseases; Diet; Enema; Family Practice; Female; Fiber Optic Technology; Gastrointestinal Diseases; Humans; Male; Middle Aged; Palpation; Physician-Patient Relations; Posture; Rectal Diseases; Sigmoidoscopes; Sigmoidoscopy
PubMed: 4817215
DOI: No ID Found -
Translational Gastroenterology and... 2023Colonoscopy is an ever-growing procedure, being the primary diagnostic and therapeutic modality to manage lower gastrointestinal pathologies. It has a decades-old... (Review)
Review
BACKGROUND AND OBJECTIVE
Colonoscopy is an ever-growing procedure, being the primary diagnostic and therapeutic modality to manage lower gastrointestinal pathologies. It has a decades-old history with significant successive endoscopic innovations that eventually led to the development of the current colonoscope, as we know it today.
METHODS
We reviewed multiple databases in non-systemic fashion using PubMed, Embase and Cochrane library to shed light on historic timeline of advancements and groundbreaking landmark achievements currently underway.
KEY CONTENT AND FINDINGS
Initially starting off as a rudimentary rigid, device that utilized candles as a light source, the primitive colonoscope was adapted to a semi-rigid framework to allow better maneuverability. Improved lenses allowed better viewing quality and the development of video capabilities with the capability of performing both diagnostic and therapeutic interventions transformed the colonoscope completely into a modern interventional device. Its utility started gaining attention in the late 90s when multiple guidelines were published, supporting its impact on survival for colorectal screening. Over the years, the therapeutic component of colonoscopy has evolved further allowing it to be used as a treatment modality for several lower gastrointestinal pathologies including control of lower gastrointestinal bleeds, management of large bowel perforation, foreign body removal and dilatation of colonic stenosis. With improving technological advances, success rates of colonoscopic interventions continue to rise and new therapeutic modalities underway further enhancing their role. Multiple developments are underway including use of artificial intelligence (AI) with as endocuff vision, amplify EYE and G-EYE among others that hold great promise for the future of colonoscopy.
CONCLUSIONS
With our review, we hope to further the understanding clinicians about the colonoscope and help contribute towards its further developments.
PubMed: 37197258
DOI: 10.21037/tgh-23-4