The Endoscopy News Podcast

BSG Campus 2021

The BSG Campus 2021 was a great success with nine half days of Gastroenterology news, 700 abstracts and 1400 delegates taking part.  The podcasts gives you a 30 minute update on Endoscopy related news and research from the Campus meeting.  A transcript and full list of references will be published on the www.friendsofendoscopy.org website 

The NHS starts screening for 50 early cancers

This week Nick Burr and Bjorn Rembacken are discussing the bright new world of molecular screening for occult cancers as the NHS starts screening for more than 50 cancers.  This summer the “Galleri blood test”, developed by an American company called ‘GRAIL’ will be piloted on 140.000 healthy people in the UK.  

Naturally, Bjorn remains sceptical, and after an unsuccessful search for the ‘study aims’, asks if getting a positive result always mean that the cancer is treatable?  Furthermore, how do you tell the difference between a true positive and a false positive? 

Surprisingly, we are also standing up for the effectiveness of CTC and wonder why an American study reports such shockingly poor results. 

Should we be more proactive in dealing with colonic lipomas and local recurrence after oesophageal CRT?

Srisha Hebbar and Peter Siersema challenge my prejudices and suggest that endoscopy can help patients with colonic lipomas and local recurrence after chemo-radiotherapy, two relatively uncommon conditions.  They both make convincing arguments!  Srisha has also uploaded a video to explain how to safely deal with colonic lipomas.  Of course, the video and references are available on the website  

Neil Shepherd on serrated polyps and much much more!

In this podcast we discuss Serrated Polyps with Professor Neil Shepherd. There is much more to these lesions than Size and Number!  Did you know that there may be two distinct syndromes and it's the Site of the lesions which distinguishes the two?  That is just the start.  It gets weirder! 

We cover a huge amount of ground and headings include (in chronological order):

• Serrated polyps - one or two distinct syndromes?
• Can you tell histologically?
• How does the Serrated Polyposis Syndrome fit ?
• What matters the most when deciding on the significance of a serrated polyp?
• Dysplasia inside a serrated polyp? - Well it's complicated ! 
• The heterogeneity of serrated lesions is also problematic
• Could AI help the Pathologist in the future?
• How can we identify patients with serrated polyposis syndrome ?
• Can we explain finding both serrated and adenomatous polyps in serrate polyposis syndrome?
• Why should I refer patient with serrated polyposis syndrome to geneticists?
• Can we tell which cancer has developed from a serrated precursor?
• What is the link between serrated polyps and colitis?
• The weird issue of stromal changes below serrated polyps
• 'Mixed polyp' or 'collision polyp'?
• How can we as endoscopist help the pathologist?
• Do you believe in DISCARD?
• What remains the remit of the pathologist to diagnose?

You need to know this to reduce the risk of missing anal cancer ...

Dr Andreia Albuguerque from Lisbon discusses her paper on the neglected topic of anal cancer recently published in Lancet Gastroenterology and Hepatology 2021;6:327-34. As larger endoscopy units should find 4-5 early anal cancers every year, I have a terrible suspicion that many of these lesions go undetected. 

Bjorn's Endoscopy News Review - April 2021

Bjorn has reviewed the upcoming 'in-press' endoscopy related manuscripts and provides his usual opinionated and patronising feedback to the brave authors of 14 manuscripts. Of course, you may agree or disagree with his comments and could even find yourself fired up to read some of the articles yourself!  But then again you don't need to, as everything is covered in his Podcast !   References are listed on the website: www.friendsofendoscopy.org 

Don't forget to say Thank You, next time you see someone from Pentax Medical because this wouldn't be possible without them !!!  

EoE, ERAT, BLI, NF-NBI and MSH6

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; 

1. Laserna MEJ et.al. Efficacy of Therapy for Eosinophilic Esophagitis in Real-World Practice.
2. Clinical Gastroenterology & Hepatology. 18(13):2903-2911.e4, 2020 12.
3. 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.
4. Clinical Gastroenterology & Hepatology. 2020 Aug 13.
5. Ding W et.al. Endoscopic retrograde appendicitis therapy (ERAT) for management of acute appendicitis. Surgical Endoscopy. 2021 May 13.
6. Becq A et.al. ERCP within 6 or 12 h for acute cholangitis: a propensity score-matched analysis. Surgical Endoscopy. 2021 May 11.
7. 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.
8. 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.
9. 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.
10. 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
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. Omidvar AH et.al. The optimal age to stop endoscopic surveillance of Barrett's esophagus patients based on sex and comorbidity: a comparative cost-effectiveness analysis. Gastroenterology. 2021 May 08.

Our Endoscopy News Review of the latest articles worth knowing about!

Bjorn's trawl of newsworthy Endoscopy papers currently in press includes; Which patients don't heal well after RFA, Chances of successfully removing a 45mm polyp is only 75% in the Netherlands,  What is 'tip-In EMR?, Tumour biology is important in UC-related PCCRC,  We should be doing more TIPS (and presumably therefore, less emergency band ligation)  and finally musculoskeletal injury is rife amongst endoscopists! 

What can we do about endoscope contamination? An interview with Marco Bruno

This week, Prof Marco Bruno, Department of Gastroenterology and Hepatology at the Erasmus University Medical Centre in Rotterdam is explaining about the problem we have with scope contamination.  Last year his department published a Nationwide Study of bacterial colonization of endoscopes. The study included 74 Dutch Centres and reported that 17% of duodenoscopes and 13% of EUS scopes were contaminated!  What can we do about this? With Marco, I discuss the current situation and possible solutions, like new endoscope designs, continuous monitoring and culturing of scopes and the training for reprocessing colleagues.

Launch of the Worlds largest audit of PCCRC

Post colonoscopy colorectal cancer is arguable one of the 'hardest' quality measures in colonoscopy. Until now, it has been difficult to identify cases often presenting several years after their colonoscopy and sometimes to a different institution. From September, NHS endoscopy units will have access to a bespoke online resource identifying cases of PCCRC. From September, this online tool will be used to audit the 1400 PCCRC cases which we see in the NHS every year. Roland Valori explains the idea behind the audit.