scholarly journals Outcome of endoscopic resection of colonic polyps larger than 10 mm in patients with inflammatory bowel disease

2019 ◽  
Vol 07 (08) ◽  
pp. E994-E1001 ◽  
Author(s):  
Siddhant Yadav ◽  
Edward V. Loftus ◽  
W. Scott Harmsen ◽  
Louis M. Wong Kee Song ◽  
Nayantara Coelho-Prabhu
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
Colonic Polyps ◽  
Published Data ◽  
Low Grade ◽  
Tubular Adenoma ◽  
En Bloc ◽  
Maximal Diameter ◽  
Inflammatory Bowel

Abstract Background and study aims There are limited published data on endoscopic removal of colorectal polyps by endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (ESD) in patients with inflammatory bowel disease (IBD). Patients and methods We performed a retrospective review of patients with colonic IBD and colonic polyps >10mm who underwent EMR and/or ESD at our institution between January 1, 2012 and June 31, 2016. Results Ninety-seven patients with pathology-confirmed IBD (median disease duration 16 years) were included. Mild or moderate active colitis (in background biopsies) was seen in 85 %. Of the total 124 polyps, location was ascending colon in 44 %, transverse in 15 % and sigmoid in 18.5 %; of the total, 55 % were < 20 mm and 45 % were ≥20mm in maximal diameter. Using the Paris classification, 56 % of polyps were polypoid sessile (Is) polyps, while 38 % were non-polypoid (IIa, IIb, IIc). EMR was used in 118 polyps, three required ESD, and three by combined EMR-ESD. Seventy-two percent were resected en-bloc; 28 % underwent piecemeal resection. Histology included low-grade dysplasia in 75, serrated adenoma in 31, and tubular adenoma in 14 polyps. Chromoendoscopy was used in 33 (26.6 %). Adverse events occurred in three patients. Colectomy was performed in 11 patients within 12 months. Recurrence was seen in 20 polyps, 11 of which were successfully resected en-bloc using EMR. Polyps ≥ 20 mm and polyps treated with APC were found to have a statistically significantly higher risk of recurrence. Conclusion This study demonstrates the efficacy and safety of endoscopic resection of large polyps in patients with IBD, making them effective alternatives to colectomy.

Endoscopic Resections in Inflammatory Bowel Disease: A Multicentre European Outcomes Study

2019 ◽  
Vol 13 (11) ◽  
pp. 1394-1400
Author(s):  
A Alkandari ◽  
S Thayalasekaran ◽  
M Bhandari ◽  
A Przybysz ◽  
M Bugajski ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
En Bloc ◽  
Increased Risk ◽  
Delayed Perforation ◽  
Inflammatory Bowel ◽  
Outcomes Study ◽  
Almost All ◽  
Current Guidelines

Abstract Background and Aims Inflammatory bowel disease is associated with an increased risk of colorectal cancer, with estimates ranging 2–18%, depending on the duration of colitis. The management of neoplasia in colitis remains controversial. Current guidelines recommend endoscopic resection if the lesion is clearly visible with distinct margins. Colectomy is recommended if complete endoscopic resection is not guaranteed. We aimed to assess the outcomes of all neoplastic endoscopic resections in inflammatory bowel disease. Methods This was a multicentre retrospective cohort study of 119 lesions of visible dysplasia in 93 patients, resected endoscopically in inflammatory bowel disease. Results A total of 6/65 [9.2%] lesions <20 mm in size were treated by ESD [endoscopic submucosal dissection] compared with 59/65 [90.8%] lesions <20 mm treated by EMR [endoscopic mucosal resection]; 16/51 [31.4%] lesions >20 mm in size were treated by EMR vs 35/51 [68.6%] by ESD. Almost all patients [97%] without fibrosis were treated by EMR, and patients with fibrosis were treated by ESD [87%], p < 0.001. In all, 49/78 [63%] lesions treated by EMR were resected en-bloc and 27/41 [65.9%] of the ESD/KAR [knife-assisted resection] cases were resected en-bloc, compared with 15/41 [36.6%] resected piecemeal. Seven recurrences occurred in the cohort. Seven complications occurred in the cohort; six were managed endoscopically and one patient with a delayed perforation underwent surgery. Conclusions Larger lesions with fibrosis are best treated by ESD, whereas smaller lesions without fibrosis are best managed by EMR. Both EMR and ESD are feasible in the management of endoscopic resections in colitis.

S1188 Tubular Adenoma and Low Grade Dysplasia in Inflammatory Bowel Disease: Who is at Risk?

2010 ◽  
Vol 138 (5) ◽  
pp. S-200
Author(s):  
Amar S. Naik ◽  
Yelena Zadvornova ◽  
Mazen Issa ◽  
Susan Skaros ◽  
Antia Ward ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Bowel Disease ◽  
Low Grade ◽  
Tubular Adenoma ◽  
Inflammatory Bowel ◽  
Low Grade Dysplasia

The Fate of Unifocal Versus Multifocal Low-Grade Dysplasia at the Time of Colonoscopy in Patients with Inflammatory Bowel Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Amy L. Lightner ◽  
Sarah Vogler ◽  
Prashansha Vaidya ◽  
John McMichael ◽  
Xue Jia ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Low Grade ◽  
Inflammatory Bowel ◽  
Low Grade Dysplasia

Comparison of Oral Prednisolone, Budesonide and Probiotics in the Treatment of Canine Inflammatory Bowel Disease

2021 ◽  
Author(s):  
M. Sandhya Bhavani ◽  
S. Kavitha ◽  
B. Gowri ◽  
Abid Ali Bhat
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Bowel Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Oral Prednisolone ◽  
Published Data ◽  
Inflammatory Bowel ◽  
Faecal Score

Background: Inflammatory bowel disease (IBD) is the common cause of chronic gastrointestinal signs in dogs. The treatment possesses numerous difficulties due to the idiopathic nature of the disease. Conventional steroid therapy usually produces side effects on long term usage. Thus, there is a need for alternative therapies. When compared to human medicine, there is no published data on the use of budesonide and probiotic in the treatment of canine IBD in India. The present study was proposed to compare oral prednisolone, budesonide and probiotics in the management of canine inflammatory bowel disease. Methods: Thirty dogs with idiopathic IBD were selected and randomly grouped. They were subjected to therapy involving prednisolone, budesonide or probiotics. Clinical assessment was performed by calculation of the post treatment Clinical Inflammatory Bowel Disease Activity Index (CIBDAI) score, faecal score and endoscopy. Biochemical analysis of alkaline phosphatase and alanine transaminase were done to record side effects of steroid administration. Result: It was observed from the present study that both prednisolone and budesonide are equally effective in the management of IBD in dogs. Probiotics were found to be less effective when compared to prednisolone and budesonide in the treatment of IBD.

High Adherence to Surveillance Guidelines in Inflammatory Bowel Disease Patients Results in Low Colorectal Cancer and Dysplasia Rates, While Rates of Dysplasia are Low Before the Suggested Onset of Surveillance

2019 ◽  
Vol 13 (10) ◽  
pp. 1343-1350 ◽  
Author(s):  
Kelita Singh ◽  
Alex Al Khoury ◽  
Zsuzsanna Kurti ◽  
Lorant Gonczi ◽  
Jason Reinglas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Duration ◽  
Interquartile Range ◽  
Colorectal Adenomas ◽  
British Society ◽  
Low Grade ◽  
High Adherence ◽  
Inflammatory Bowel

Abstract Background Patients with Crohn’s disease [CD] and ulcerative colitis [UC] are at increased risk for colorectal dysplasia [CRD] and colorectal cancer [CRC]. Adherence to CRC surveillance guidelines is reportedly low internationally. Aim To evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center [MUHC] and to determine CRD/CRC incidence. Methods A representative inflammatory bowel disease cohort with at least 8 years of disease duration [or with primary sclerosing cholangitis] who visited the MUHC between July 1 and December 31, 2016 were included. Adherence to surveillance guidelines was compared to modified 2010 British Society of Gastroenterology guidelines. Incidence rates of CRC, high-grade dysplasia [HGD], low-grade dysplasia [LGD] and colorectal adenomas [CRA] were calculated based on pathology. Results In total, 1356 CD and UC patients (disease duration: 12 [interquartile range: 6–22) and 10 [interquartile range: 5–19] years) were identified. The surveillance cohort consisted of 680 patients [296 UC and 384 CD]. Adherence to surveillance guidelines was 76/82% in UC/colonic CD. An adequate number of biopsies were taken in 54/54% of UC/colonic CD patients. The incidence of CRC/HGD in UC and CD with colonic involvement was 19.5/58.5 and 25.1/37.6 per 100,000 patient-years, respectively. The incidence of dysplasia before 8 years of disease duration was low in both UC/CD [19.5 and 12.5/100,000 patient-years] with no CRC detected. The CRA rate was 30/38% in UC/colonic CD. Conclusion High adherence to surveillance guidelines and low CRC and dysplasia, but not CRA rates were found, suggesting that adhering to updated, stratified, surveillance recommendations may result in low advanced neoplasia rates. The incidence of dysplasia before the start of surveillance was low.

Increased risk of high-grade dysplasia and colorectal cancer in inflammatory bowel disease patients with recurrent low-grade dysplasia

2020 ◽  
Vol 91 (6) ◽  
pp. 1334-1342.e1 ◽  
Author(s):  
Michiel E. de Jong ◽  
Heleen Kanne ◽  
Loes H.C. Nissen ◽  
Joost P.H. Drenth ◽  
Lauranne A.A. P. Derikx ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Low Grade Dysplasia
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