scholarly journals Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Zhou Haibin ◽  
Zhang Xiaofeng ◽  
Yang Jianfeng
Keyword(s):  
Retrospective Study ◽  
Transverse Colon ◽  
Intestinal Tract ◽  
Left Colon ◽  
Right Colon ◽  
School Of Medicine ◽  
The Difference ◽  
The Right ◽  
Bowel Segments ◽  
Intestinal Preparation

Objective. To analyze the correlation of intestinal cleanliness in each segment of the Boston Intestinal Preparation Scale. Methods. From February 2017 to October 2019, the data of patients who underwent colonoscopy in the Department of Gastroenterology, Hangzhou First People’s Hospital, Zhejiang University School of Medicine, were collected. Statistical analysis was performed according to the Boston Intestinal Preparation Scale score, and the correlation of intestinal cleanliness in each region was obtained. Results. A total of 1739 patients were included. The overall score of BBPS was 6.77±1.88. The scores of each region were 2.04±0.84 (right lateral colon), 2.25±0.68 (transverse colon), and 2.48±0.64 (left colon). The difference between the regions was statistically significant (P<0.05). The bowel cleanliness showed a gradual deterioration trend, and there was a positive correlation between colon cleanliness in each region. The accuracy of the transverse colon in predicting the right colon (AUC=0.809) is higher than that of the left colon (AUC=0.735), and the accuracy of predicting the cleanliness of the right colon intestinal tract by the cleanliness of the left colon intestinal tract is relatively low. Conclusion. Intestinal cleanliness gradually deteriorates from the direction of the insert. It is not reliable to predict the right side of poor cleanliness by using the left colon intestinal cleanliness (BBPS 0-1 score). It should continue to further endoscopy. When the cleanliness of the transverse colon is poor, then stopping further endoscopy is considered.

scholarly journals Racial Disparities in Epigenetic Aging of the Right vs Left Colon

2020 ◽  
Author(s):  
Matthew Devall ◽  
Xiangqing Sun ◽  
Fangcheng Yuan ◽  
Gregory S Cooper ◽  
Joseph Willis ◽  
...  
Keyword(s):  
Dna Methylation ◽  
African Americans ◽  
Racial Differences ◽  
Age Of Onset ◽  
Left Colon ◽  
Right Colon ◽  
Normal Colon ◽  
Epigenetic Aging ◽  
Epigenetic Age Acceleration ◽  
The Right

Abstract There are well-documented racial differences in age-of-onset and laterality of colorectal cancer. Epigenetic age acceleration is postulated to be an underlying factor. However, comparative studies of side-specific colonic tissue epigenetic aging are lacking. Here, we performed DNA methylation analysis of matched right and left biopsies of normal colon from 128 individuals. Among African Americans (n = 88), the right colon showed accelerated epigenetic aging as compared to individual-matched left colon (1.51 years; 95% CI = 0.62 to 2.40 years; two-sided P = .001). In contrast, among European Americans (n = 40), the right colon shows remarkable age deceleration (1.93 years; 95% CI = 0.65 to 3.21 years; two-sided P = .004). Further, epigenome-wide analysis of DNA methylation identifies a unique pattern of hypermethylation in African American right colon. Our study is the first to report such race and side-specific differences in epigenetic aging of normal colon, providing novel insight into the observed younger age-of-onset and relative preponderance of right-side colon neoplasia in African Americans.

scholarly journals MALIGNANCY IN LARGE COLORECTAL LESIONS

2014 ◽  
Vol 51 (3) ◽  
pp. 235-239
Author(s):  
Carlos Eduardo Oliveira dos SANTOS ◽  
Daniele MALAMAN ◽  
Tiago dos Santos CARVALHO ◽  
César Vivian LOPES ◽  
Júlio Carlos PEREIRA-LIMA
Keyword(s):  
Invasive Carcinoma ◽  
Lesion Size ◽  
Primary Treatment ◽  
Left Colon ◽  
Right Colon ◽  
High Prevalence ◽  
Early Adenocarcinoma ◽  
The Mean ◽  
The Right ◽  
Low Rate

Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm). Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3%) lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5%) and IV (53.9%) pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma), with no difference in morphology and site. Only one lesion (1.3%) invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001). The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

scholarly journals Experimental Study of the Quantification of Indocyanine Green Fluorescence in Ischemic and Non-Ischemic Anastomoses, Using the Sergreen Software Program

2021 ◽  
Author(s):  
Xavier Serra-Aracil ◽  
Albert García-Nalda ◽  
Borja Serra-Gomez ◽  
Alvaro Serra-Gomez ◽  
Laura Mora-Lopez ◽  
...  
Keyword(s):  
Experimental Study ◽  
Indocyanine Green ◽  
Left Colon ◽  
Right Colon ◽  
Indocyanine Green Fluorescence ◽  
Tissue Ischemia ◽  
Control Stage ◽  
Initial Control ◽  
The Right ◽  
Sequential Images

Abstract Background: Tissue ischemia is a key risk factor for anastomotic leakage (AL). Indocyanine green (ICG) is widely used in colorectal surgery to define the segments with the best vascularization. In an experimental model, we present a new system for quantifying ICG saturation, SERGREEN software.Methods: This was a controlled experimental study with eight pigs. In the initial control stage, ICG saturation was analyzed at the level of two anastomoses in the right and left colon. Control images of the two segments were taken after ICG administration. The images were processed with the SERGREEN program. Then, in the experimental ischemia stage, the inferior mesenteric artery was sectioned at the level of the anastomosis of the left colon. Fifteen minutes after the section, sequential images of the two anastomoses were taken every 30’ for the following 2 h.Results: At the control stage, the mean scores were 134.2 (95% CI: 116.3-152.2) for the right colon and 147 (95% CI: 134.7-159.3) for the left colon (p = 0.174). The right colon remained stable throughout the experiment. In the left colon, saturation fell by 47.9 points with respect to the preischemia value (p <0.01). After the first postischemia determination, the values of the ischemic left colon remained stable throughout the experiment. The relative decrease in ICG saturation of the ischemic left colon was 32.6%.Conclusions: The SERGREEN program quantifies ICG saturation in normal and ischemic situations and detects differences between them. A reduction in ICG saturation of 32.6% or more was correlated with complete tissue ischemia.

scholarly journals A multicenter, prospective, inpatient feasibility study to evaluate the use of an intra-colonoscopy cleansing device to optimize colon preparation in hospitalized patients: the REDUCE study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helmut Neumann ◽  
Melissa Latorre ◽  
Tim Zimmerman ◽  
Gabriel Lang ◽  
Jason Samarasena ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Bowel Preparation ◽  
Transverse Colon ◽  
Bowel Movement ◽  
Left Colon ◽  
Hospitalized Patients ◽  
Inpatient Setting ◽  
Right Colon ◽  
Colon Preparation ◽  
Inadequate Bowel Preparation

Abstract Background High quality bowel preparation prior to colonoscopy can be difficult to achieve in the inpatient setting. Hospitalized patients are at risk for extended hospital stays and low diagnostic yield due to inadequate bowel preparation. The Pure-Vu System is a novel device intended to fit over existing colonoscopes to improve intra-colonoscopy bowel preparation. The objective of the REDUCE study was to conduct the first inpatient study to evaluate optimization of bowel preparation quality following overnight preparation when using the Pure-Vu System during colonoscopy. Methods This multicenter, prospective feasibility study enrolled hospitalized subjects undergoing colonoscopy. Subjects recorded the clarity of their last bowel movement using a 5-point scale prior to colonoscopy. After one night of preparation, all enrolled subjects underwent colonoscopy utilizing the Pure-Vu System. The primary endpoint was improvement of colon cleanliness from baseline to post-cleansing with the Pure-Vu System as assessed by the improvement in Boston Bowel Preparation Scale (BBPS). An exploratory analysis was conducted to assess whether the clarity of the last bowel movement could predict inadequate bowel preparation. Results Ninety-four subjects were included. BBPS analyses showed significant improvements in bowel preparation quality across all evaluable colon segments after cleansing with Pure-Vu, including left colon (1.74 vs 2.89; p < 0.0001), transverse colon (1.74 vs 2.91; p < 0.0001), and the right colon (1.41 vs 2.88; p < 0.0001). Prior to Pure-Vu, adequate cleansing (BBPS scores of ≥ 2) were reported in 60%, 62%, and 47% for the left colon, transverse colon, and right colon segments, respectively. After intra-colonoscopy cleansing with the Pure-Vu System, adequate colon preparation was reported in 100%, 99%, and 97% of the left colon, transverse colon, and right colon segments, respectively. Subjects with lower bowel movement clarity scores were more likely to have inadequate bowel preparation prior to cleansing with Pure-Vu. Conclusions In this feasibility study, the Pure-Vu System appears to be effective in significantly improving bowel preparation quality in hospitalized subjects undergoing colonoscopy. Clarity of last bowel movement may be useful indicator in predicting poor bowel preparation. Larger studies powered to evaluate clinical outcomes, hospital costs, and blinded BBPS assessments are required to evaluate the significance of these findings. Trial registration Evaluation of the Bowel Cleansing in Hospitalized Patients Using Pure-Vu System (NCT03503162).

scholarly journals Efficacy of infliximab treatment on the mucosal healing of different intestinal segments in patients with ileocolonic Crohn’s disease

2020 ◽  
Vol 13 ◽  
pp. 175628482097692
Author(s):  
Yaling Wu ◽  
Lei Zhang ◽  
Jingli Cao ◽  
Haichao Wang ◽  
Chen Ye ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Transverse Colon ◽  
Mucosal Healing ◽  
Treat To Target ◽  
Infliximab Treatment ◽  
Right Colon ◽  
Single Center Study ◽  
The Right

Background: Mucosal healing (MH) is the key aim of the treat-to-target strategy for patients with Crohn’s disease (CD). The efficacy of infliximab (IFX) on MH in different ileocolonic segments is unclear. The aim of this study was to investigate endoscopic MH in different ileocolonic segments in patients with CD who received IFX treatment. Methods: A retrospective, single-center study was performed in patients with active ileocolonic CD between January 2012 and December 2018. All patients underwent IFX treatment for at least 30 weeks. The MH of five ileocolonic segments was assessed by the Simple Endoscopic Score for CD (SES-CD) at baseline, 14/22 weeks and 30/38 weeks. The SES-CD values were analyzed by a mixed-effects model after the correction for confounding factors. Results: A total of 101 eligible patients were included. The baseline endoscopic severity was similar across segments. At 30/38 weeks, the greatest changes in the SES-CD ulcer size and ulcerated surface subscores were −94.29% and −94.32% both in the transverse colon ( p < 0.0001), and the smallest changes were −67.88% and −69.67% both in the terminal ileum ( p < 0.0001) compared with baseline. Stenosis mainly presented in the right colon (12/29, 41.38%). The change in the SES-CD stenosis subscore was −6.25% in the right colon at 30/38 weeks compared with −71.88% at 14/22 weeks ( p = 0.0030). At 30/38 weeks, the transverse colon achieved the highest rate of complete MH (CMH) at 81.2%, and the lowest CMH rate occurred in the terminal ileum at 45.6%. Moreover, the degree of improvement in the rectum was negatively correlated with disease progression ( p = 0.011). Conclusions: Ileocolonic segments in CD presented different degrees of endoscopic MH during IFX treatment. The transverse colon showed the highest CMH rate, whereas the right colon with stenosis showed the poorest improvement. The differing propensities of ileocolonic segments may provide an individualized IFX treatment strategy.

Distribution of neuroendocrine marker-positive cells in colorectal cancer tissue and adjacent mucosa.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 617-617
Author(s):  
Takashi Ogimi ◽  
Sotaro Sadahiro ◽  
Hiroshi Miyakita ◽  
Gota Saito ◽  
Lin Fung Chan ◽  
...  
Keyword(s):  
Chromogranin A ◽  
Normal Mucosa ◽  
Tumor Location ◽  
Left Colon ◽  
Cancer Tissue ◽  
Positive Staining ◽  
Right Colon ◽  
Neuroendocrine Marker ◽  
Adjacent Mucosa ◽  
The Right

617 Background: Neuroendocrine carcinoma (NEC) is a rare disease and has been reported to most frequently arise in the right side of the colon. In the 2010 WHO classification, mixed adenoneuroendocrine carcinoma (MANEC) was defined as a neoplasm consisting of NEC and adenocarcinoma components. To clarify the histogenesis of NEC, we attempted to detect neuroendocrine marker-positive cells in cancer tissue and in the adjacent mucosa in patients with adenocarcinoma. Methods: The study group comprised 390 patients with Stage II or III colorectal adenocarcinoma between 2007 and 2012. Immunostaining was performed with anti chromogranin A, synaptophysin, and CD56 antibodies. Cases with positively stained cells in cancer tissue were defined as positive. In the adjacent mucosa, at least 5 cm from the tumor, the numbers of positive cells per 15 HPF were measured. Results: Tumor location was right side in 181 patients, left side in 173, and the rectum in 36 patients. Positive rates of Chromogranin A in cancer tissues were 23.7% in the right colon, 13.2% in the left colon, and 19.4% in the rectum. Those of synaptopysin were 35.3%, 21.9%, and 30.6%, respectively. Those of CD56 were 22.6%, 8.0%, and 16.7%, respectively. Positive rates of these three markers in right colon were significantly higher than those in left colon and rectum. (p = 0.0115, p = 0.0054, p = 0.0062). In the adjacent mucosa, the mean numbers of positive cells for chromogranin A were 62.2 ± 20.5 in the right colon, 131.9 ± 44.7 in the left colon, and 243.7 ± 60.2 in the rectum (p < 0.001). Those for synaptophysin were 47.7 ± 23.5, 95.3 ± 35.1, and 156.9 ± 56.8, respectively. (p < 0.001). There were no significant differences in the number of positive cells for CD56 among the sites (p = 0.295). Conclusions: In cancer tissue, the rate of positive staining for neuroendocrine marker-positive cells was higher in the right side of the colon, whereas in normal mucosa the rates of positive staining for these cells were higher in the sigmoid colon and the rectum. These results suggest that neuroendocrine marker-positive cells are an acquired characteristic of cancer tissue.

EFFICACY OF 90Y-RADIOEMBOLIZATION IN METASTATIC COLORECTAL CANCER DEPENDING ON THE PRIMARY TUMOR SIDE

2020 ◽  
Author(s):  
Philipp Schindler ◽  
Max Masthoff ◽  
Fabian Harders ◽  
Hartmut Schmidt ◽  
Lars Stegger ◽  
...  
Keyword(s):  
Median Survival ◽  
Primary Tumor ◽  
Progressive Disease ◽  
Complete Response ◽  
Tumor Burden ◽  
Hepatic Tumor ◽  
Left Colon ◽  
Right Colon ◽  
90Y Radioembolization ◽  
The Right

Metastatic colorectal cancer (mCRC) is associated with different molecular biology, clinical characteristics and outcome depending on the primary tumor localization. We aimed to evaluate the effectiveness of 90Y-radioembolization (RE) for therapy of colorectal liver metastases depending on the primary tumor side. We performed a retrospective analysis of n=73 patients with mCRC and RE in our university liver center between 2009 and 2018. Patients were stratified according to the primary tumor side (left vs. right hemicolon), treatment response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) at follow-up after 3 months. Kaplan-Meier analysis was performed to analyze survival followed by Cox regression to determine independent prognostic factors for survival. Prior to RE all patients had received systemic therapy, with either stable or progressive disease, but no partial or complete response. In n=22/73 (30.1%) patients the primary tumor side was in the right colon, in n=51/73 (69.9%) patients in the left colon. Hepatic tumor burden was ≤25% in n=36/73 (49.3%) patients and >25% in n=37/73 (50.7%) patients. At 3 months, n=21 (33.8%) patients showed treatment response [n=2 (3.2%) complete response, n=19 (30.6%) partial response], n=13 (21.0%) stable disease, and n=28 (45.2%) progressive disease after RE. The median survival in case of primary tumor side in the left colon was significantly higher than for primary tumors in the right colon (8.7 vs. 6.0 months, p=0.033). The median survival for a hepatic tumor burden ≤25% was significantly higher compared with >25% (13.9 vs. 4.3 months, p<0.001). The median overall survival was 6.1 months. The median survival after RE in hepatic-metastatic CRC depends on the primary tumor side and the pre-procedural hepatic tumor burden.

Is the outcome of the left colon antegrade continence enema better than that of the right colon antegrade continence enema?

2009 ◽  
Vol 44 (4) ◽  
pp. 783-787 ◽  
Author(s):  
Hyun-Young Kim ◽  
Sung-Eun Jung ◽  
Seong-Cheol Lee ◽  
Kwi-Won Park ◽  
Woo-Ki Kim
Keyword(s):  
Left Colon ◽  
Right Colon ◽  
Antegrade Continence Enema ◽  
The Right ◽  
Better Than

scholarly journals Smoking-Related Risks of Colorectal Cancer by Anatomical Subsite and Sex

2020 ◽  
Vol 189 (6) ◽  
pp. 543-553 ◽  
Author(s):  
Inger T Gram ◽  
Song-Yi Park ◽  
Lynne R Wilkens ◽  
Christopher A Haiman ◽  
Loïc Le Marchand
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cox Regression ◽  
Left Colon ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Increased Risk ◽  
The Right ◽  
Incident Cases

Abstract The purpose of this study was to examine whether the increased risk of colorectal cancer due to cigarette smoking differed by anatomical subsite or sex. We analyzed data from 188,052 participants aged 45–75 years (45% men) who were enrolled in the Multiethnic Cohort Study in 1993–1996. During a mean follow-up period of 16.7 years, we identified 4,879 incident cases of invasive colorectal adenocarcinoma. In multivariate Cox regression models, as compared with never smokers of the same sex, male ever smokers had a 39% higher risk (hazard ratio (HR) = 1.39, 95% confidence interval (CI): 1.16, 1.67) of cancer of the left (distal or descending) colon but not of the right (proximal or ascending) colon (HR = 1.03, 95% CI: 0.89, 1.18), while female ever smokers had a 20% higher risk (HR = 1.20, 95% CI: 1.06, 1.36) of cancer of the right colon but not of the left colon (HR = 0.96, 95% CI: 0.80, 1.15). Compared with male smokers, female smokers had a greater increase in risk of rectal cancer with number of pack-years of smoking (P for heterogeneity = 0.03). Our results suggest that male smokers are at increased risk of left colon cancer and female smokers are at increased risk of right colon cancer. Our study also suggests that females who smoke may have a higher risk of rectal cancer due to smoking than their male counterparts.

Sign in / Sign up

Export Citation Format

Share Document