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      International Digestive Endoscopy Network to Strengthen Network for Lower Gastrointestinal Diseases Including Inflammatory Bowel Disease and Colorectal Cancer

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          The International Digestive Endoscopy Network 2012 organized by Korean Society of Gastrointestinal Endoscopy was held at Seoul, Korea on June 9 to 10, 2012, during which invited lectures of world renowned experts on the lower gastrointestinal (GI) tract were given with a wide range of the latest knowledge and novel imaging of inflammatory bowel disease (IBD) and colorectal endoscopic submucosal dissection (ESD). There were very informative five sessions in the lower GI part consisting of: Colonoscopy in IBD; what can we do in 2012?; A look into the bowel beyond colon in IBD; How to estimate the invasion depth of early GI cancer?; No more no man's land: small bowel exploration; and colorectal ESD: can it be a popular procedure?

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          Most cited references 9

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          Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study.

          The aims of this prospective study were to document the incidence of colon immediate postpolypectomy bleeding (IPPB) according to grade, and to identify potential risk factors of IPPB in patients who have received complete colonoscopy and polypectomy because of a colorectal polyp. This was a prospective, cross-sectional study of 5,152 patients treated at 11 tertiary medical centers between July 2003 and July 2004. Patient-related, polyp-related, and procedure-related variables were evaluated as potential risk factors for IPPB. IPPB was defined as a bleeding occurring during the procedure and was graded as G1-G4. Risk factors associated with IPPB were analyzed by univariate and multivariate logistic regression analysis. A total of 9,336 colonic polyps were removed in 5,152 patients, and 262 (2.8%) colorectal polyps in 215 patients presented with IPPB. Polyp-based multivariate analysis revealed that old age (>or=65 yr), comorbid cardiovascular or chronic renal disease, anticoagulant use, polyp size greater than 1 cm, gross morphology of polyps such as pedunculated polyp or laterally spreading tumor, poorer bowel preparation, cutting mode of the electrosurgical current, and the inadvertent cutting of a polyp before current application were significant risk factors for IPPB. Nine factors have been found to be associated with IPPB and polypectomy should be undertaken with caution under these conditions.
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            Colonoscopy: a prospective report of complications.

            Patients (N = 2,097) undergoing ambulatory office colonoscopy were followed to determine the incidence of endoscopic complications. In this group, 1,320 patients had diagnostic colonoscopy with or without biopsy; 777 patients had 2,019 polyps removed. Three of 2,097 patients (0.1%) had transient hypotension requiring i.v. fluid resuscitation and oxygen administration. All patients went home without sequelae. Acute postpolypectomy bleeding occurred in 11 of 777 patients (1%) requiring acute management; bleeding was controlled during colonoscopy in all. Postpolypectomy syndrome occurred in 9 of 777 patients (1%). All patients were treated medically. Late postpolypectomy bleeding occurred in 15 of 777 patients (2%). Perforation occurred in two of 777 patients (0.3%), at 1 and 9 days postpolypectomy. Both patients underwent surgery with uneventful recoveries. We conclude that office colonoscopy including polypectomy is safe. The overall complication rate for therapeutic ambulatory colonoscopy was 5%, with major events requiring hospitalization in 2% of patients.
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              Current status and future perspectives of endoscopic submucosal dissection for colorectal tumors.

              Endoscopic submucosal dissection (ESD) allows for en bloc tumor resection irrespective of the size of the lesion. In Japan, ESD has been established as a standard method for endoscopic ablation of malignant tumors in the upper gastrointestinal tract. Although the use of colorectal ESD has been gradually spreading with the development of numerous devices, ESD has not yet been fully established as a standard therapeutic method for colorectal lesions. Currently, colorectal ESD is performed as an 'advanced medical treatment' without national health insurance coverage. With the recent accumulation of numerous cases, the safety and simplicity of colorectal ESD have improved remarkably. Currently in Japan, a prospective multicenter cohort study organized by the Japan Gastroenterological Endoscopy Society is ongoing to clarify the safety and efficacy of colorectal ESD to obtain remuneration from national health insurance. In this report, we showed the outcome regarding safety and efficacy of colorectal ESD through a review of the published work. Of 2719 cases with colorectal ESD at 13 institutions, the complete en bloc resection and perforation rates were 82.8% (61-98.2%, 2082/2516) and 4.7% (1.4-8.2%, 127/2719), respectively. Additional surgery for perforation was very rare because perforations were tiny enough to be closed endoscopically by clips in most of the cases and treated conservatively. In the near future, colorectal ESD will be a common therapeutic method for early colorectal carcinoma. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

                Author and article information

                Department of Gastroenterology, Gachon University Gil Medical Center, Incheon, Korea.
                Author notes
                Correspondence: Kwang An Kwon. Department of Gastroenterology, Gachon University Gil Medical Center, 21 Namdong-daero 774 beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: +82-32-460-3778, Fax: +82-32-460-3408, toptom@
                Clin Endosc
                Clin Endosc
                Clinical Endoscopy
                The Korean Society of Gastrointestinal Endoscopy
                September 2012
                22 August 2012
                : 45
                : 3
                : 251-253
                Copyright © 2012 Korean Society of Gastrointestinal Endoscopy

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Special Issue Articles of IDEN 2012
                Session II - Lower Gut


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