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Effect of Nigella Sativa Oil on Oxidative Stress, Inflammatory, and Glycemic Control Indices in Diabetic Hemodialysis Patients: A Randomized Double-Blind, Controlled Trial
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      Evaluation and long-term outcomes of the different modalities used in colonic endoscopic mucosal resection

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          Abstract

          Endoscopic mucosal resection (EMR) has been used in western countries to remove colonic polyps for at least the last two decades. Significant experience has been accumulated and the efficacy of the method has recently been evaluated in a large meta-analysis. A number of variations to modify the technique, including knife-assisted, cap-assisted, ligation devices, and underwater EMR, have been developed in an attempt to improve outcomes. However, to date there are only limited data comparing these techniques or demonstrating the superiority of any one of them. This article reviews the current evidence on the efficacy of each of these modified techniques.

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          JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection.

          Shinji Tanaka, Hiroshi Kashida, Yutaka Saito … (2015)
          Colorectal endoscopic submucosal dissection (ESD) has become common in recent years. Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also many types of precarcinomatous adenomas. It is important to establish practical guidelines in which the preoperative diagnosis of colorectal neoplasia and the selection of endoscopic treatment procedures are properly outlined, and to ensure that the actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with the guidelines. In cooperation with the Japanese Society for Cancer of the Colon and Rectum, the Japanese Society of Coloproctology, and the Japanese Society of Gastroenterology, the Japan Gastroenterological Endoscopy Society has recently compiled a set of colorectal ESD/endoscopic mucosal resection (EMR) guidelines using evidence-based methods. The guidelines focus on the diagnostic and therapeutic strategies and caveat before, during, and after ESD/EMR and, in this regard, exclude the specific procedures, types and proper use of instruments, devices, and drugs. Although eight areas, ranging from indication to pathology, were originally planned for inclusion in these guidelines, evidence was scarce in each area. Therefore, grades of recommendation were determined largely through expert consensus in these areas.
          Article 0 comments Cited 176 times – based on 0 reviews     Review now
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            Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia.

            Stephen Bourke, Zhi Chen, Alan Moss … (2011)
            Large sessile colonic polyps usually are managed surgically, with significant morbidity and potential mortality. There have been few prospective, intention-to-treat, multicenter studies of endoscopic mucosal resection (EMR). We investigated whether endoscopic criteria can predict invasive disease and direct the optimal treatment strategy. The Australian Colonic Endoscopic (ACE) resection study group conducted a prospective, multicenter, observational study of all patients referred for EMR of sessile colorectal polyps that were 20 mm or greater in size (n=479, mean age, 68.5 y; mean lesion size, 35.6 mm). We analyzed data on lesion characteristics and procedural, clinical, and histologic outcomes. Multiple logistic regression analysis identified independent predictors of EMR efficacy and recurrence of adenoma, based on findings from follow-up colonoscopy examinations. Risk factors for submucosal invasion were as follows: Paris classification 0-IIa+c morphology, nongranular surface, and Kudo pit pattern type V. The most commonly observed lesion (0-IIa granular) had a low rate of submucosal invasion (1.4%). EMR was effective at completely removing the polyp in a single session in 89.2% of patients; risk factors for lack of efficacy included a prior attempt at EMR (odds ratio [OR], 3.8; 95% confidence interval, 1.77-7.94; P=.001) and ileocecal valve involvement (OR, 3.4; 95% confidence interval, 1.20-9.52; P=.021). Independent predictors of recurrence after effective EMR were lesion size greater than 40 mm (OR, 4.37; 95% confidence interval, 2.43-7.88; P<.001) and use of argon plasma coagulation (OR, 3.51; 95% confidence interval, 1.69-7.27; P=.0017). There were no deaths from EMR; 83.7% of patients avoided surgery. Large sessile colonic polyps can be managed safely and effectively by endoscopy. Endoscopic assessment identifies lesions at increased risk of containing submucosal cancer. The first EMR is an important determinant of patient outcome-a previous attempt is a significant risk factor for lack of efficacy. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
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              Local recurrence after endoscopic mucosal resection of nonpedunculated colorectal lesions: systematic review and meta-analysis.

              Tim Belderbos, Max Leenders, Leon Moons … (2014)
              Local recurrence has been observed after endoscopic mucosal resection (EMR) of nonpedunculated colorectal lesions. The indications for follow-up colonoscopy and the optimal time interval are currently unclear. The aims of this systematic review were to assess the frequency of local recurrence after EMR, to identify risk factors for recurrence, and to provide follow-up recommendations.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Gastroenterol
                Journal ID (iso-abbrev): Ann Gastroenterol
                Title: Annals of Gastroenterology : Quarterly Publication of the Hellenic Society of Gastroenterology
                Publisher: Hellenic Society of Gastroenterology (Greece )
                ISSN (Print): 1108-7471
                ISSN (Electronic): 1792-7463
                Publication date (Print): 2017
                Publication date (Electronic): 04 November 2016
                Volume: 30
                Issue: 2
                Pages: 145-151
                Affiliations
                [1]Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK
                Author notes
                Correspondence to: Dr Asimina Gaglia, Consultant Gastroenterologist, Prescot Street, L7 8XP, Liverpool, Merseyside, UK, Tel.: +44 74290 12348, e-mail: asimina.gaglia@ 123456rlbuht.nhs.uk
                Article
                Publisher ID: AnnGastroenterol-30-145
                DOI: 10.20524/aog.2016.0104
                PMC ID: 5320026
                PubMed ID: 28243034
                SO-VID: 91d81d08-0775-4580-9f03-1cb0e5b7bdbb
                Copyright © Copyright: © Hellenic Society of Gastroenterology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 31 March 2016
                Date accepted : 04 July 2016
                Categories
                Subject: Invited Review

                Keywords: endoscopic mucosal resection,colorectal polyps,endoscopic mucosal resection-precutting
                Data availability:
                Keywords: endoscopic mucosal resection, colorectal polyps, endoscopic mucosal resection-precutting

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