Detecting more polyps with the rearview mirror colonoscope
Video report of live endoscopies performed at the Endo Club Nord 2013 in Hamburg, November 1 – 2, 2013.
© Dr. Falk Pharma GmbH, Freiburg. All rights reserved.
One of the most spectacular developments shown at the Endoclub Nord 2013 were new colonoscopes with an enlarged viewing angle of over 180° – almost like a rearview mirror – allowing examiners to view behind colonic folds and thus improve the quality of screening colonoscopy.
Two new different colonoscopes with such an extended field of view were presented:
The first system, the ‘full spectrum endoscopy’ or ‘FUSE’ system, consists of an endoscope with several LEDs at its tip to illuminate the intestinal lumen, and 3 separate video cameras with views towards the front, the left rear and the right rear. Pictures from these three video cameras are shown on separate screens.
The second system presented has a lateral optical device at the tip of the endoscope, in addition to the conventional forward viewing lens, which expands the field of view to a total of 235°. The advantage of this system is that the entire 235° field of view can be displayed on one monitor and viewed by a single investigator as usual.
However, further tests, and larger controlled studies in particular, must be awaited before these promising new endoscopic systems can be used in routine practice.
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Editor: Prof. W. Kreisel, Medical University Hospital, 79106 Freiburg, Germany
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Screening colonoscopy and sigmoidoscopy were associated with reduced colorectal-cancer mortality; only colonoscopy was associated with reduced mortality from proximal colon cancer.
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This meta-analysis shows: Linaclotide improves bowel function and reduces abdominal pain and overall severity of irritable bowel syndromes with constipation or chronic constipation, compared with placebo.
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Adalimumab and infliximab are equally effective in anti-TNF-naïve patients with Crohn’s disease.
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Carvedilol leads to a significantly greater decrease in hepatic venous pressure gradient than propranolol. Using carvedilol for primary prophylaxis a substantial proportion of non-responders to propranolol can achieve a hemodynamic response, which is associated with improved outcome with regard to prevention of variceal bleeding, hepatic decompensation and death.
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Combination of lactulose plus rifaximin is more effective than lactulose alone in the treatment of overt hepatic encephalopathy.
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Chelating agents are effective therapies for most patients with Wilson disease; D-penicillamine and trientine produce comparable outcomes, although D-penicillamine had a higher rate of adverse events. Few patients receiving chelation therapy had neurologic deterioration, which occurred more frequently in patients who received trientine.
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Persistence of non-dysplastic Barrett’s esophagus over several endoscopic examinations identifies patients who are at low risk for development of esophageal adenocarcinoma.
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Oral bisphosphonate use may increase the risk for Barrett’s esophagus, especially among patients with gastroesophageal reflux disease.
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Sequential or concomitant quadruple therapy containing omeprazole, amoxicillin, clarithromycin and metronidazole for 14 days cures more than 90% of patients with Helicobacter pylori infection in areas of high clarithromycin and metronidazole resistance.
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In type 1 autoimmune pancreatitis relapses are common. Relapse-free survival is similar in those treated with steroids plus immunomodulator compared to those treated with steroids alone.
</b>Falk Symposium 192<br><b>IBD 2014: Thinking Out of the Box</b>
May 30 – 31, Le Palais des Congrès de Paris, 2 Place de la Porte Maillot, 75853 Paris Cedex 1, France
</b>Falk Symposium 193<br><b>Celiac Disease and Other Small Bowel Disorders</b>
September 5 – 6, Beurs van Berlage, Damrak 243, 1021 ZJ Amsterdam, The Netherlands
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