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Background and Aims. Colonoscopy with polypectomy are associated with a reduction in the incidence of colorectal cancer (CRC), as well as mortality, secondary to CRC. Because of the variation in physicians' performance and the risk of interval CRC after a colonoscopy, several quality indicators have been established. ADR (adenoma detection rate) is a generally accepted quality indicator. But it is also a target of possible gaming and achieving an adequate number of colonoscopies only from screening may be a problem for some practices. The aim of this study was to compare ADR for colonoscopies done for various indications and to look for correlations between the ADR of screening and all examinations. Methods. We retrospectively assessed the quality indicators of all colonoscopies performed in a nonuniversity hospital, Frydek-Mistek, from January 2013 to December 2017. We calculated the ADR for all colonoscopies in patients over 50 years of age (subdivided into screening, surveillance, diagnostic) and separately only for screening colonoscopies. Correlations were made using the Pearson's correlation coeficient. Results. The sample was composed of 6925 patients over 50 years of age (3620 men, 3305 women, mean age 66.2 years). The ADRs for screening and surveillance were higher than for diagnostic colonoscopies for all of the endoscopists, and the ADRs for all colonoscopies were lower than for screening, but sufficiently over 25%. There was a positive correlation between the ADR of screening and all colonoscopies (r=0.906, P

Doporucene postupy Ceske gastroenterologicke spolecnosti k zavedeni perkutanni endoskopicke gastrostomie.

Piecemeal endoscopic mucosal resection (EMR) is frequently used for the treatment of non-poly-poid colorectal lesions larger than 20 mm. Nevertheless, local residual neoplasia occurs (LRN) in as much as 15 % of cases. The aim of our prospective interventional study was to evaluate the efficacy of treatment of LRN under standardized conditions.In two high volume non-university endoscopy centers, LRN has been treated according to the newly proposed classification based on endoscopic appearance by argon plasma coagulation (APC), endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Primary outcome, efficacy of LRN treatment, was defined as both endoscopic and histological absence of neoplastic tissue in the post-EMR site 6 months after LRN treatment session.Twenty-five patients with 25 LRN lesions were enrolled. Among them, 12 (48 %), 8 (32 %) and 5 (20 %) were treated by APC, EMR and ESD, respectively, with efficacy in 10 (90.9 %), 7 (87.5 %) and 4 (100 %), respectively.Using standardized approach based on therapy directed by LRN morphology, LRN may be eradicated in 91.3 % during one session.colonoscopy - endoscopic mucosal resection - local residual neoplasia.

There are one-step and two-steps programs for colorectal cancer screening. The aim of all screening examinations is to detect early stage of the disease in asymptomatic patient. The aim of this article is actual review of current screening modalities such as fecal occult blood test, flexible sigmoideoscopy, colonoscopy, CT colonography, capsule endoscopy, blood-based tests and stool DNA tests. Colonoscopy still remains the gold standard for detection of colorectal neoplasias. In majority of countries worldwide programs for colorectal cancer screening are based on immunochemical fecal occult blood test followed by colonoscopy when positive.

The objective of the present study was to determine if there is correlation between signs of reflux laryngitis (RL) and reflux oesophagitis (RE) in patients with gastro-oesophageal reflux disease (GORD) symptoms. Laryngeal photography obtained from patients during oesophagogastroduodenoscopy were examined by two otolaryngologists experienced in the field of extra-oesophageal reflux regarding the presence and severity of RL. The presence of RE was evaluated by gastroenterologist. Smokers, heavy drinkers and patients with bronchial asthma were excluded from the statistical analysis. A total of 681 patients were analysed. RL was diagnosed in 367 (53.9%) cases, of whom 182 patients had mild, 118 moderate and 67 severe (Reflux Finding Score7) RL. RE was diagnosed in 103 (28.1%) patients with RL and in 80 (25.7%) patients without RL. Neither the difference between the overall group of patients with RL and those without (OR 1.141, 95% CI 0.811-1.605, p = 0.448), nor the differences between the respective subgroups of patients with mild, moderate and severe RL and those without RL were statistically significant. The OR and 95% CI for mild, moderate and severe RL were 1.042, 95% CI 0.712-1.526, p = 0.834, 1.182, 95% CI 0.764-1.831, p = 0.453 and 1.0, 95% CI 0.566-1.766, p = 0.999 respectively. It can be concluded that there is no correlation between RL and RE in patients with GORD symptoms.Lo scopo dello studio è stato determinare l’esistenza di una correlazione tra i segni di laringite da reflusso (RL) ed esofagite da reflusso (RE) in pazienti con sintomi da malattia da reflusso gastroesofageo (GORD). Durante l’esecuzione di esofagogastroduodenoscopie, sono state ottenute fotografie laringee, le quali sono state esaminate da otorinolaringoiatri esperti di reflusso extra-esofageo al fine di valutare la presenza e la gravità di RL. La presenza di RE, invece, è stata valutata dai gastroenterologi. Fumatori, alcolisti e pazienti con asma bronchiale sono stati esclusi dall’analisi statistica. Sono stati analizzati 681 pazienti. RL è stata diagnosticata in 367 (53,9%) pazienti, dei quali 182 avevano una forma lieve, 118 una forma moderata, e 67 una forma severa (Reflux Finding Score7). RE è stata diagnosticata in 103 (28,1%) pazienti con RL e in 80 (25,7%) pazienti senza RL. In merito alla presenza di RE, la differenza tra l’intero gruppo di pazienti con RL e quelli senza RL non è stata statisticamente significativa (OR 1.141, 95% CI 0.811-1.605, p = 0.448), e allo stesso modo non si sono rivelate statisticamente significative le differenze tra ciascuno dei sottogruppi di pazienti con RL lieve, moderata e severa, e quelli senza RL. L’OR e il 95% CI per RL lieve, moderata e severa sono stati rispettivamente i seguenti: 1.042, 95% CI 0.712-1.526, p = 0.834, 1.182, 95% CI 0.764-1.831, p = 0.453 and 1.0, 95% CI 0.566-1.766, p = 0.999. In conclusione, non è risultata nessuna correlazione tra RL e RE in pazienti con sintomi da malattia da reflusso gastroesofageo.

Among superficial neoplastic lesions of the colon and rectum, a laterally spreading tumor (LST) is a flat elevated type at least 10 mm in size. It can be treated by conventional endoscopic resection (CER). Nevertheless, local residual neoplasia (LRN) may occur during follow-up. The aim of this prospective study was to evaluate the occurrence of LRN and the risk factors for its presence.Consecutive patients referred for CER of an LST were included. Follow-up colonoscopies were performed after 3 and 15 months. LRN was defined histologically as the presence of neoplastic tissue in the post-CER site.Of a total of 127 patients with 127 lesions, follow-up could not be completed in 48 (37.8%). Of the remaining 79 (62.2%) patients (64.6% men, mean age 66.1±9.7 years), 63 (79.7%) were negative and 16 (20.3%) were positive for the presence of LRN after 15 months. Of 62 (78.5%) patients without LRN after 3 months, 55 (88.7%) remained negative after 15 months. Of 17 (21.5%) patients with LRN after 3 months, eight (47.1%) were negative after 15 months. In a multivariate analysis, LST size of at least 20 mm was found to be a significant risk factor after 3 months (odds ratio, 5.837; 95% confidence interval 1.199-28.425; P=0.029). After 15 months, the only significant risk factor was the presence of LRN observed after 3 months (odds ratio, 6.0; 95% confidence interval, 1.793-20.073; P=0.004).This prospective study shows that the occurrence of LRN is frequent and its treatment is less effective than reported previously. These are important limitations of CER and should be taken into consideration for the management of patients with LSTs.

To compare the dietary habits between colorectal neoplasia patients, their first-degree relatives, and unrelated controls.From July 2008 to April 2011, we collected epidemiological data relevant to colorectal cancer from patients with colorectal neoplasias, their first-degree relatives, and also from a control group consisting of people referred for colonoscopy with a negative family history of colorectal cancer and without evidence of neoplasia after colonoscopic examination. The first-degree relatives were divided into two groups following the colonoscopic examination: (1) patients with neoplasia or (2) patients without neoplasia. Dietary habits of all groups were compared. A χ (2) test was used to assess the association between two dichotomous categorical variables.The study groups consisted of 242 patients with colorectal neoplasias (143 men, 99 women; mean age: 64 ± 12 years) and 160 first-degree relatives (66 men, 94 women; mean age: 48 ± 11 years). Fifty-five of the first-degree relatives were found to have a neoplastic lesion upon colonoscopy, while the remaining 105 were without neoplasia. The control group contained 123 individuals with a negative family history for neoplastic lesions (66 men, 57 women; mean age: 54 ± 12 years). Two hypotheses were tested. In the first, the dietary habits of first-degree relatives with neoplasia were more similar to those of patients with neoplasia, while the dietary habits of first-degree relatives without neoplasia were similar to those of the control group. In the second, no sex-related differences in dietary habits were expected between the particular groups. Indeed, no significant differences were observed in the dietary habits between the groups of patients, controls and first-degree relatives with/without neoplastic lesions. Nevertheless, statistically significant sex-related differences were observed in all groups, wherein women had healthier dietary habits than men.In all groups examined, women had healthier dietary habits than men. Modification of screening guidelines according to sex may improve the efficiency of screening programs.

The method of radiofrequency ablation (RFA) is currently used for the treatment of high-grade dysplasia in Barrett's oesophagus. It has theoretical potential also for the use in squamous epithelial neoplasias. The authors present a case report of an early diagnosis of squamous cancer in a high-risk patient, its endoscopic treatment and follow-up, and successful RFA of recurrent neoplasia. RFA can expand our therapeutic possibilities for the management of recurrent neoplastic lesions after endoscopic treatment of squamous oesophageal cancer.