Search Results for: Ipertrofia prostatica benigna (IPB) (Adenoma Prostatico)

In Italia, il carcinoma della prostata rappresenta la neoplasia più diffusa tra gli uomini over 50, incidendo per circa il 30% su tutti i tumori maschili, con 40.192 nuovi casi stimati solo nel 2024. È stata presentata oggi, in Senato la campagna di sensibilizzazione ‘Allo Specchio della Salute – uno spazio di confronto sul carcinoma prostatico’, pensata per coinvolgere l’intera comunità nel dibattito intorno alla gestione e cura di questa patologia. Un’intera giornata dedicata al carcinoma della prostata suddivisa in due appuntamenti sinergici e xomplementari: la conferenza stampa seguita dalla campagna di awareness.

While the adenoma detection rate (ADR) is associated with post-colonoscopy colorectal cancer (PCCRC) risk, it is unknown to what extent this reflects missed colorectal cancer (CRC) versus missed pre-cancerous lesions. We evaluated the association between physician ADR and prevalent CRC detection during colonoscopy.

H. pylori infection may represent a significant risk factor for the development of colorectal cancer. The effect of anti-H. pylori treatment on colorectal cancer incidence and mortality necessitates further investigation through large-scale, randomized controlled trials with prolonged follow-up durations.

In Reply We appreciate the valuable feedback provided by the authors of the Letters regarding our study on the association between ADR and postcolonoscopy CRC incidence. Their comments highlight important points about quality metrics in colonoscopy, methodological differences, and potential areas for further investigation. Below, we address the key issues raised.

To the Editor The study by Dr Pilonis and colleagues, examining the association between physician ADRs and postcolonoscopy CRC incidence, offers important insights into quality metrics for colonoscopy.

To the Editor The recent study by Dr Pilonis and colleagues explored the association between adenoma detection rate (ADR) and risk of colorectal cancer (CRC) after colonoscopy. The authors provided evidence supporting ADR as a critical quality benchmark for CRC prevention. They demonstrated that an improved ADR over time was associated with lower CRC risk in patients who underwent colonoscopy, but this association was observed only among patients whose physician had a baseline ADR of less than 26%.

Message Computer-aided detection (CADe) has increased adenoma detection in randomised trials. However, unlike other detection adjuncts, CADe is lesion specific, that is, it is trained on a specific set of lesions. If the training does not include sufficient examples of precancerous lesion subsets, CADe may not perform adequately for lesions in that subset. In a prospective assessment of a second-generation CADe programme in 165 colonoscopies, we identified 26 flat lesions ≥10 mm in 17 patients. The endoscopist identified 22 of 26 lesions before the CADe programme. In 13 lesions, the CADe either generated no detection signal or only a signal over part of the lesion after colonoscope position or luminal inflation adjustment. Thus, the second-generation CADe algorithm, like the first generation, frequently fails to effectively detect large flat colorectal lesions, which are likely very important lesions that a CADe programme should identify. Details The first CADe…

Introduction
Chronic constipation is an independent risk factor for inadequate bowel preparation. The objective of this study is to evaluate the effectiveness and safety of the combined use of linaclotide and oral sulfate solution (OSS) in patients with chronic constipation undergoing colonoscopy.

Methods and analysis
This is a prospective, randomised, controlled, single-blind (endoscopist) clinical trial that compares three bowel cleansing regimens for patients with chronic constipation undergoing colonoscopy. Regimen A consists of 2d-linaclotide and OSS, regimen B consists of 3d-linaclotide and OSS, and regimen C consists of OSS. All patients are required to consume a low-fibre diet for 3 days and then a clear fluid diet for 1 day before the colonoscopy. The primary outcome is adequate bowel preparation (defined as a Boston Bowel Preparation Scale (BBPS) score ≥2 for each segment and a total BBPS score ≥6). The secondary outcomes include defecation frequency, caecal intubation rate, adenoma detection rate and colonoscope insertion time and withdrawal time. The tertiary outcomes include complications of colonoscopy, adverse events and degree of comfort, which is evaluated via a self-designed questionnaire of comfort.

Ethics and dissemination
The research will be conducted according to Good Clinical Practice principles. Ethical approval has been obtained from the Ethics Committee of Beijing Shijitan Hospital, Capital Medical University (IIT2024-146-003). Study findings will be published in peer-reviewed journals.

Trial registration number
ChiCTR2500096394.

Colonoscopy is expected to reduce colorectal cancer (CRC) incidence in Lynch syndrome (LS) by detecting and removing adenomas. The existence of gene-specific differences in adenoma detection has been proposed yet remains insufficiently explored. This study aims to elucidate gene-specific adenoma detection rates and their association with post-colonoscopy CRC (PCCRC), which stands as an important issue in LS surveillance.

This review explores the transformative potential of artificial intelligence in the diagnosis and management of biliopancreatic disorders. By leveraging cutting-edge techniques such as deep learning and convolutional neural networks, artificial intelligence has significantly advanced gastroenterology, particularly in endoscopic procedures such as colonoscopy, upper endoscopy, and capsule endoscopy. These applications enhance adenoma detection rates, and improve lesion characterization and diagnostic accuracy.

We read with great interest the study by O’Sullivan et al,1 examining the technical and procedural outcomes of Cold Endoscopic Mucosal Resection (C-EMR) versus Hot EMR (H-EMR). We congratulate the authors for conducting this important research, which adds valuable information to the body of knowledge guiding our choice of the optimal treatment modality for large, benign colorectal polyps. However, we would like to address several points. First, readers should be aware that this study focuses on a highly selected group of large non-pedunculated colon polyps (LNPCPs) as only 20% of referred lesions during the study period of 4 years met the inclusion criteria, being flat lesions of 15–50 mm, without macronodule, depressed area or optical suspicion of submucosal invasive cancer (SMIC). Despite this selection, 2.2% unrecognised SMIC was found, all of which were not curatively treated by piecemeal resection and required additional surgery. This underscores the relative performance…

Colonoscopy, a crucial procedure for detecting and removing colorectal polyps, has seen transformative advancements through the integration of Artificial Intelligence (AI), specifically in Computer-Aided Detection (CADe) and Diagnosis (CADx). These tools enhance real-time detection and characterization of lesions, potentially reducing human error, and standardizing the quality of colonoscopy across endoscopists. CADe has proven effective in increasing adenoma detection rate, potentially reducing long-term colorectal cancer incidence.

Objective
Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA.

Design
Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded. All remaining cases as well as a subgroup of them, after propensity-score matching (nearest-neighbour-method) based on age, gender, anthropometrics, comorbidities, size and histological subtype, were analysed. The median follow-up was 21 months (IQR 10–47) after the primary intervention. Primary outcomes were rates of complete resection (R0) and complications. Groups were compared by Fisher’s exact or 2 test, Mann-Whitney-U-test and log-rank test for survival.

Results
Of 1673 patients in the database, 1422 underwent EP and 251 TSA. Of them, 23.2% were excluded for missing or inconclusive data and 19.8% of patients for prior interventions or hereditary syndromes. Final histology showed in 24.2% of EP and 14.8% of TSA patients a histology other than adenoma or adenocarcinoma while advanced cancers were recorded in 10.9% of EP and 36.6% of TSA patients. Finally, 569 EP and 63 TSA were included in the overall analysis, with a higher rate of more advanced cases and higher R0 resection rates in the TSA groups (90.5% vs 73.1%; p

Gastroenterologists are required to interpret visual data during endoscopy and make clinical decisions based on this data in real time. Room lighting is a key factor that affects this complex task. Hoff et al demonstrated that room light conditions affect the adenoma detection rate in screening colonoscopies.1 However, lighting remains a relatively unexplored feature of gastrointestinal (GI) endoscopy.

This observational study investigates the association of adenoma detection rates among physicians who perform colonoscopy and postcolonoscopy colorectal cancer incidence.