The Endoscopy News Podcast

Srisha Hebbar and Peter Siersema challenge my prejudices and suggest that endoscopy can help patients with colonic lipomas and local recurrence after chemo-radiotherapy, two relatively uncommon conditions.  They both make convincing arguments!  Srisha has also uploaded a video to explain how to safely deal with colonic lipomas.  Of course, the video and references are available on the website  

This week Nick Burr and Bjorn Rembacken are discussing the bright new world of molecular screening for occult cancers as the NHS starts screening for more than 50 cancers.  This summer the “Galleri blood test”, developed by an American company called ‘GRAIL’ will be piloted on 140.000 healthy people in the UK.  

Naturally, Bjorn remains sceptical, and after an unsuccessful search for the ‘study aims’, asks if getting a positive result always mean that the cancer is treatable?  Furthermore, how do you tell the difference between a true positive and a false positive? 

Surprisingly, we are also standing up for the effectiveness of CTC and wonder why an American study reports such shockingly poor results. 

The BSG Campus 2021 was a great success with nine half days of Gastroenterology news, 700 abstracts and 1400 delegates taking part.  The podcasts gives you a 30 minute update on Endoscopy related news and research from the Campus meeting.  A transcript and full list of references will be published on the www.friendsofendoscopy.org website 

Professor Mark Pritchard, has a simple plea; when you are dealing with gastric NET's, make sure that you know what you are doing!  In this Podcast he highlights the pitfalls and provides us with Endoscopy Gold !!! 

There have been some recent developments shedding welcome light on the issue of cancer in colitis.  We take a closer look at the papers and have a chat with Lauranne Derikx about her recent GIE publication.  To my surprise, I find that my long lamented 'cancer field theory' is very much alive !  

References 

■ de Jong ME, van Tilburg SB, Nissen LHC et.al. Long-term Risk of advanced Neoplasia after finding LGD in pts with IBD - A Nationwide Cohort Study. Journal of Crohn's and Colitis 2019;1485-91.

■ de Jong ME, Kanne H, Nissen LHC et.al. Increased risk of HGD and CRC in IBD patients with recurrent LGD. GIE 2020;91:1334-42.

Jamal Al-Asiry (Wakefield), Mo Thoufeeq (Sheffield), Pradeep Mundre (Bradford) and Nick Burr, (Endoscopy Fellow at Leeds) Battle it out at this Years Leeds Endoscopy Christmas Quiz !  Ten Questions, 3 answer options and 1 correct answer. 

Arguably, the most exciting thing which has happen in ERCP, in the last 50 years, is EUS and the development of easy to place, 'lumen apposing metal stents' (LAMS).  It's transforming ERCP for the benefits of patients who no longer need to put up with painful PTC's.  Ideally, every region should offer this service but who should be referred for EUS-guided biliary drainage (EUS-BD) and what risks should you quote to your patients?  Monz Ahmed poses some probing questions to Bharat Paranandi and Aaron On in Leeds. 

The UK 'National Endoscopy Database' (NED)  is set to be the largest Endoscopy Dataset in the World.  In theory, it should capture information on every single endoscopy carried out in the UK, providing detailed, up-to-the minute information.  Matt Rutter has been there from the start and tells us about it's origins, current challenges and future hopes. 

Today we are reporting on the 'FLIP device' and give you an update on the likely aetiology of achalasia. 

There have been studies on 'motorised spiral enteroscopy'. Is a motor really a good thing inside the small bowel? 

We are surprised to see a complete turnaround in the recommendations from Sheffield on how to diagnose Coeliac disease ! 

Sadly, surveillance in patients with MUTyH related polyposis doesn't seem to save lives. 

Should we all start doing 'full thickness' colonic resections?  I urge caution!  

Finally, there have been some good news and some bad news on the topic of emergency GI bleeding ...

References:

1. Savarino E. T Use of the Functional Lumen Imaging Probe.  American Journal of Gastroenterology 2020;115(11):1786-96

Today I am talking to Dr Nick Burr, one of our Rising Stars in Gastroenterology, working in Leeds.  You may recognise his name from some of the most influential papers written on the topic of ADR and PCCRC in the recent past.  I’ve decided to ambush him with some difficult questions about our unhealthy obsession with ADR and see if I can convince him that the PCRCR rate is irrelevant to individual colonoscopists.  

1. Karminski MF. Quality Indicators for Colonoscopy and the Risk of Interval Cancer. NEJM 2010;362:1795-803