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An editorial is presented which discusses about the colorectal polyps during endoscopy, the difference of endoscopists and pathologists, communication between the two departments and the verification of adenomatous polyps by gastroenterologists.

Background and study aims: In order to reduce time, costs, and risks associated with resection of diminutive colorectal polyps, the American Society for Gastrointestinal Endoscopy (ASGE) recently proposed performance thresholds that new technologies should meet for the accurate real-time assessment of histology of colorectal polyps. In this study, we prospectively assessed whether laser-induced fluorescence spectroscopy (LIFS), using the new WavSTAT4 optical biopsy system, can meet the ASGE criteria. Patients and methods: 27 patients undergoing screening or surveillance colonoscopy were included. The histology of 137 diminutive colorectal polyps was predicted in real time using LIFS and findings were compared with the results of conventional histopathological examination. The accuracy of predicting polyp histology with WavSTAT4 was assessed according to the ASGE criteria. Results: The overall accuracy of LIFS using WavSTAT4 for predicting polyp histology was 84.7 % with sensitivity, specificity, and negative predictive value (NPV) of 81.8 %, 85.2 %, and 96.1 %. When only distal colorectal diminutive polyps were considered, the NPV for excluding adenomatous histology increased to 100 % (accuracy 82.4 %, sensitivity 100 %, specificity 80.6 %). On-site, LIFS correctly predicted the recommended surveillance intervals with an accuracy of 88.9 % (24/27 patients) when compared with histology-based United States guideline recommendations; in the 3 patients for whom LIFS- and histopathology-based recommended surveillance intervals differed, LIFS predicted shorter surveillance intervals. Conclusions: From the data of this pilot study, LIFS using the WavSTAT4 system appears accurate enough to allow distal colorectal polyps to be left in place and nearly reaches the threshold to “resect and discard” them without pathologic assessment. WavSTAT4 therefore has the potential to reduce costs and risks associated with the removal of diminutive colorectal polyps. [ABSTRACT FROM AUTHOR]

Background and study aim: The differential diagnosis of ulcerative colitis from Crohn's disease is of pivotal importance for the management of inflammatory bowel diseases, as both entities involve specific therapeutic management strategies. Confocal laser endomicroscopy (CLE) allows on-demand, in vivo characterization of architectural and cellular details during endoscopy. The aim of this study was to assess the efficacy of CLE to differentiate between ulcerative colitis and Crohn's disease. Patients and methods: This was a prospective study involving consecutive patients with a wellestablished diagnosis of ulcerative colitis or Crohn's disease who underwent colonoscopy with fluorescein-aided confocal imaging. Results: Overall, 79 patients were included (40 Crohn's disease, 39 ulcerative colitis). CLE findings in patients with Crohn's disease, showed significantly more discontinuous inflammation (87.5% vs. 5.1 %), focal cryptitis (75.0% vs. 12.8 %), and discontinuous crypt architectural abnormality (87.5% vs. 10.3 %) than in ulcerative colitis (P<0.0001). Conversely, ulcerative colitis was associated with severe, widespread crypt distortion (87.2% vs. 17.5% in Crohn's disease), decreased crypt density (79.5% vs. 22.5 %), and frankly irregular surface (89.7% vs. 17.5 %; P<0.0001 for all comparisons). Statistically significant differences were not seen for heavy, diffuse lamina propria cell increase or mucin preservation. No granulomas were visible. Based on these findings, a CLE scoring system was developed that revealed excellent accuracy (93.7 %) when compared with the historical clinical diagnosis and the histopathological gold standard. Conclusions: CLE could visualize several disease specific microscopic features, which are conventionally used in standard histopathology to differentiate between ulcerative colitis and Crohn's disease. However, because of the limited penetration depth of CLE, submucosal details or granulomas were not visible. The new scoring system may allow in vivo diagnosis of ulcerative colitis or Crohn's disease. [ABSTRACT FROM AUTHOR]

The article discusses the safety, importance, and limitations of standard endoscopy for the diagnosis and treatment of inflammatory bowel. The researchers have evaluated the medical appliances used in patients for colonoscopy in colorectal cancer screening, polyp surveillance, and diagnostic evaluation. The findings indicate potential limitations such as non-randomized approach, no comparison in forward viewing, and limited sampling size.

The Clutch Cutter is a forceps-type resection device with a serrated cutting edge that allows simultaneous grasping and cutting or coagulating of tissue. Next, granulomatous tissue was grasped with the opened Clutch Cutter and, with tissue inside the forceps, the Clutch Cutter was gently pulled back in order to avoid cutting too deep (Video 1). [Extracted from the article]

The article discusses research being done on confocal laser endomicroscopy (CLE). It references the study "Confocal Laser Endomicroscopy: A Novel Method for Prediction of Relapse in Crohn's Disease," by J. G. Karstensen et al. in the 2016 issue. Topics addressed include the use of CLE with fluorescein in the colon and ileum, the heterogeneity of the Crohn's disease population, and the efficacy of using CLE in patients with inflammatory bowel diseases (IBD).

The article presents a case study of an 85-year-old man under contrast-enhanced computed tomography scan with hepatic artery proper partially thrombotic aneurysm. The study discusses resection for the patient, but not into feasibility due to cardiovascular co-morbidity. Also mentioned is the planned biliary tract decompression through endoscopic retrograde cholangiopancreatography.

The article discusses a case study of a 62-year-old man who was taken to the hospital for colonoscopy because of abdominal pain and melena. The patient underwent diagnostic colonoscopy during which a perforation ostium was examined in the sigmoid followed by the treatment of Over-The-Scope-Clip (OTSC) system. The patient was later diagnosed of the small-bowel fixation and pneumoperitoneum as the outcome of the unsuccessful use of the OTSC.

The article discusses a case study of a 41-year-old man who was admitted due to postprandial abdominal pain, diarrhea and reduced physical activity. The diagnosis and evaluation of gastrointestinally mediated allergy by double-balloon enteroscopy is highlighted. Endscopic and enteroscopic images of the ileum and intestine are presented.

The article presents a case study of a 64-year-oldman presented with abdominal pain, anemia and positive hemocult. The patient was diagnosed with small-bowel diverticulosis using On Demand Enteroscopy (ODE) technique. The topics discussed include endoscopic imagining methods, mucosal atrophy and anemia.