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Mistakes in polypectomy and how to avoid them

David James Tate, Lynn Debels

Summary

AI Generated

An article on mistakes in polypectomy discusses best practices in colorectal polypectomy to guide training priorities for both trainees and established practitioners.

  • The article addresses best practice in colorectal polypectomy.
  • The content can guide training priorities among trainees and established endoscopic practitioners.
  • Complete resection of polyps is identified as a component of polypectomy quality that emphasizes the preventive effects of the procedure.
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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Winawer SJ, Zauber AG, Ho MN, et al. Prevention of Colorectal Cancer by Colonoscopic Polypectomy. New England Journal of Medicine 1993. [Link]
2.
Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine 2012; 366(8): 687-96. [Link]
3.
Anderson R, Burr NE, Valori R. Causes of Post-Colonoscopy Colorectal Cancers Based on World Endoscopy Organization System of Analysis. Gastroenterology 2020; 158(5): 1287--99.e2. [Link]
4.
Pohl H, Srivastava A, Bensen SP, et al. Incomplete polyp resection during colonoscopy - Results of the complete adenoma resection (CARE) study. Gastroenterology 2013; 144(1): 74--80.e1. [Link]
5.
Waschke KA, Anderson J, Valori RM, et al. ASGE principles of endoscopic training. Gastrointest Endosc 2019; 90(1): 27-34. [Link]
6.
Jegadeesan R, Aziz M, Desai M, et al. Hot snare vs. cold snare polypectomy for endoscopic removal of 4 - 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies. Endoscopy international open 2019; 7(5): E708--E16. [Link]
7.
Qu J, Jian H, Li L, et al. Effectiveness and safety of cold versus hot snare polypectomy: A meta-analysis. Journal of Gastroenterology and Hepatology (Australia) 2019; 34(1): 49-58. [Link]
8.
Kawamura T, Takeuchi Y, Asai S, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018; 67(11): 1950-7. [Link]
9.
Rodríguez Sánchez J, Sánchez Alonso M, Pellisé Urquiza M. The 'bubble sign': a novel way to detect a perforation after cold snare polypectomy. Endoscopy 2019; 51(8): 796-7. [Link]
10.
Tate DJ, Desomer L, Heitman SJ, et al. Clinical implications of decision making in colorectal polypectomy: an international survey of Western endoscopists suggests priorities for change. Endoscopy international open 2020; 8(3): E445--E55. [Link]
11.
Schett B, Wallner J, Weingart V, et al. Efficacy and safety of cold snare resection in preventive screening colonoscopy. Endoscopy International Open 2017; 5(7): E580--E6. [Link]
12.
Paspatis GA, Tribonias G, Konstantinidis K, et al. A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of postpolypectomy bleeding in small colonic polyps. Colorectal Dis 2011; 13(10): e345-8. [Link]
13.
Sidhu M, Forbes N, Tate DJ, et al. A Randomized Controlled Trial of Cold Snare Polypectomy Technique: Technique Matters More Than Snare Wire Diameter. Am J Gastroenterol 2022; 117(1): 100. [Link]
14.
Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49(03): 270-97. [Link]
15.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice demonstration of cold snare polypectomy; [starts at Chapter 4]. Available from https://www.gieqs.com/login?destination=viewvideo&videoid=704&chapternumber=4 [Link]
16.
Repici A, Hassan C, Vitetta E, et al. Safety of cold polypectomy for <10mm polyps at colonoscopy: a prospective multicenter study. Endoscopy 2012; 44(1): 27-31 [Link]
17.
Moss A, Bourke MJ, Williams SJ, et al. Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia. Gastroenterology 2011; 140(7): 1909-18. [Link]
18.
Moss A, Williams SJ, Hourigan LF, et al. Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut 2015; 64(1): 57-65. [Link]
19.
Peery AF, Cools KS, Strassle PD, et al. Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States. Gastroenterology 2018; 154(5): 1352--60.e3. [Link]
20.
Bahin FF, Heitman SJ, Bourke MJ. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2019; 68(6): 1130. [Link]
21.
Adler J, Robertson DJ. Interval Colorectal Cancer After Colonoscopy: Exploring Explanations and Solutions. American Journal of Gastroenterology 2015; 110(12): 1657--64-- quiz 65. [Link]
22.
Kudo S-e, Tamura S, Nakajima T, Yamano H-o, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointestinal Endoscopy 1996; 44(1): 8-14. [Link]
23.
Sano Y, Tanaka S, Kudo S-e, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Digestive Endoscopy 2016; 28(5): 526-33. [Link]
24.
Hewett DG, Kaltenbach T, Sano Y, et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143(3): 599--607 e1. [Link]
25.
Debels L, Tate DJ. The Accuracy of Human Detection Of Submucosal Invasive Cancer - Analysis of 739 Individual Assessments of Large Non-Pedunculated Colorectal Polyps (LNPCPS) using a Novel Clinical Decision Support Tool. United European Gastroenterology Journal 2021; 9(10): 1197-221. [Link]
26.
Burgess NG, Hourigan LF, Zanati SA, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017. [Link]
27.
Tate DJ. GIEQs Prediction tool for Submucosal Invasion. https://www.gieqs.com/smi. [Link]
28.
Bahin FF, Heitman SJ, Bourke MJ, et al. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2018; 67(11): 1965-73. [Link]
29.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Imaging of Colorectal Polyps Online Course covering many aspects of how to detect cancer within colorectal polyps. Available from: https://www.gieqs.com/login?destination=viewasset&assetid=14 [Link]
30.
Dekker E, Houwen B, Puig I, et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52(10): C10. [Link]
31.
Gupta S, Miskovic D, Bhandari P, et al. A novel method for determining the difficulty of colonoscopic polypectomy. Frontline Gastroenterology 2013; 4(4): 244-8. [Link]
32.
Sidhu M, Tate DJ, Desomer L, et al. The size, morphology, site, and access score predicts critical outcomes of endoscopic mucosal resection in the colon. Endoscopy 2018; 50(7): 684-92. [Link]
33.
Anderson J, Lockett M. Training in therapeutic endoscopy: meeting present and future challenges. Frontline Gastroenterology 2019; 10(2): 135-40. [Link]
34.
Sidhu M, Tate DJ, Desomer L, et al. SMSA-EMR score is a novel endoscopic risk assessment tool for predicting critical endoscopic mucosal resection outcomes Gastrointestinal endoscopy 2018; 87(6): AB467--AB8 [Link]
35.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Lecture regarding competency in Polypectomy covering SMSA and SMSA+ scores in practice; [starts at Chapter 17]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=696&chapternumber=17. [Link]
36.
Tate DJ, Desomer L, Hourigan LF, Moss A, Singh R, Bourke MJ. Two-stage endoscopic mucosal resection is a safe and effective salvage therapy after a failed single-session approach. Endoscopy 2017; 49(9): 888-98. [Link]
37.
Tate DJ, Bahin FF, Desomer L, Sidhu M, Gupta V, Bourke MJ. Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) is an effective and safe strategy for the management of non-lifting large laterally spreading colonic lesions. Endoscopy 2018; 50(1): 52-62. [Link]
38.
Uraoka T, Saito Y, Ikematsu H, Yamamoto K, Sano Y. Sano's capillary pattern classification for narrow-band imaging of early colorectal lesions. Dig Endosc 2011; 23 Suppl 1: 112-5. [Link]
39.
Tate DJ, Sidhu M, Bar-Yishay I, et al. Impact of en bloc resection on long-term outcomes after endoscopic mucosal resection: a matched cohort study. 2020. [Link]
40.
Klein A, Tate DJ, Jayasekeran V, et al. Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection. Gastroenterology 2019; 156(3): 604--13.e3 [Link]
41.
Sidhu M, Shahidi N, Gupta S, et al. Outcomes of Thermal Ablation of the Mucosal Defect Margin After Endoscopic Mucosal Resection: A Prospective, International, Multicenter Trial of 1000 Large Nonpedunculated Colorectal Polyps. Gastroenterology 2021; 161(1): 163--70.e3. [Link]
42.
The Gastrointestinal Endoscopy Quality and Safety (GIEQs) Foundation T, D. J. GIEQs Online. 2021. https://gieqs.com/online. [Link]
43.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice endoscopic mucosal resection. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692 [Link]
44.
Dobrowolski S, Dobosz M, Babicki A, Głowacki J, Nałęcz A. Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy. Gastrointestinal endoscopy 2006; 63(7): 1004-9. [Link]
45.
Kim HS, Kim TI, Kim WH, et al. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol 2006; 101(6): 1333-41. [Link]
46.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Mechanical ligation for pedunculated colonic polyps. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=144 [Link]
47.
ERBE Elektromedizin GmbH, Waldhörnlestraße 17, 72072 Tübingen, Germany. Mail: info@erbe-med.com, Website:[Link]
48.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Assessing the mucosal defect after colorectal polypectomy. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=715 [Link]
49.
Bahin FF, Naidoo M, Williams SJ, et al. Prophylactic endoscopic coagulation to prevent bleeding after wide-field endoscopic mucosal resection of large sessile colon polyps. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2015; 13(4): 722-4. [Link]
50.
Bahin FF, Rasouli KN, Byth K, et al. Prediction of Clinically Significant Bleeding Following Wide-Field Endoscopic Resection of Large Sessile and Laterally Spreading Colorectal Lesions: A Clinical Risk Score. American Journal of Gastroenterology 2016; 111(8): 1115-22. [Link]
51.
Burgess NG, Bassan MS, McLeod D, Williams SJ, Byth K, Bourke MJ. Deep mural injury and perforation after colonic endoscopic mucosal resection: a new classification and analysis of risk factors. Gut 2016. [Link]
52.
Gupta S, Sidhu M, Shahidi N, et al. Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial. Lancet Gastroenterol Hepatol 2022; 7(2): 152-60. [Link]
53.
Pohl H, Grimm IS, Moyer MT, et al. Clip Closure Prevents Bleeding After Endoscopic Resection of Large Colon Polyps in a Randomized Trial. Gastroenterology 2019; 157(4): 977-84.e3. [Link]
54.
Hassan C, Repici A, Sharma P, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 2015; 65(5): 806-20. [Link]
55.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice in application of thermal ablation to the post-polypectomy defect margin; [starts at Chapter 2]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692&chapternumber=2 [Link]
56.
Hassan C, Antonelli G, Dumonceau J-M, et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy 2020; 52(8): 687-700. [Link]
57.
Gupta S, Lieberman D, Anderson JC, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115(3): 415-34. [Link]
58.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. How to identify an endoscopic resection scar. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=492 [Link]
59.
Desomer L, Tutticci N, Tate DJ, Williams SJ, McLeod D, Bourke MJ. A standardized imaging protocol is accurate in detecting recurrence after EMR. Gastrointestinal endoscopy 2016. [Link]
60.
Pellise M, Desomer L, Burgess NG, et al. The influence of clips on scars after EMR: clip artifact. Gastrointestinal endoscopy 2016;83(3):608-616. [Link]
61.
Mbbs GS, Mph KCVM, Md DKR, Sreepati G, Vemulapalli KC, Rex DK. Clip artifact after closure of large colorectal EMR sites: incidence and recognition. Gastrointestinal endoscopy 2015; 82(2): 344-9. [Link]

Abstract

The Mistakes in polypectomy article discusses the best practice in colorectal polypectomy, which can guide training priorities among trainees and established endoscopic practitioners. The quality of polypectomy, the complete resection of polyps, plays a role in emphasizing the preventive effects of the procedure.


Topics

Digestive Oncology Endoscopy

Citation

Tate D. J and Debels L. Mistakes in polypectomy and how to avoid them. UEG Education 2022; 22: 29–35.

Published

2022

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Winawer SJ, Zauber AG, Ho MN, et al. Prevention of Colorectal Cancer by Colonoscopic Polypectomy. New England Journal of Medicine 1993. [Link]
2.
Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine 2012; 366(8): 687-96. [Link]
3.
Anderson R, Burr NE, Valori R. Causes of Post-Colonoscopy Colorectal Cancers Based on World Endoscopy Organization System of Analysis. Gastroenterology 2020; 158(5): 1287--99.e2. [Link]
4.
Pohl H, Srivastava A, Bensen SP, et al. Incomplete polyp resection during colonoscopy - Results of the complete adenoma resection (CARE) study. Gastroenterology 2013; 144(1): 74--80.e1. [Link]
5.
Waschke KA, Anderson J, Valori RM, et al. ASGE principles of endoscopic training. Gastrointest Endosc 2019; 90(1): 27-34. [Link]
6.
Jegadeesan R, Aziz M, Desai M, et al. Hot snare vs. cold snare polypectomy for endoscopic removal of 4 - 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies. Endoscopy international open 2019; 7(5): E708--E16. [Link]
7.
Qu J, Jian H, Li L, et al. Effectiveness and safety of cold versus hot snare polypectomy: A meta-analysis. Journal of Gastroenterology and Hepatology (Australia) 2019; 34(1): 49-58. [Link]
8.
Kawamura T, Takeuchi Y, Asai S, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018; 67(11): 1950-7. [Link]
9.
Rodríguez Sánchez J, Sánchez Alonso M, Pellisé Urquiza M. The 'bubble sign': a novel way to detect a perforation after cold snare polypectomy. Endoscopy 2019; 51(8): 796-7. [Link]
10.
Tate DJ, Desomer L, Heitman SJ, et al. Clinical implications of decision making in colorectal polypectomy: an international survey of Western endoscopists suggests priorities for change. Endoscopy international open 2020; 8(3): E445--E55. [Link]
11.
Schett B, Wallner J, Weingart V, et al. Efficacy and safety of cold snare resection in preventive screening colonoscopy. Endoscopy International Open 2017; 5(7): E580--E6. [Link]
12.
Paspatis GA, Tribonias G, Konstantinidis K, et al. A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of postpolypectomy bleeding in small colonic polyps. Colorectal Dis 2011; 13(10): e345-8. [Link]
13.
Sidhu M, Forbes N, Tate DJ, et al. A Randomized Controlled Trial of Cold Snare Polypectomy Technique: Technique Matters More Than Snare Wire Diameter. Am J Gastroenterol 2022; 117(1): 100. [Link]
14.
Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49(03): 270-97. [Link]
15.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice demonstration of cold snare polypectomy; [starts at Chapter 4]. Available from https://www.gieqs.com/login?destination=viewvideo&videoid=704&chapternumber=4 [Link]
16.
Repici A, Hassan C, Vitetta E, et al. Safety of cold polypectomy for <10mm polyps at colonoscopy: a prospective multicenter study. Endoscopy 2012; 44(1): 27-31 [Link]
17.
Moss A, Bourke MJ, Williams SJ, et al. Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia. Gastroenterology 2011; 140(7): 1909-18. [Link]
18.
Moss A, Williams SJ, Hourigan LF, et al. Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut 2015; 64(1): 57-65. [Link]
19.
Peery AF, Cools KS, Strassle PD, et al. Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States. Gastroenterology 2018; 154(5): 1352--60.e3. [Link]
20.
Bahin FF, Heitman SJ, Bourke MJ. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2019; 68(6): 1130. [Link]
21.
Adler J, Robertson DJ. Interval Colorectal Cancer After Colonoscopy: Exploring Explanations and Solutions. American Journal of Gastroenterology 2015; 110(12): 1657--64-- quiz 65. [Link]
22.
Kudo S-e, Tamura S, Nakajima T, Yamano H-o, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointestinal Endoscopy 1996; 44(1): 8-14. [Link]
23.
Sano Y, Tanaka S, Kudo S-e, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Digestive Endoscopy 2016; 28(5): 526-33. [Link]
24.
Hewett DG, Kaltenbach T, Sano Y, et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143(3): 599--607 e1. [Link]
25.
Debels L, Tate DJ. The Accuracy of Human Detection Of Submucosal Invasive Cancer - Analysis of 739 Individual Assessments of Large Non-Pedunculated Colorectal Polyps (LNPCPS) using a Novel Clinical Decision Support Tool. United European Gastroenterology Journal 2021; 9(10): 1197-221. [Link]
26.
Burgess NG, Hourigan LF, Zanati SA, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017. [Link]
27.
Tate DJ. GIEQs Prediction tool for Submucosal Invasion. https://www.gieqs.com/smi. [Link]
28.
Bahin FF, Heitman SJ, Bourke MJ, et al. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2018; 67(11): 1965-73. [Link]
29.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Imaging of Colorectal Polyps Online Course covering many aspects of how to detect cancer within colorectal polyps. Available from: https://www.gieqs.com/login?destination=viewasset&assetid=14 [Link]
30.
Dekker E, Houwen B, Puig I, et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52(10): C10. [Link]
31.
Gupta S, Miskovic D, Bhandari P, et al. A novel method for determining the difficulty of colonoscopic polypectomy. Frontline Gastroenterology 2013; 4(4): 244-8. [Link]
32.
Sidhu M, Tate DJ, Desomer L, et al. The size, morphology, site, and access score predicts critical outcomes of endoscopic mucosal resection in the colon. Endoscopy 2018; 50(7): 684-92. [Link]
33.
Anderson J, Lockett M. Training in therapeutic endoscopy: meeting present and future challenges. Frontline Gastroenterology 2019; 10(2): 135-40. [Link]
34.
Sidhu M, Tate DJ, Desomer L, et al. SMSA-EMR score is a novel endoscopic risk assessment tool for predicting critical endoscopic mucosal resection outcomes Gastrointestinal endoscopy 2018; 87(6): AB467--AB8 [Link]
35.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Lecture regarding competency in Polypectomy covering SMSA and SMSA+ scores in practice; [starts at Chapter 17]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=696&chapternumber=17. [Link]
36.
Tate DJ, Desomer L, Hourigan LF, Moss A, Singh R, Bourke MJ. Two-stage endoscopic mucosal resection is a safe and effective salvage therapy after a failed single-session approach. Endoscopy 2017; 49(9): 888-98. [Link]
37.
Tate DJ, Bahin FF, Desomer L, Sidhu M, Gupta V, Bourke MJ. Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) is an effective and safe strategy for the management of non-lifting large laterally spreading colonic lesions. Endoscopy 2018; 50(1): 52-62. [Link]
38.
Uraoka T, Saito Y, Ikematsu H, Yamamoto K, Sano Y. Sano's capillary pattern classification for narrow-band imaging of early colorectal lesions. Dig Endosc 2011; 23 Suppl 1: 112-5. [Link]
39.
Tate DJ, Sidhu M, Bar-Yishay I, et al. Impact of en bloc resection on long-term outcomes after endoscopic mucosal resection: a matched cohort study. 2020. [Link]
40.
Klein A, Tate DJ, Jayasekeran V, et al. Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection. Gastroenterology 2019; 156(3): 604--13.e3 [Link]
41.
Sidhu M, Shahidi N, Gupta S, et al. Outcomes of Thermal Ablation of the Mucosal Defect Margin After Endoscopic Mucosal Resection: A Prospective, International, Multicenter Trial of 1000 Large Nonpedunculated Colorectal Polyps. Gastroenterology 2021; 161(1): 163--70.e3. [Link]
42.
The Gastrointestinal Endoscopy Quality and Safety (GIEQs) Foundation T, D. J. GIEQs Online. 2021. https://gieqs.com/online. [Link]
43.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice endoscopic mucosal resection. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692 [Link]
44.
Dobrowolski S, Dobosz M, Babicki A, Głowacki J, Nałęcz A. Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy. Gastrointestinal endoscopy 2006; 63(7): 1004-9. [Link]
45.
Kim HS, Kim TI, Kim WH, et al. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol 2006; 101(6): 1333-41. [Link]
46.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Mechanical ligation for pedunculated colonic polyps. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=144 [Link]
47.
ERBE Elektromedizin GmbH, Waldhörnlestraße 17, 72072 Tübingen, Germany. Mail: info@erbe-med.com, Website:[Link]
48.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Assessing the mucosal defect after colorectal polypectomy. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=715 [Link]
49.
Bahin FF, Naidoo M, Williams SJ, et al. Prophylactic endoscopic coagulation to prevent bleeding after wide-field endoscopic mucosal resection of large sessile colon polyps. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2015; 13(4): 722-4. [Link]
50.
Bahin FF, Rasouli KN, Byth K, et al. Prediction of Clinically Significant Bleeding Following Wide-Field Endoscopic Resection of Large Sessile and Laterally Spreading Colorectal Lesions: A Clinical Risk Score. American Journal of Gastroenterology 2016; 111(8): 1115-22. [Link]
51.
Burgess NG, Bassan MS, McLeod D, Williams SJ, Byth K, Bourke MJ. Deep mural injury and perforation after colonic endoscopic mucosal resection: a new classification and analysis of risk factors. Gut 2016. [Link]
52.
Gupta S, Sidhu M, Shahidi N, et al. Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial. Lancet Gastroenterol Hepatol 2022; 7(2): 152-60. [Link]
53.
Pohl H, Grimm IS, Moyer MT, et al. Clip Closure Prevents Bleeding After Endoscopic Resection of Large Colon Polyps in a Randomized Trial. Gastroenterology 2019; 157(4): 977-84.e3. [Link]
54.
Hassan C, Repici A, Sharma P, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 2015; 65(5): 806-20. [Link]
55.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice in application of thermal ablation to the post-polypectomy defect margin; [starts at Chapter 2]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692&chapternumber=2 [Link]
56.
Hassan C, Antonelli G, Dumonceau J-M, et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy 2020; 52(8): 687-700. [Link]
57.
Gupta S, Lieberman D, Anderson JC, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115(3): 415-34. [Link]
58.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. How to identify an endoscopic resection scar. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=492 [Link]
59.
Desomer L, Tutticci N, Tate DJ, Williams SJ, McLeod D, Bourke MJ. A standardized imaging protocol is accurate in detecting recurrence after EMR. Gastrointestinal endoscopy 2016. [Link]
60.
Pellise M, Desomer L, Burgess NG, et al. The influence of clips on scars after EMR: clip artifact. Gastrointestinal endoscopy 2016;83(3):608-616. [Link]
61.
Mbbs GS, Mph KCVM, Md DKR, Sreepati G, Vemulapalli KC, Rex DK. Clip artifact after closure of large colorectal EMR sites: incidence and recognition. Gastrointestinal endoscopy 2015; 82(2): 344-9. [Link]

Abstract

Barrett’s oesophagus is the precursor to oesophageal adenocarcinoma, which carries a poor prognosis, and it is likely that all endoscopists and gastroenterologists will encounter Barrett’s oesophagus in their clinical practice. Careful assessment and management of patients who have Barrett’s oesophagus with endoscopic surveillance and endoscopic endotherapy aim to reduce the risk of progression to invasive adenocarcinoma. Advances in endoscopic diagnosis and therapy should, therefore, help to reduce the risk of progression. As with all premalignant conditions and surveillance programmes, careful multidisciplinary management of the patient is important to reduce the risk of causing them to become unduly concerned. Here, we present some mistakes that in our experience are commonly made in the endoscopic diagnosis and management of Barrett’s oesophagus and give advice on how to avoid them. 

Topics

Endoscopy Oesophagus

Citation

Haidry RJ and Magee C. Mistakes in the endoscopic diagnosis and management of Barrett’s oesophagus and how to avoid them. UEG Education 2018; 2018: 12–14.

Published

2024

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UEG Mistakes In Articles
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Mistakes in newly diagnosed Crohn's disease and how to avoid them

Joana Roseira, Nurulamin Noor

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Winawer SJ, Zauber AG, Ho MN, et al. Prevention of Colorectal Cancer by Colonoscopic Polypectomy. New England Journal of Medicine 1993. [Link]
2.
Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine 2012; 366(8): 687-96. [Link]
3.
Anderson R, Burr NE, Valori R. Causes of Post-Colonoscopy Colorectal Cancers Based on World Endoscopy Organization System of Analysis. Gastroenterology 2020; 158(5): 1287--99.e2. [Link]
4.
Pohl H, Srivastava A, Bensen SP, et al. Incomplete polyp resection during colonoscopy - Results of the complete adenoma resection (CARE) study. Gastroenterology 2013; 144(1): 74--80.e1. [Link]
5.
Waschke KA, Anderson J, Valori RM, et al. ASGE principles of endoscopic training. Gastrointest Endosc 2019; 90(1): 27-34. [Link]
6.
Jegadeesan R, Aziz M, Desai M, et al. Hot snare vs. cold snare polypectomy for endoscopic removal of 4 - 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies. Endoscopy international open 2019; 7(5): E708--E16. [Link]
7.
Qu J, Jian H, Li L, et al. Effectiveness and safety of cold versus hot snare polypectomy: A meta-analysis. Journal of Gastroenterology and Hepatology (Australia) 2019; 34(1): 49-58. [Link]
8.
Kawamura T, Takeuchi Y, Asai S, et al. A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study). Gut 2018; 67(11): 1950-7. [Link]
9.
Rodríguez Sánchez J, Sánchez Alonso M, Pellisé Urquiza M. The 'bubble sign': a novel way to detect a perforation after cold snare polypectomy. Endoscopy 2019; 51(8): 796-7. [Link]
10.
Tate DJ, Desomer L, Heitman SJ, et al. Clinical implications of decision making in colorectal polypectomy: an international survey of Western endoscopists suggests priorities for change. Endoscopy international open 2020; 8(3): E445--E55. [Link]
11.
Schett B, Wallner J, Weingart V, et al. Efficacy and safety of cold snare resection in preventive screening colonoscopy. Endoscopy International Open 2017; 5(7): E580--E6. [Link]
12.
Paspatis GA, Tribonias G, Konstantinidis K, et al. A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of postpolypectomy bleeding in small colonic polyps. Colorectal Dis 2011; 13(10): e345-8. [Link]
13.
Sidhu M, Forbes N, Tate DJ, et al. A Randomized Controlled Trial of Cold Snare Polypectomy Technique: Technique Matters More Than Snare Wire Diameter. Am J Gastroenterol 2022; 117(1): 100. [Link]
14.
Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49(03): 270-97. [Link]
15.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice demonstration of cold snare polypectomy; [starts at Chapter 4]. Available from https://www.gieqs.com/login?destination=viewvideo&videoid=704&chapternumber=4 [Link]
16.
Repici A, Hassan C, Vitetta E, et al. Safety of cold polypectomy for <10mm polyps at colonoscopy: a prospective multicenter study. Endoscopy 2012; 44(1): 27-31 [Link]
17.
Moss A, Bourke MJ, Williams SJ, et al. Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia. Gastroenterology 2011; 140(7): 1909-18. [Link]
18.
Moss A, Williams SJ, Hourigan LF, et al. Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut 2015; 64(1): 57-65. [Link]
19.
Peery AF, Cools KS, Strassle PD, et al. Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States. Gastroenterology 2018; 154(5): 1352--60.e3. [Link]
20.
Bahin FF, Heitman SJ, Bourke MJ. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2019; 68(6): 1130. [Link]
21.
Adler J, Robertson DJ. Interval Colorectal Cancer After Colonoscopy: Exploring Explanations and Solutions. American Journal of Gastroenterology 2015; 110(12): 1657--64-- quiz 65. [Link]
22.
Kudo S-e, Tamura S, Nakajima T, Yamano H-o, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointestinal Endoscopy 1996; 44(1): 8-14. [Link]
23.
Sano Y, Tanaka S, Kudo S-e, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Digestive Endoscopy 2016; 28(5): 526-33. [Link]
24.
Hewett DG, Kaltenbach T, Sano Y, et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143(3): 599--607 e1. [Link]
25.
Debels L, Tate DJ. The Accuracy of Human Detection Of Submucosal Invasive Cancer - Analysis of 739 Individual Assessments of Large Non-Pedunculated Colorectal Polyps (LNPCPS) using a Novel Clinical Decision Support Tool. United European Gastroenterology Journal 2021; 9(10): 1197-221. [Link]
26.
Burgess NG, Hourigan LF, Zanati SA, et al. Risk Stratification for Covert Invasive Cancer Among Patients Referred for Colonic Endoscopic Mucosal Resection: A Large Multicenter Cohort. Gastroenterology 2017. [Link]
27.
Tate DJ. GIEQs Prediction tool for Submucosal Invasion. https://www.gieqs.com/smi. [Link]
28.
Bahin FF, Heitman SJ, Bourke MJ, et al. Wide-field endoscopic mucosal resection versus endoscopic submucosal dissection for laterally spreading colorectal lesions: a cost-effectiveness analysis. Gut 2018; 67(11): 1965-73. [Link]
29.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Imaging of Colorectal Polyps Online Course covering many aspects of how to detect cancer within colorectal polyps. Available from: https://www.gieqs.com/login?destination=viewasset&assetid=14 [Link]
30.
Dekker E, Houwen B, Puig I, et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52(10): C10. [Link]
31.
Gupta S, Miskovic D, Bhandari P, et al. A novel method for determining the difficulty of colonoscopic polypectomy. Frontline Gastroenterology 2013; 4(4): 244-8. [Link]
32.
Sidhu M, Tate DJ, Desomer L, et al. The size, morphology, site, and access score predicts critical outcomes of endoscopic mucosal resection in the colon. Endoscopy 2018; 50(7): 684-92. [Link]
33.
Anderson J, Lockett M. Training in therapeutic endoscopy: meeting present and future challenges. Frontline Gastroenterology 2019; 10(2): 135-40. [Link]
34.
Sidhu M, Tate DJ, Desomer L, et al. SMSA-EMR score is a novel endoscopic risk assessment tool for predicting critical endoscopic mucosal resection outcomes Gastrointestinal endoscopy 2018; 87(6): AB467--AB8 [Link]
35.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Lecture regarding competency in Polypectomy covering SMSA and SMSA+ scores in practice; [starts at Chapter 17]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=696&chapternumber=17. [Link]
36.
Tate DJ, Desomer L, Hourigan LF, Moss A, Singh R, Bourke MJ. Two-stage endoscopic mucosal resection is a safe and effective salvage therapy after a failed single-session approach. Endoscopy 2017; 49(9): 888-98. [Link]
37.
Tate DJ, Bahin FF, Desomer L, Sidhu M, Gupta V, Bourke MJ. Cold-forceps avulsion with adjuvant snare-tip soft coagulation (CAST) is an effective and safe strategy for the management of non-lifting large laterally spreading colonic lesions. Endoscopy 2018; 50(1): 52-62. [Link]
38.
Uraoka T, Saito Y, Ikematsu H, Yamamoto K, Sano Y. Sano's capillary pattern classification for narrow-band imaging of early colorectal lesions. Dig Endosc 2011; 23 Suppl 1: 112-5. [Link]
39.
Tate DJ, Sidhu M, Bar-Yishay I, et al. Impact of en bloc resection on long-term outcomes after endoscopic mucosal resection: a matched cohort study. 2020. [Link]
40.
Klein A, Tate DJ, Jayasekeran V, et al. Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection. Gastroenterology 2019; 156(3): 604--13.e3 [Link]
41.
Sidhu M, Shahidi N, Gupta S, et al. Outcomes of Thermal Ablation of the Mucosal Defect Margin After Endoscopic Mucosal Resection: A Prospective, International, Multicenter Trial of 1000 Large Nonpedunculated Colorectal Polyps. Gastroenterology 2021; 161(1): 163--70.e3. [Link]
42.
The Gastrointestinal Endoscopy Quality and Safety (GIEQs) Foundation T, D. J. GIEQs Online. 2021. https://gieqs.com/online. [Link]
43.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice endoscopic mucosal resection. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692 [Link]
44.
Dobrowolski S, Dobosz M, Babicki A, Głowacki J, Nałęcz A. Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy. Gastrointestinal endoscopy 2006; 63(7): 1004-9. [Link]
45.
Kim HS, Kim TI, Kim WH, et al. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol 2006; 101(6): 1333-41. [Link]
46.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Mechanical ligation for pedunculated colonic polyps. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=144 [Link]
47.
ERBE Elektromedizin GmbH, Waldhörnlestraße 17, 72072 Tübingen, Germany. Mail: info@erbe-med.com, Website:[Link]
48.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Assessing the mucosal defect after colorectal polypectomy. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=715 [Link]
49.
Bahin FF, Naidoo M, Williams SJ, et al. Prophylactic endoscopic coagulation to prevent bleeding after wide-field endoscopic mucosal resection of large sessile colon polyps. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2015; 13(4): 722-4. [Link]
50.
Bahin FF, Rasouli KN, Byth K, et al. Prediction of Clinically Significant Bleeding Following Wide-Field Endoscopic Resection of Large Sessile and Laterally Spreading Colorectal Lesions: A Clinical Risk Score. American Journal of Gastroenterology 2016; 111(8): 1115-22. [Link]
51.
Burgess NG, Bassan MS, McLeod D, Williams SJ, Byth K, Bourke MJ. Deep mural injury and perforation after colonic endoscopic mucosal resection: a new classification and analysis of risk factors. Gut 2016. [Link]
52.
Gupta S, Sidhu M, Shahidi N, et al. Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial. Lancet Gastroenterol Hepatol 2022; 7(2): 152-60. [Link]
53.
Pohl H, Grimm IS, Moyer MT, et al. Clip Closure Prevents Bleeding After Endoscopic Resection of Large Colon Polyps in a Randomized Trial. Gastroenterology 2019; 157(4): 977-84.e3. [Link]
54.
Hassan C, Repici A, Sharma P, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 2015; 65(5): 806-20. [Link]
55.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. Best practice in application of thermal ablation to the post-polypectomy defect margin; [starts at Chapter 2]. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=692&chapternumber=2 [Link]
56.
Hassan C, Antonelli G, Dumonceau J-M, et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy 2020; 52(8): 687-700. [Link]
57.
Gupta S, Lieberman D, Anderson JC, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115(3): 415-34. [Link]
58.
The Gastrointestinal Quality and Safety Foundation [Internet]. Brussels: GIEQs Online Educational Platform; c2022 [cited 2022 Aug 18]. How to identify an endoscopic resection scar. Available from: https://www.gieqs.com/login?destination=viewvideo&videoid=492 [Link]
59.
Desomer L, Tutticci N, Tate DJ, Williams SJ, McLeod D, Bourke MJ. A standardized imaging protocol is accurate in detecting recurrence after EMR. Gastrointestinal endoscopy 2016. [Link]
60.
Pellise M, Desomer L, Burgess NG, et al. The influence of clips on scars after EMR: clip artifact. Gastrointestinal endoscopy 2016;83(3):608-616. [Link]
61.
Mbbs GS, Mph KCVM, Md DKR, Sreepati G, Vemulapalli KC, Rex DK. Clip artifact after closure of large colorectal EMR sites: incidence and recognition. Gastrointestinal endoscopy 2015; 82(2): 344-9. [Link]

Abstract

Crohn’s disease (CD) is a chronic inflammatory bowel condition that can present with a wide range of intestinal and extra-intestinal manifestations. This condition can develop at any age and have a significant impact and impairment on quality of life for individuals including on relationships, educational attainment and work productivity. In particular, the time around and after diagnosis often involves the most upheaval for patients, and equally the biggest opportunity for effective intervention. Several recent advances have had a major impact on optimal management of patients with newly diagnosed CD. Here, we discuss the mistakes that are commonly made when managing patients presenting with a new diagnosis of CD. We summarise the evidence base and offer helpful and pragmatic tips for practising clinicians.

Topics

IBD

Citation

Roseira J and Noor N. Mistakes in newly diagnosed crohn's disease and how to avoid them. UEG Education 2025; 25: 18-23.

Published

2025

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UEG Podcast Episode
UEG Podcast
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Coeliac disease with David Sanders

David S. Sanders, Pradeep Mundre

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Abstract

Topics

Small Intestine & Nutrition

Published

2026

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Coeliac disease with David Sanders

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Pradeep Mundre Pradeep Mundre, David S. Sanders

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