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Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

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Introduction

Colorectal endoscopic mucosal resection (EMR) is associated with high recurrence rates, which requires a regular surveillance program by colonoscopy. Our aim was to study the 5-year follow-up of a population undergoing EMR and the risk factors associated with recurrence.

Aims & Methods

Prospective cohort study, single centre, including patients who underwent colorectal EMR of lesions ≥20mm with a minimum follow-up of 5 years, between 2009 and 2019. We analysed the lesions’ characteristics, as well as the recurrence rate, and logistic regression conducted for risk factors associated with recurrence.

Results

Included 407 EMR and patients were 58% male, with a mean age of 68.5±9.8 years. From our analysis: 65.8% of the lesions were 20-40mm, 21.4% 40-60mm and 12.8% were ≥60mm; 49.4% were sessile and 50,6% flat; 34.1% were localized in the right colon, 21.6% in the transverse colon, 15.5% in the left colon, and 28.7% in the rectum; 85.7% were granular and 14.3% non-granular. The mean SMSA score was 12.5±1.8. The overall recurrence rate was 19,9%, with rates and respective time of follow-up as follows: 15,8%, 7,4%, 3,6% and 0% at 3, 12, 36 and 60 months.
Evaluating the risk factors for recurrence, anal location (32.6% vs. 18.4%; p=0.02) and size of lesion: ≥60mm vs. 40-60mm vs. ≤40mm (34.7% vs. 33.7% vs. 12.8%; p<0.001) were statistically significant, but not with argon plasma therapy (23.3% vs. 18.1%; p=0.21) and non-granular morphology (19.0% vs. 20.3%; p=0.82). Logistic regression analysis revealed that only an escalation in size in multiples of 20mm had a significant risk of recurrence (OR 1.98; p<0.001). The global complication rate was 6.1%, including early complications (perforations, n=3) and late complications (bleeding, n=17 and post-polypectomy syndrome, n=3).

Conclusion

Despite the high overall recurrence rate, a 5-year surveillance has demonstrated to be an adequate time interval to evaluate the EMR’s efficacy and safety.

SURVEILLANCE OF COLORECTAL ENDOSCOPIC MUCOSAL RESECTIONS (EMR): A SINGLE CENTRE TEN-YEAR EXPERIENCE

Maria Inês Viegas 1, Luís Elvas 1, Miguel Areia 1, Mafalda João 1, Maria Inês Viegas 1, Daniel Brito 1, Sandra Saraiva 1, Maria Inês Viegas 1

1 Portuguese Oncology Institute of Coimbra, Coimbra, Portugal

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

UEG Online Course

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Acute severe ulcerative colitis (ASUC) remains the most severe form of UC and is sometimes associated with mortality. Adequate evaluation, early and correct intervention, and follow-up with a multidisciplinary approach are crucial in management. A comprehensive approach to ASUC, epidemiology, definition, diagnosis, evaluation, and medical and surgical management are all discussed in this online course by Haluk Tarik Kani, Irene Marafini, Joana Roseira, Wilhelmus A. Bemelman and Fernando Magro.

Target audience
We believe both gastroenterology trainees and early career gastroenterologists and surgeons will find in this online course a thorough and updated review on ASUC management.

Acute Severe Ulcerative Colitis

Fernando Magro, Haluk Tarik Kani, Joana Roseira, Irene Marafini, Wilhelmus A. Bemelman

Event

Acute Severe Ulcerative Colitis

Topics

IBD

Accreditation status

accredited

Duration

1 hour

Published

2025

UEG Podcast Episode

Journal Podcast

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Interactive Insights With Your UEG Podcast Hosts: UEGW Special

Ahsen Ustaoglu 1, Haluk Tarik Kani 2, Egle Dieninyte - Misiune 3, Pradeep Mundre 4, Enrique de-Madaria 5, Joost Drenth 6

1 Early Cancer Institute, University of Cambridge, United Kingdom

2 Department of Gastroenterology, Marmara University, School Of Medicine, Istanbul, Turkey

3 Center of hepatology, gastroenterology and dietetics, Vilnius university Santaros Klinikos, Lithuania

4 Bradford Teaching Hospitals NHS trust, Leeds, United Kingdom

5 Hospital General Universitario de Alicante, Alicante, Spain

6 Amsterdam UMC, Netherlands

Published

2023

UEG Podcast Episode

Journal Podcast

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European guidelines on microscopic colitis: UEG and European Microscopic Colitis Group (EMCG) statements and recommendations

Iago Rodríguez-Lago 1, Stephan Miehlke 2

1 Hospital Universitario de Galdakao, Bilbao, Spain

2 Eppendorf Center for Digestive Diseases, Hamburg, Germany

Topics

IBD

Published

2021

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Introduction

Women with inflammatory bowel disease (IBD) are highly recommended to maintain treatment during pregnancy because discontinuation has been associated with flare-ups, which are linked to a worse prognosis for the mother and the fetus. It is widely known that biologic drugs cross the placenta, but most studies focused on the impact on the risk of infection. Data regarding the impact on psychomotor development are very limited, particularly on non anti-TNF biologics.

Aims & Methods

Our aim was to evaluate the impact of the exposure of biologics in utero on the psychomotor development of children during the first year of life.
Data from children included in the DUMBO registry with complete AQS-3 available up to 12 months of age were analysed. DUMBO is a prospective, observational, and multicentre registry endorsed by GETECCU, which enrols pregnant women with IBD throughout 5 years in 60 centres in Spain. This subanalysis to evaluate the neurodevelopment of the babies, follows up mothers and babies since the pregnancy diagnosis until delivery during each trimester and then, every 3 months during the first 12 months of babies´ life. Normal psychomotor development was defined by ASQ-3 scores above the lower limit of normality (referral zone) in all domains. Serious adverse events (SAE) were defined in accordance with the ICH Topic E 2 A Clinical Safety Data Management.

Results

352 children born to 343 mothers were included (9 pair of twins).134 children (38%) had been exposed to biologics in utero; from them, 50 (37%) had been exposed to adalimumab, 44 (32%) to infliximab, 3 (2.2%) to certolizumab, 1 (0.7%) to golimumab, 28 (20%) to ustekinumab, and 10 (7.5%) to vedolizumab. To assess psychomotor development, 2073 ASQ-3 questionnaires were analyzed. No differences were observed in any of the evaluations or domains throughout the first year, except at 12 months, where exposed babies were more likely to achieve normal results in the domain of gross motor skills.
In the univariate analysis between babies with normal development at 12 months and those who did not we only found differences in: Exposure to biologic drugs, which was higher in those who presented a normal ASQ-3. The type of maternal IBD, that babies from mothers with UC had lower likelihood of normal psychomotor development, and prematurity, serious adverse events, and hospitalizations, all of which were more frequent in those who presented abnormal ASQ-3 results. In the multivariate analysis, to have been born to a mother with CD (vs. UC) was associated with higher likelihood (OR=2, 95%CI=1.1-3.9), while to be premature was associated with lower likelihood (OR=0.3, 95%CI=0.1-0.6) of having ASQ-3 scores above the limit of normality in all domains at 12 months of age.

Conclusion

In the multicenter, prospective DUMBO registry, the exposure to biologics for the treatment of IBD in utero (including anti-TNF and non-anti-TNF agents) did not impair the psychomotor development of the children. Our findings support the safety of these drugs and reinforce the recommendation to continue them during pregnancy.

UNVEILING THE IMPACT ON IN UTERO EXPOSURE TO BIOLOGIC TREATMENTS FOR INFLAMMATORY BOWEL DISEASE (IBD) ON CHILDREN'S PSYCHOMOTOR DEVELOPMENT: INSIGHTS FROM THE DUMBO REGISTRY OF GETECCU

Laura María Palomino Pérez 1, Marta Velasco Rodríguez-Belvís 1, Yanire Brenes 2, Eduardo Leo-Carnerero 3, Cristina Calviño Suarez 4, Montserrat Rivero 5, Marta Isabel Calvo Moya 6, María Teresa Arroyo-Villarino 7, Agnès Fernández-Clotet 8, Isabel Pérez-Martínez 9, Angeles Masedo Gonzalez 10, Vicent Hernández 11, Alexandra Ruiz-Cerulla 12, Pilar López Serrano 13, Pablo Vega 14, Iago Rodríguez-Lago 15, Raquel Vicente Lidón 16, Miguel Ángel De Jorge Turrión 17, Iván Guerra 18, Lara Arias García 19, Gema Molina Arriero 20, Daniel Hervías Cruz 21, David Busquets Casals 22, Ana Gutiérrez-Casbas 23, Manuel Van Domselar 24, Gemma Valldosera Gomis 25, Juan Maria Vázquez Morón 26, Marta Piqueras Cano 27, Alfredo J. Lucendo 28, María Dolores Martín-Arranz 29, Patricia Ramírez de la Piscina Urraca 30, María del Pilar Martínez Tirado 31, Virginia Robles Alonso 32, Sandra Marin 33, Raquel Camargo Camero 34, Edisa Maria Armesto González 35, Carlos Tardillo Marín 36, Esther Bernardos Martín 37, MAría del Carmen Rodríguez Grau 38, Jose Maria Huguet 39, Lucía Márquez-Mosquera 40, Pau Sendra Rumbeu 41, Luis Bujanda Fernández de Piérola 42, Carlos Castaño-Milla 43, EMPAR SAINZ ARNAU 44, Luis Hernández Villalba 45, Rosa Ana Muñoz Codoceo 1, Alberto García- Salido 1, Javier P. Gisbert 2, María Chaparro 2

1 Hospital Infantil Universitario Niño Jesús, Madrid, Spain

2 Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

3 Hospital Universitario Virgen del Rocío, Sevilla, Spain

4 Complejo Hospitalario Universitario de Santiago, La Coruña, Spain

5 Marqués de Valdecilla Universitary Hospital, Santander, Spain

6 Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain

7 Hospital Clínico Universitario Lozano Blesa, IIS Aragón y CIBERehd, Zaragoza, Spain

8 Hospital Clinic, Barcelona, Spain

9 Hospital Universitario Central de Asturias, Oviedo, Spain

10 Hospital Universitario 12 Octubre, Madrid, Spain

11 Hospital Álvaro Cunqueiro. Instituto Investigación Sanitaria Galicia Sur, Redondela, Spain

12 Hospital Universitari de Bellvitge, Mollet Del Valles, Spain

13 Hospital Universitario Fundación Alcorcón, Madrid, Spain

14 Complexo Hospitalario Universitario de Ourense, Ourense, Spain

15 Hospital Universitario de Galdakao, Bilbao, Spain

16 H. U. Miguel Servet, Zaragoza, Spain

17 Hospital Universitario de Cabueñes, Oviedo, Spain

18 Hospital Severo Ochoa, Madrid, Spain

19 Hospital Universitario de Burgos, Burgos, Spain

20 Complejo Hospitalaro de Ferrol, Ferrol, Spain

21 Hospital General Universitario de Ciudad Real, Ciudad Real, Spain

22 H. de Girona Dr. J. Trueta/ICO, Girona, Spain

23 Hospital General Universitario Alicante, Alicante, Spain

24 Hospital Universitario de Torrejón, Universidad Francisco de Vitoria, Madrid, Spain

25 Hospital Universitario Joan XXIII, Tarragona, Spain

26 Hospital Universitario Juan Ramón Jimenez, Huelva, Spain

27 Hospital Consorci Terrassa, Terrassa, Spain

28 Hospital General de Tomelloso, Madrid, Spain

29 Hospital La Paz, Madrid, Spain

30 Hospital Universitario de Álava, Álava, Spain

31 Hospital Clínico Universitario San Cecilio, Granada, Spain

32 H. Vall D'Hebron, Barcelona, Spain

33 Hospital Universitario Reina Sofía, Córdoba, Spain

34 Hospital Universitario Virgen de La Victoria, Málaga, Spain

35 Hospital Universitario San Agustín, Avilés, Spain

36 Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain

37 Hospital Mancha Centro, Ciudad Real, Spain

38 Hospital Universitario del Henares, Madrid, Spain

39 Hospital General Universitario de Valencia, Valencia, Spain

40 Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

41 Hospital Universitario Son Espases, Mallorca, Spain

42 Instituto Biodonostia, San Sebastián, Spain

43 Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain

44 Hospital Sant Joan de Déu - Althaia, Manresa, Spain

45 Santos Reyes, Aranda de Duero, Spain

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Online Course

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Perianal Crohn’s disease is a perianal complication of Crohn’s disease. It consists of inflammation near the anus in the form of skin tags, fistulas, abscesses and fissures. Affecting almost one in four Crohn’s patients, perianal Crohn’s disease needs to be assessed and treated in a multidisciplinary fashion.

This online course covers the definition and epidemiology of perianal Crohn’s disease. The diagnosis and assessment are divided into symptoms, clinical assessment and examination under anaesthesia. Various perianal Crohn’s disease treatment options are introduced, from initial medical to surgical management.

The course included comprehensive PPT slides and bespoke video presentations by Peter Irving and Amy Lightner, filmed in London and the United States in 2022. The combined material has a total duration of approximately 50 minutes. The estimated time needed to complete the course, including the final assessment, is 60 minutes.

Target audience

This course is suitable for gastroenterologists in training but is also appropriate for physicians and surgeons in other disciplines, as well as IBD clinical nurse specialists.

Perianal Crohn's disease

Peter Irving, Amy Lightner

Event

Perianal Crohn's disease

Topics

IBD Surgery

Accreditation status

accredited

Duration

1 hour

Published

2023

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Introduction

Pain, discomfort, and bloating can occur during and after colonoscopy, secondary to bowel distention. Insufflation is the major reason for bowel distention after a colonoscopy. Room air (RA) has slower re-absorption through the intestinal mucosa than carbon dioxide (CO2). Theoretically, with a faster resorption speed, abdominal pain, discomfort, and bloating are expected to be less with CO2 use. Nevertheless, in some clinical studies, CO2 was not found to be superior to RA in terms of post-procedure pain sensation.

Aims & Methods

The aim of this study was to compare abdominal pain sensation and bloating after colonoscopy using RA versus CO2 insufflation. A prospective randomized controlled study conducted on patients performing diagnostic colonoscopy. Enrolled patients were randomized to RA (group 1) versus CO2 insufflation (group 2). All patients were sedated with midazolam (2.5-5 mg) and all colonoscopies were performed by a single endoscopist. Abdominal pain sensation and bloating after the procedure as the primary outcome measure was assessed by a 10-point visual analogue scale (VAS), numerical rating scales from 0 (no pain) to 10 points (maximal pain). The participants were asked about abdominal pain and bloating at 15, 60, and 180 minutes and 24 hours post-procedural.

Results

From July 2021 to August 2022, a total of 64 patients were enrolled. There was 31 males and 33 females. Their mean age was 48.27±16 years. There was a statistically significant increase in abdominal bloating in group 1 (59.4%) compared to group 2 (18.7%), (P=0.018). Also, there was a statistically significant increase in abdominal pain sensation in group 1 compared to group 2 at 60 min (43.8% vs 21.9%) (P=0.011), 180 min (28.1% vs 9.4%) (P=0.017), respectively. None of the studied patients developed pain after 24 hours and there was no statistically significant difference between the studied groups regarding cecal intubation time and total examination time. No adverse events were noted in both groups.