Open Access Medical Books


Edited by Marco Bustamante .
286 pages .

Colorectal cancer (CRC) is the third more commonly diagnosed cancer in both sexes and it is also the third leading cause of cancer-related death among men and women in the United States.It represents a global public health problem and a heavy burdenfor any healthcare system. Fortunately,
most CRCs originate from an adenoma, a precursor lesion that is easily accessible and removable.
This is the rationale for CRC screening programs, which are aimed to diagnose CRC at an early stage or even better, to detect and resect the advanced adenoma before CRC has developed. Recent evidence suggests that colonoscopy with polypectomy is efficient in reducing the incidence of and mortality from CRC. Moreover, the CRC resection rates have recently been shown to be reduced after the implementation of colonoscopy-based screening programs. As a consequence, CRC screening programs, either directly with colonoscopy or based on fecal occult blood test, are being implemented in most countries. The physicians who are devoted to endoscopy or who are involved in CRC screening programs face several challenges. They are requested to participate in the organization of population-based CRC screening programs; screening colonoscopies have to be performed accomplishing quality standards; difficult endoscopic resections are expected because performing colonoscopy in asymptomatic individuals makes possible an early diagnosis of advanced adenomas; and finally clinical decisions have to be made based on the information provided by the number and histology of the detected adenomas.
In this background, this book providesaccurate and updated information on several topics to be faced when implementing a CRC screening program.It is divided in four sections, the first one dealing with the epidemiology of CRC and the rationale and challenges of implementing such a program both from a European and American point of view. The second section tackles the issue of managing the findings of a screening colonoscopy, commenting on the use of endoscopic submucosal dissection to resect difficult polyps, the significance and management of the malignant polyp and the possibility of using image enhancing technologies to make a presumptive histological diagnosis of diminutive polyps reducing costs without losing efficacy. The third section summarizes the main risks of diagnostic and therapeutic colonoscopy and how to manage them. And finally the last section comments on virtual colonoscopy and colon capsule endoscopy, technologies that are being developed and soon will become part of our screening armamentarium.
The relevance of the topics covered in it and the updated evidence included by the authors turns this book into a very useful tool to introduce the reader in the amazing and evolving field of colonoscopy and CRC screening.

Marco Bustamante, MD, PhD
University Hospital La Fe
Valencia, Spain


Section 1 of the textbook :  Overview of Colorectal Cancer. Implementation of Colorectal Cancer Screening Programs .

Chapter 1 Colorectal Cancer 3
Kouklakis S. Georgios and Asimenia D. Bampali

Chapter 2 Issues in Screening and Surveillance Colonoscopy 25
Anjali Mone, Robert Mocharla, Allison Avery and Fritz Francois

Chapter 3 The Future of Colonoscopy: The Use of Data Envelopment Analysis (DEA) for Colorectal Cancer Screening — Italian Experience 71
Alberto Vannelli, Michel Zanardo, Valerio Basilico, Baldovino Griffa, Fabrizio Rossi, Massimo Buongiorno, Luigi Battaglia, Vincenzo Pruiti, Sara De Dosso and Giulio Capriata

Section 2 of the textbook : Managing Precursor Lesions: Resection Techniques and Beyond .

Chapter 4 Evolution and Strategy of Endoscopic Treatment for Colorectal Tumours 95
Koh Z.L. Sharon, H. Yamamoto and Tsang B.S. Charles

Chapter 5 Malignant Colorectal Polyps: Diagnosis, Treatment and Prognosis 123
Luis Bujanda Fernández de Piérola, Joaquin Cubiella Fernández, Fernando Múgica Aguinaga, Lander Hijona Muruamendiaraz and Carol Julyssa Cobián Malaver

Chapter 6 The Malignant Polyp: Polypectomy or Surgical Resection? 141
Josef M. Taylor and Kenneth B. Hosie

Chapter 7 Desmoplastic Reaction in Biopsy Specimens of T1 Stage Colorectal Cancer Plays a Critical Role in Defining the Level of Sub-Mucosal Invasion 161
Shigeki Tomita, Kazuhito Ichikawa and Takahiro Fujimori

Chapter 8 In vivo Optical Diagnosis of Polyp Histology: Can We Omit Pathological Examination of Diminutive Polyps? 177
Marco Bustamante-Balén

Section 3 of the textbook : Complications of Colonoscopy: Minimizing the Risks of a Screening Tool .

Chapter 9 The Major Complications of Colonoscopy: Sedation-Related, Hemorrhage Associated with Polypectomy and Colonic Perforation 197
Paul Miskovitz

Chapter 10 Complications of Colonoscopy 215
Muhammed Sherid, Salih Samo and Samian Sulaiman

Section 4 of the textbook : Colonoscopy Is Not the End of the Way: Other Screening Technologies .

Chapter 11 Colon Capsule Endoscopy: Quo Vadis? 243
Samuel N. Adler and Cesare Hassan

Chapter 12 Virtual Colonoscopy 253
Robert J. Richards and Jerome Zhengrong Liang 

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Published by: Unknown - Wednesday, February 13, 2013


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