Efficacy of artificial intelligence for adenoma detection in water exchange colonoscopy: A two-center randomized controlled trial.

Background Water exchange (WE) and artificial intelligence-based computer-aided detection (CADe) separately improve the adenoma detection rate (ADR) and adenomas per colonoscopy (APC). We aimed to determine whether combining WE with CADe enhanced APC compared with WE alone. Methods This randomized controlled trial was conducted at hospitals in Italy (ENDO-AID; Olympus) and Taiwan (CAD-EYE; Fujifilm) using different CADe devices.

Prevalence of Endoscopic and Histological Lesions at Upper Endoscopy: A Cross-Sectional, Multicentre Study in Clinical Practice.

Background/aim: Prevalence of gastroduodenal endoscopic and histological lesions may modify over time due to different factors. We assessed both macroscopic and histological lesions currently detected at upper endoscopy performed in routine practice.

Patients And Methods: Clinical, endoscopic, and histological data of consecutive adult patients referred for upper endoscopy in the 28 participating centres were analysed.

Upper Gastrointestinal Endoscopy Quality in Italy: A Nationwide Study.

Background And Aims: International guidelines advise improving esophagogastroduodenoscopy (EGD) quality in Western countries, where gastric cancer is still diagnosed in advanced stages. This nationwide study investigated some indicators for the quality of EGD performed in endoscopic centers in Italy.

Methods: Clinical, endoscopic, and procedural data of consecutive EGDs performed in one month in the participating centers were reviewed and collected in a specific database.

Comparison of Right Colon Flat Polyp Detection Rate by Water Exchange Versus Water Immersion-pooled Results of Data File of 3 Published Reports.

Goals: We tested the hypothesis that water exchange (WE) achieved a significantly higher right colon flat polyp detection rate (rFPDR) than water immersion (WI).

Background: Current endoscopy methods provide real-time morphology but not histopathology. Flat serrated polyps are difficult to find during colonoscopy.

Small-bowel capsule endoscopy in patients with Meckel's diverticulum: clinical features, diagnostic workup, and findings. A European multicenter I-CARE study.

Background And Aims: Meckel's diverticulum (MD) may remain silent or be associated with adverse events such as GI bleeding. The main aim of this study was to evaluate indicative small-bowel capsule endoscopy (SBCE) findings, and the secondary aim was to describe clinical presentation in patients with MD.

Methods: This retrospective European multicenter study included patients with MD undergoing SBCE from 2001 until July 2021.

Incidence, risk and protective factors of symptoms after colonoscopy.

Background: Few studies focused on minor adverse events which may develop after colonoscopy.

Aims: To investigate the incidence and factors associated to post-colonoscopy symptoms.

Methods: This is a prospective study conducted in 10 Italian hospitals.

Enteroscopy in diagnosis and treatment of small bowel bleeding: A Delphi expert consensus.

Background: Enteroscopy plays an important role in the management of small bowel bleeding. However, current guidelines are not specifically designed for small bowel bleeding and recommendations from different international societies do not always align. Consequently, there is heterogeneity in the definitions of clinical entities, clinical practice policies, and adherence to guidelines among clinicians.

Score reproducibility and reliability in differentiating small bowel subepithelial masses from innocent bulges.

Aims: The primary aim of this study was to assess the reliability, intra- and inter-observer variation of the SPICE, Mucosal protrusion angle (MPA) and SHYUNG scores in differentiating a subepithelial mass (SEM) from a bulge.

Methods: This retrospective multicentre study analysed the 3 scores, radiological studies, enteroscopy and/or surgical findings.

Results: 100 patients with a potential SEM (mean age 57.

Nomenclature and Definition of Atrophic Lesions in Small Bowel Capsule Endoscopy: A Delphi Consensus Statement of the International CApsule endoscopy REsearch (I-CARE) Group.

(1) Background: Villous atrophy is an indication for small bowel capsule endoscopy (SBCE). However, SBCE findings are not described uniformly and atrophic features are sometimes not recognized; (2) Methods: The Delphi technique was employed to reach agreement among a panel of SBCE experts. The nomenclature and definitions of SBCE lesions suggesting the presence of atrophy were decided in a core group of 10 experts.

Quality performance measures in upper gastrointestinal endoscopy for lesion detection: Italian AIGO-SIED-SIGE joint position statement.

Esophagogastroduodenoscopy (EGD) plays a crucial role in the management of gastroduodenal diseases by allowing a direct and accurate evaluation of the mucosa and the execution of several operative maneuvers. Despite a constant development of new imaging tools and operative devices, the widespread use of EGD has not resulted in a significant reduction of mortality for patients affected by esophageal/gastric cancer during the last three decades in Western countries. Evidence indicates that this disheartening scenario derives from a high variability of execution of EGD which determines its quality and diagnostic yield, delaying the diagnosis of neoplastic diseases.

Determinants of symptom burden related to bowel preparation for colonoscopy.

Background: Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure.

Aims: We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy.

Methods: This is a prospective multicenter study conducted in 10 Italian hospitals.

A survey of colonoscopists with and without in-depth knowledge of water-aided colonoscopy.

Background And Aim: Endoscopy featured water-aided colonoscopy (WAC) as novel in the Innovation Forum in 2011. Gastrointestinal Endoscopy published a modified Delphi consensus review (MDCR) that supports WAC for clinical practice in 2021. We tested the hypothesis that experience was an important predictor of WAC use, either as water immersion (WI), water exchange (WE), or a combination of WI and WE.

Impact of colonoscopy on working productivity: a prospective multicenter observational study.

Background And Aims: Patients undergoing colonoscopy are often in the workforce. Therefore, colonoscopy may affect patients' work productivity in terms of missed working days and/or reduced working efficiency. We aimed to investigate the impact of colonoscopy on work productivity and factors influencing this impact.

Water immersion sigmoidoscopy versus standard insufflation for colorectal cancer screening: A cohort study.

Background: Although the efficacy of water-assisted colonoscopy is well established, the role of water immersion sigmoidoscopy (WIS) remains unclear. We compared WIS with carbon dioxide insufflation sigmoidoscopy (COS) on patient outcomes.

Methods: We conducted an analysis of prospectively collected data from a single-center quality improvement program about patients undergoing unsedated screening sigmoidoscopy (WIS and COS) between May 2019 and January 2020.

Quality performance measures for small capsule endoscopy: Are the ESGE quality standards met?

 The European Society of Gastrointestinal Endoscopy (ESGE) recently issued a quality performance measures document for small bowel capsule endoscopy (SBCE). The aim of this nationwide survey was to explore SBCE practice with ESGE quality measures as a benchmark.  A dedicated per-center semi-quantitative questionnaire based on ESGE performance measures for SBCE was created by a group of SBCE experts.

1L- vs. 4L-Polyethylene glycol for bowel preparation before colonoscopy among inpatients: A propensity score-matching analysis.

Background: Inpatients are at risk for inadequate colon cleansing. Experts recommend 4L-polyethylene-glycol (PEG) solution. A higher colon cleansing adequacy rate for a hyperosmolar 1L-PEG plus ascorbate prep has been recently reported.

The diagnostic yield of colonoscopy in hospitalized patients. An observational multicenter prospective study.

Background: Colonoscopy demands a considerable amount of resources, and little is known about its diagnostic yield among inpatients.

Aims: To assess indications, diagnostic yield and findings of colonoscopy for inpatients, and to identify risk factors for relevant findings and cancer.

Methods: Multicentre, prospective, observational study including 12 hospitals.

Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations.

Background And Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy. We reviewed and graded the research evidence with potential clinical application. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR.

Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery.

 As the post-peak phase of the epidemic is approaching, there is an urgent need of an action plan to help resume endoscopy activity. To manage the Covid-19 pandemic-imposed backlog of postponed colonoscopy examinations, an efficient approach is needed. The practice of on-demand sedation with benzodiazepines and/or opiates will allow most patients to complete a water-aided examination with minimal or no sedation.

Factors That Affect Adequacy of Colon Cleansing for Colonoscopy in Hospitalized Patients.

Background & Aims: Hospitalization is associated with inadequate colon cleansing before colonoscopy. We aimed to identify factors associated to inadequate colon cleansing among inpatients, and to derive and validate a model to identify inpatients with inadequate cleansing.

Methods: We performed a prospective observational study at 12 hospitals in Italy.