1.Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art
Alessia CHINI ; Michele MANIGRASSO ; Grazia CANTORE ; Rosa MAIONE ; Marco MILONE ; Francesco MAIONE ; Giovanni Domenico DE PALMA
Clinical Endoscopy 2022;55(2):183-190
Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential.
2.Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe GALLORO ; Angelo ZULLO ; Gaetano LUGLIO ; Alessia CHINI ; Donato Alessandro TELESCA ; Rosa MAIONE ; Matteo POLLASTRO ; Giovanni Domenico DE PALMA ; Raffaele MANTA
Clinical Endoscopy 2022;55(3):339-346
Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.