Novel approaches to the endoscopic management of gastrointestinal disorders

© 2017 Dr. Sujievvan ChandranEndoscopy has evolved since its humble beginnings. Over the past decade advances include the rapid evolution in endoscopic visual assessment of the bowel and its role in the management and prevention of colorectal cancer. Endoscopy has developed key diverse technologies that include capsule endoscopy and endoscopic ultrasound. Innovation and advances have not been limited to the endoscopes themselves but increasingly the devices that are utilized during endoscopy help to extend the boundaries of both diagnostic and therapeutic interventions. The aim of this thesis is to assess new and novel endoscopic techniques and technologies in the management of gastrointestinal disorders. The first area of study is to assess novel endoscopic techniques and technologies in the area of colonoscopy. This procedure is of key importance in Australia where despite having one of the highest rates per capita of colonoscopy worldwide, colorectal cancer remains the second most commonly diagnosed malignancy. Given that there is no contemporary local data on colonoscopy and polypectomy practices, we first undertook a national survey of practising endoscopists to assess whether significant variations in colonoscopy and polypectomy practice exist across Australia. The second area of study is whether prediction of colonoscopy surveillance intervals based on real time endoscopic assessment of polyp histology is safe, feasible, accurate and cost effective. A prospective cohort study was performed across public and private centres, 94 patients who underwent colonoscopy and polypectomy of diminutive (