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Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
e175
Material and methods:
Data were retrospectively collected. We
analyzed data of 206 Pts affected by chronic constipation, previously
not evaluated by others gastroenterologists and not affected by
secondary constipation. We measured number of Pts studied by
DE+BET and concordance between tests.
Results:
Pts were 71% females, with an average age of 58 years old
and affected by constipation on average by 18 years. DE and/or BET
were performed in 157 Pts (76%). Both tests were performed in 119
Pts (57%) and were concordant in 73% of Pts. A concordant (DE+ BET)
positive pattern confirming ODS was present in 41% of Pts studied by
both tests. A concordant (DE+BET) negative pattern excluding ODS
was present in 32% of Pts studied by both tests.
Conclusions:
The prevalence of concordant (DE+BET) positive
pattern confirming ODS in unselected Pts evaluated in a open
access ambulatory was 41%. We were confident to stop other ano-
rectal studies in 32% of Pts negatives for both tests. We think that
a clinical approach by DE combined with BET is feasible in daily
clinical practice, is helpful to guide diagnostic work-up in most of
constipated Pts and could prevent further ano-rectal investigation.
The prevalence of ODS is elevated in an open access primary center.
P.09.10
CLINICAL USE OF VIDEO CAPSULE ENDOSCOPY FOR SMALL
BOWEL SURVEILLANCE IN HEREDITARY COLORECTAL CANCER
SYNDROMES
Stigliano V.*, Sanchez Mete L., Anti M.
Regina Elena National Cancer Institute, Roma, Italy
Background and aim:
Patients with Hereditary Colorectal
Cancer Syndromes (HCCS) have an increased risk to develop
adenocarcinoma of the small bowel (SB) arising from premalignant
polyps. In the last fifteen years, the advent of capsule endoscopy
(VCE) and balloon enteroscopy allowed to reach a comprehensive
exploration of the entire SB and changed the clinical management of
these patients (pts). The indications of the International Guidelines
for SB surveillance in HCCS are still undefined. The aims of the
present study were: 1) to evaluate the prevalence and characteristics
of SB neoplasm in pts with HCCS assessed by VCE; 2) to evaluate the
safety and diagnostic accuracy of VCE.
Material and methods:
From January 2007, pts with a diagnosis
of HCCS in follow-up at Regina Elena National Cancer Institute
HCCS Clinics were enrolled in the study. All pts were clinically
asymptomatic and underwent VCE examination, gastroscopy (with
side viewing in FAP cases) and lower endoscopy within one month
from VCE examination. Pts with SB neoplasm detected at VCE
underwent Push enteroscopy (PE) or Single balloon enteroscopy
within 1-3 months from VCE examination.
Results:
86 patients with HCCS (36M/50F, mean age at VCE
examination of 40.2 years, range 17-67), were enrolled in the study.
VCE detected SB polyps in 48 cases (55,8%), 35/64 FAP (57,8%), 7/8
PJS (87,5%), 4/12 LS (33,3%) and none of the MAP pts. We observed
that each HCCS had its typical polyp pattern: low burden (n<5),
small size (<5 mm) and most frequently upper SB involvement in
FAP; a low burden, large size (> 1 cm), upper SB involvement in LS;
a variable number, a large size and the entire SB involvement in PJS.
Comparison of VCE with endoscopy (gold standard) showed a low
diagnostic accuracy (70.9%; IC 61,33-80,53), sensitivity (71.7%, IC
57,38-86,02) and specificity (69.7%, IC 56,70-82,70). In FAP cases we
evaluated the association between Spigelman stage and presence
of non duodenal SB polyps and it resulted not significant (Kappa
coefficient of concordance=0.402).
Conclusions:
In FAP and LS cases, in which upper SB resulted mostly
involved (in line with scientific literature), duodenoscopy and upper
PE could be adequate and VCE could be performed only in selected
cases. In PJS patients, VCE had high performance and allowed to
evaluate the whole SB usually entirely involved. In conclusion, VCE
is a safe, well-tolerated, non invasive but expensive tool, its use
could be routinary in PJS and limited to selected cases in FAP and LS.
P.09.11
ASSOCIATION BETWEEN COLORECTAL POLYPS AND COLONIC
DIVERTICULOSIS
Ciccone F.*, Valerii G., Gabrieli D., Calcina S., Capannolo A.,
Viscido A., Melideo D., Frieri G., Necozione S., Latella G.
Università degli studi dell’Aquila, L’Aquila, Italy
Background and aim:
colonic diverticula and neoplastic colorectal
lesions are found in similar ranges of age and populations, but it is
unclear whether there is a shared pathway in their development.
Their frequency increases with age and seems to be associated with
a lack of dietary fibres, increased dietary saturated fats, obesity
and a slow colonic transit time. The association of diverticulosis
and colorectal polyps has been previously evaluated, reporting
conflicting results. Despite common epidemiologic predisposing
factors, the association between diverticulosis and colon polyps
remains unclear and needs to be better defined, as it could have
important implications for the screening of colorectal cancer. The
aim is to evaluate the association between colorectal polyps, cancer
and colonic diverticulosis.
Material and methods:
A one-year prospective study including all
consecutive patients undergoing to routine colonoscopy at our GI
Unit from September 2014 to September 2015. The presence and
location of diverticula, polyps, and cancers was recorded using
colonoscopy reports. Types of colorectal neoplastic lesions were
defined by histopathological examination. Polyps were classified into
adenoma (with low or high dysplasia), hyperplastic or inflammatory
polyps. A multiple logistic regression analysis was done to evaluate
the association between diverticular disease and colonic lesions.
Results:
447 patients were included in the study (245 M, 202 F, mean
age 66 years): 166 (37.1%) patients presented only diverticulosis, 155
(34.7%) patients presented only polyps, and 126 (28.2%) patients
presented both the diseases associated.
There was no significant association between adenoma and colonic
diverticula, as well as between colorectal cancer and diverticula. On
the other hand, colorectal inflammatory polyps showed a significant
association with diverticulosis.
Conclusions:
The results of the study show no association between
adenomas and diverticula nor between cancer and diverticula.
Therefore, patients with colonic diverticulosis do not require a
different follow-up for the prevention of colorectal cancer than the
general population. Inflammatory polyps are frequently associated
to colonic diverticular disease probably due to the same pathogenic
factors.
P.09.12
ASSESSMENT OF FECAL MICROBIOTA AND FECAL METABOLOME
IN SYMPTOMATIC UNCOMPLICATED DIVERTICULAR DISEASE OF
THE COLON
Tursi A.*
1
, Mastromarino P.
2
, Capobianco D.
2
, Elisei W.
3
, Miccheli A.
4
,
Capuani G.
4
, Picchio M.
5
, Giorgetti G.
6
, Fabiocchi F.
6
, Di Fonzo M.
7
,
Brandimarte G.
7
1
Gastroenterology Service, ASL BAT, Andria (BT), Italy,
2
Department of
Public Health, Section of Microbiology, “Sapienza” University, Roma, Italy,
3
Division of Gastroenterology, ASL RMH, Albano Laziale (Roma), Italy,
4
Department of Chemistry, “Sapienza” University, Roma, Italy,
5
Division of
Surgery, “P. Colombo” Hospital, ASL RMH, Velletri (Roma), Italy,
6
Digestive
Endoscopy and Nutrition Unit, “S. Eugenio” Hospital, Roma, Italy,
7
Division of Gastroenterology, “Cristo Re” Hospital, Roma, Italy