Browsing by Author "Bourke, Michael J."

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    The colonoscopist's guide to the vocabulary of colorectal neoplasia: histology, morphology, and management
    (Elsevier, 2017) Rex, Douglas K.; Hassan, Cesare; Bourke, Michael J.; Department of Medicine, IU School of Medicine
    Prevention of colorectal cancer by colonoscopy requires effective and safe insertion technique, high level detection of precancerous lesions, and skillful use of curative endoscopic resection techniques. Lesion detection, characterization, use of appropriate resection methods, prediction of cancer at colonoscopy, and management of malignant polyps, all depend on an accurate and complete understanding of an extensive vocabulary describing the histology and morphology of neoplastic colorectal lesions. Incomplete understanding of vocabulary terms can lead to management errors. We provide a colonoscopist’s perspective on the vocabulary of colorectal neoplasia, and discuss the interaction of specific terms with management decisions.
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    Proposal for the return to routine endoscopy during the COVID-19 pandemic
    (Elsevier, 2020) Gupta, Sunil; Shahidi, Neal; Gilroy, Nicole; Rex, Douglas K.; Burgess, Nicholas G.; Bourke, Michael J.; Medicine, School of Medicine
    In response to the COVID-19 pandemic, many jurisdictions and gastroenterological societies around the world have suspended nonurgent endoscopy. Subject to country-specific variability, it is projected that with current mitigation measures in place, the peak incidence of active COVID-19 infections may be delayed by over 6 months. Although this aims to prevent the overburdening of healthcare systems, prolonged deferral of elective endoscopy will become unsustainable. Herein, we propose that by incorporating readily available point-of-care tests and conducting accurate clinical risk assessments, a safe and timely return to elective endoscopy is feasible. Our algorithm not only focuses on the safety of patients and healthcare workers, but also assists in rationalizing the use of invaluable resources such as personal protective equipment.
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    When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement
    (Elsevier, 2021) Medina-Prado, Lucía; Hassan, Cesare; Dekker, Evelien; Bisschops, Raf; Alfieri, Sergio; Bhandari, Pradeep; Bourke, Michael J.; Bravo, Raquel; Bustamante-Balen, Marco; Dominitz, Jason; Ferlitsch, Monika; Fockens, Paul; van Leerdam, Monique; Lieberman, David; Herráiz, Maite; Kahi, Charles; Kaminski, Michal; Matsuda, Takahisa; Moss, Alan; Pellisé, Maria; Pohl, Heiko; Rees, Colin; Rex, Douglas K.; Romero-Simó, Manuel; Rutter, Matthew D.; Sharma, Prateek; Shaukat, Aasma; Thomas-Gibson, Siwan; Valori, Roland; Jover, Rodrigo; Medicine, School of Medicine
    Background & Aims There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on the indications and appropriate techniques for colonic tattoo through a modified Delphi process. Methods The baseline questionnaire was classified into 3 areas: where tattooing should not be used (1 domain, 6 questions), where tattooing should be used (4 domains, 20 questions), and how to perform tattooing (1 domain 20 questions). A total of 29 experts participated in the 3 rounds of the Delphi process. Results A total of 15 statements were approved. The statements that achieved the highest agreement were as follows: tattooing should always be used after endoscopic resection of a lesion with suspicion of submucosal invasion (agreement score, 4.59; degree of consensus, 97%). For a colorectal lesion that is left in situ but considered suitable for endoscopic resection, tattooing may be used if the lesion is considered difficult to detect at a subsequent endoscopy (agreement score, 4.62; degree of consensus, 100%). A tattoo should never be injected directly into or underneath a lesion that might be removed endoscopically at a later point in time (agreement score, 4.79; degree of consensus, 97%). Details of the tattoo injection should be stated clearly in the endoscopy report (agreement score, 4.76; degree of consensus, 100%). Conclusions This expert consensus has developed different statements about where tattooing should not be used, when it should be used, and how that should be done.