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| 1 | Sessile serrated adenoma/polyps: Where are we at in 2016?显示文摘It is currently known that colorectal cancers(CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway(50%-70%); the mutator 'Lynch syndrome' route(3%-5%); and the serrated pathway(30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps(HP),sessile serrated adenomas/polyps(SSA/P) and traditional serrated adenomas(TSA),the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders,submucosal injection of a dye solution(for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions. | Rajvinder Singh Leonardo Zorrón Cheng Tao Pu Doreen Koay Alastair Burt | 2016 | World Journal of Gastroenterology2016，22，34： | 13 |
| 2 | Narrow band imaging with magnification for the diagnosis of lesions in the upper gastrointestinal tract显示文摘Endoscopy plays an important role in the diagnosis and management of gastrointestinal(GI)tract disorders.Chromoendoscopy has proven to be superior to white light endoscopy for early detection of various GI lesions.This has however been fraught with problems.The use of color stains,time taken to achieve an effect and the learning curve associated with the technique has been some of the pitfalls.Narrow band imaging(NBI)particularly in combination with magnifying endoscopy may allow the endoscopist to accomplish a fairly accurate diagnosis with good histological correlation similar to results achieved with chromoendoscopy.Such enhanced detection of pre-malignant and early neoplastic lesions in the gastrointestinal tract should allow better targeting of biopsies and could ultimately prove to be cost effective.Various studies have been done demonstrating the utility of this novel technology.This article will review the impact of NBI in the diagnosis of upper gastrointestinal tract disorders. | Rajvinder Singh Asif Hussain Cheong Kuan Loong | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，12： | 12 |
| 3 | Endoscopic diagnosis and treatment of gastric dysplasia and early cancer:Current evidence and what the future may hold显示文摘Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality.The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage.In high prevalence regions such as Japan and Korea,this has led to the implementation of population screening programs.However,guidelines remain ambiguous in lower prevalence regions.In recent years,there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions.More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection.In addition,promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging.Data on endoscopic resection(ER)are particularly robust in Japan and Korea,with high rates of curative ER and markedly reduced procedural morbidity.However,there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries.Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER,as both technology and proceduralist expertise continue to grow. | Edward Young Hamish Philpott Rajvinder Singh | 2021 | World Journal of Gastroenterology2021，27，31： | 12 |
| 4 | Advanced endoscopic imaging in Barrett's oesophagus:A review on current practice显示文摘Over the last few years,improvements in endoscopic imaging technology have enabled identification of dysplasia and early cancer in Barrett's oesophagus.New techniques should exhibit high sensitivities and specificities and have good interobserver agreement.They should also be affordable and easily applicable to the community gastroenterologist.Ideally,these modalities must exhibit the capability of imaging wide areas in real time whilst enabling the endoscopist to specifically target abnormal areas.This review will specifically focus on some of the novel endoscopic imaging modalities currently available in routine practice which includes chromoendoscopy,autofluorescence imaging and narrow band imaging. | Rajvinder Singh SweeLin Chen Yi Mei Sandeep Sethi | 2011 | World Journal of Gastroenterology2011，17，38： | 4 |
| 5 | Randomised controlled trial comparing modified Sano's and narrow band imaging international colorectal endoscopic classifications for colorectal lesions显示文摘AIM To assess the utility of modified Sano′s(MS) vs thenarrow band imaging international colorectal endoscopic(NICE) classification in differentiating colorectal polyps.METHODS Patients undergoing colonoscopy between 2013 and 2015 were enrolled in this trial.Based on the MS or the NICE classifications,patients were randomised for real-time endoscopic diagnosis.This was followed by biopsies,endoscopic or surgical resection.The endoscopic diagnosis was then compared to the final(blinded) histopathology.The primary endpoint was the sensitivity(Sn),specificity(Sp),positive predictive value(PPV) and negative predictive value(NPV) of differentiating neoplastic and non-neoplastic polyps(MSⅡ/Ⅱo/Ⅲa/Ⅲb vs I or NICE 1 vs 2/3).The secondary endpoints were 'endoscopic resectability'(MSⅡ/Ⅱo/Ⅲa vs Ⅰ/Ⅲb or NICE 2 vs 1/3),NPV for diminutive distal adenomas and prediction of post-polypectomy surveillance intervals.RESULTS A total of 348 patients were evaluated.The Sn,Sp,PPV and NPV in differentiating neoplastic polyps from non-neoplastic polyps were,98.9%,85.7%,98.2% and 90.9% for MS;and 99.1%,57.7%,95.4% and 88.2% for NICE,respectively.The area under the receiver operating characteristic curve(AUC) for MS was 0.92(95%CI:0.86-0.98);and AUC for NICE was 0.78(95%CI:0.69,0.88).The Sn,Sp,PPV and NPV in predicting 'endoscopic resectability' were 98.9%,86.1%,97.8% and 92.5% for MS;and 98.6%,66.7%,94.7% and 88.9% for NICE,respectively.The AUC for MS was 0.92(95%CI:0.87-0.98);and the AUC for NICE was 0.83(95%CI:0.75-0.90).The AUC values were statistically different for both comparisons(P = 0.0165 and P = 0.0420,respectively).The accuracy for diagnosis of sessile serrated adenoma/polyp(SSA/P) with high confidence utilizing MS classification was 93.2%.The differentiation of SSA/P from other lesions achieved Sp,Sn,PPV and NPV of 87.2%,91.5%,89.6% and 98.6%,respectively.The NPV for predicting adenomas in diminutive rectosigmoid polyps(n = 150) was 96.6% and 95% with MS and NICE respectively.The calculated accuracy of post-polypectomy surveillance for MS group was 98.2%(167 out of 170) and for NICE group was 92.1%(139 out of 151).CONCLUSION The MS classification outperformed the NICE classification in differentiating neoplastic polyps and predicting endoscopic resectability.Both classifications met ASGE PIVI thresholds. | Leonardo Zorrón Cheng Tao Pu Kuan Loong Cheong Doreen Siew Ching Koay Sze Pheh Yeap Amanda Ovenden Mahima Raju Andrew Ruszkiewicz Philip W Chiu James Y Lau Rajvinder Singh | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，9： | 4 |
| 6 | White light endoscopy,narrow band imaging and chromoendoscopy with magnification in diagnosing colorectal neoplasia显示文摘AIM:To evaluate the sensitivity(Sn),specificity(Sp),positive predictive value(PPV) and negative predictive value(NPV) of 3 different techniques:high resolution white light endoscopy(WLE),Narrow Band Imaging(NBI) and Chromoendoscopy(CHR),all with magnification in differentiating adenocarcinomas,adenomatous and hyperplastic colorectal polyps.METHODS:Each polyp was sequentially assessed first by WLE,followed by NBI and finally by CHR.Digital images of each polyp with each modality were taken and stored.Biopsies or polypectomies were then performed followed by blinded histopathological analysis.Each image was blindly graded based on the Kudo's pit pattern(KPP).In the assessment with NBI,the mesh brown capillary network pattern(MBCN) of each polyp was also described.The Sn,Sp,PPV and NPV of differentiating hyperplastic(Type Ⅰ & Ⅱ-KPP,Type Ⅰ-MBCN) adenomatous(Types Ⅲ,Ⅳ-KPP,Type Ⅱ-MBCN) and carcinomatous polyps(Type Ⅴ-KPP,Type Ⅲ-MCBN) was then compared with reference to the final histopathological diagnosis.RESULTS:A total of 50 colorectal polyps(5 adenocarcinomas,38 adenomas,7 hyperplastic) were assessed.CHR and NBI [KPP,MBCN or the combined classification(KPP & MBCN)] were superior to WLE in the prediction of polyp histology(P < 0.001,P=0.002,P=0.001 and P < 0.001,respectively).NBI,using the MBCN pattern or the combined classification showed higher numerical accuracies compared to CHR,but this was not statistically significant(P=0.625,0.250).CONCLUSION:This feasibility study demonstrated that this combined classification with NBI could potentially be useful in routine clinical practice,allowing the endoscopist to predict histology with higher accuracies using a less cumbersome and technically less challenging method. | Rajvinder Singh Victoria Owen Anthony Shonde Philip Kaye Christopher Hawkey Krish Ragunath | 2009 | World Journal of Gastrointestinal Endoscopy2009，1，1： | 3 |
| 7 | Carbon dioxide insufflation during colonoscopy in deeply sedated patients显示文摘AIM:To compare the impact of carbon dioxide(CO2) and air insufflation on patient tolerance/safety in deeply sedated patients undergoing colonoscopy.METHODS:Patients referred for colonoscopy were randomized to receive either CO2 or air insufflation during the procedure.Both the colonoscopist and patient were blinded to the type of gas used.During the procedure,insertion and withdrawal times,caecal intubationrates,total sedation given and capnography readings were recorded.The level of sedation and magnitude of patient discomfort during the procedure was assessed by a nurse using a visual analogue scale(VAS)(0-3).Patients then graded their level of discomfort and abdominal bloating using a similar VAS.Complications during and after the procedure were recorded.RESULTS:A total of 142 patients were randomized with 72 in the air arm and 70 in the CO2 arm.Mean age between the two study groups were similar.Insertion time to the caecum was quicker in the CO2 group at 7.3 min vs 9.9 min with air(P = 0.0083).The average withdrawal times were not significantly different between the two groups.Caecal intubation rates were 94.4% and 100% in the air and CO2 groups respectively(P = 0.012).The level of discomfort assessed by the nurse was 0.69(air) and 0.39(CO2)(P = 0.0155) and by the patient 0.82(air) and 0.46(CO2)(P = 0.0228).The level of abdominal bloating was 0.97(air) and 0.36(CO2)(P = 0.001).Capnography readings trended to be higher in the CO2 group at the commencement,caecal intubation,and conclusion of the procedure,even though this was not significantly different when compared to readings obtained during air insufflation.There were no complications in both arms.CONCLUSION:CO2 insufflation during colonoscopy is more efficacious than air,allowing quicker and better cecal intubation rates.Abdominal discomfort and bloating were significantly less with CO2 insufflation. | Rajvinder Singh Eu Nice Neo Nazree Nordeen Ganesananthan Shanmuganathan Angelie Ashby Sharon Drummond Garry Nind Elizabeth Murphy Andrew Luck Graeme Tucker William Tam | 2012 | World Journal of Gastroenterology2012，18，25： | 3 |
| 8 | Real-time histology with the endocytoscope显示文摘Endoscopic Imaging has progressed tremendously over the last few decades. Novel imaging technologies such as high-resolution and high-magnification white light endoscopy, narrow band imaging, optimal band imaging, auto? ourescence imaging and optical coherence tomography not only aid the endoscopist in detecting malignant or pre-malignant lesions but also assist in predicting histology. Recently, the introduction of Endocytoscopy (EC) and Confocal Endomicroscopy has taken us into a new realm of diagnostic endoscopy. With the ability to magnify up to 1000 ×, cellular structures can be visualized in real-time. This advance in technology could potentially lead to a paradigm shift negating the need to obtain biopsies. EC is, however, still in the early stages of development and further research needs to be carried out before it can be accepted as standard practice. This review will focus on the diagnostic utility of the Endocytoscope. | Rajvinder Singh Swee Lin Chen Yi Mei William Tam Devinder Raju Andrew Ruszkiewicz | 2010 | World Journal of Gastroenterology2010，16，40： | 3 |
| 9 | Multicenter randomised controlled trial comparing the high definition white light endoscopy and the bright narrow band imaging for colon polyps显示文摘AIM To compare high definition white light endoscopy and bright narrow band imaging for colon polyps' detection rates. METHODS Patients were randomised to high definition white light endoscopy(HD-WLE) or the bright narrow band imaging(b NBI) during withdrawal of the colonoscope. Polyps identified in either mode were characterised using b NBI with dual focus(b NBI-DF) according to the Sano's classification. The primary outcome was to compare adenoma detection rates(ADRs) between the two arms. The secondary outcome was to assess the negative predictive value(NPV) in differentiating adenomas from hyperplastic polyps for diminutive rectosigmoid lesions.RESULTS A total of 1006 patients were randomised to HD-WLE(n = 511) or b NBI(n = 495). The mean of adenoma per patient was 1.62 and 1.84, respectively. The ADRs in b NBI and HD-WLE group were 37.4% and 39.3%, respectively. When adjusted for withdrawal time(OR = 1.19, 95%CI: 1.15-1.24, P < 0.001), the use of b NBI was associated with a reduced ADR(OR = 0.69, 95%CI: 0.52-0.92). Nine hundred and thirty three polyps(86%) in both arms were predicted with high confidence. The sensitivity(Sn), specificity(Sp), positive predictive value and NPV in differentiating adenomatous from non-adenomatous polyps of all sizes were 95.9%, 87.2%, 94.0% and 91.1% respectively. The NPV in differentiating an adenoma from hyperplastic polyp using b NBI-DF for diminutive rectal polyps was 91.0%.CONCLUSION ADRs did not differ between b NBI and HD-WLE, however HD-WLE had higher ADR after adjustment of withdrawal time. b NBI surpassed the PIVI threshold for diminutive polyps. | Rajvinder Singh Kuan Loong Cheong Leonardo Zorron Cheng Tao Pu Dileep Mangira Doreen Siew Ching Koay Carmen Kee Siew Chien Ng Rungsun Rerknimitr Satimai Aniwan Tiing-Leong Ang Khean-Lee Goh Shiaw Hooi Ho James Yun-Wong Lau | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，6： | 2 |
| 10 | Mucosal imaging in colon polyps:New advances and what the future may hold显示文摘An expanding range of advanced mucosal imaging technologies have been developed with the goal of improving the detection and characterization of lesions in the gastrointestinal tract.Many technologies have targeted colorectal neoplasia given the potential for intervention prior to the development of invasive cancer in the setting of widespread surveillance programs.Improvement in adenoma detection reduces miss rates and prevents interval cancer development.Advanced imaging technologies aim to enhance detection without significantly increasing procedural time.Accurate polyp characterisation guides resection techniques for larger polyps,as well as providing the platform for the“resect and discard”and“do not resect”strategies for small and diminutive polyps.This review aims to collate and summarise the evidence regarding these technologies to guide colonoscopic practice in both interventional and non-interventional endoscopists. | Edward John Young Arvinf Rajandran Hamish Lachlan Philpott Dharshan Sathananthan Sophie Fenella Hoile Rajvinder Singh | 2022 | World Journal of Gastroenterology2022，28，47： | 2 |
| 11 | Role of endoscopy in the surveillance and management of colorectal neoplasia in inflammatory bowel disease显示文摘Endoscopy has become increasingly fundamental in the management of patients with inflammatory bowel disease(IBD). It is required for diagnosis, assessment of therapeutic response, postoperative follow up and in the surveillance of dysplasia. With rapid advances in technology, including high definition colonoscopy and chromoendoscopy, questions have arisen regarding the most appropriate surveillance and management strategies of colorectal neoplasia in IBD. We aim to review current surveillance strategies, explore the utility of new technologies, and examine the role of endoscopic resection, with the aim of clarifying these questions. | Shaad Manchanda Qurat-ul-ain Rizvi Rajvinder Singh | 2019 | World Journal of Clinical Cases2019，7，1： | 1 |
| 12 | Endoscopic Mucosal Resection Outcomes and Prediction of Submucosal Cancer From Advanced Colonic Mucosal Neoplasia显示文摘 | Alan Moss Michael J. Bourke Stephen J. Williams Luke F. Hourigan Gregor Brown William Tam Rajvinder Singh Simon Zanati Robert Y. Chen Karen Byth | 2011 | Gastroenterology2011，，7： | 1 |
| 13 | Evaluation of clinical efficiency of micro implant as an anchorage in comparison with conventional first molar anchorage显示文摘 | Srinivas N Reddy G H Rajvinder J | 2012 | Journal of International Oral Health2012，4，1： | 1 |
| 14 | Endoscopic Mucosal Resection Outcomes and Prediction of Submucosal Cancer From Advanced Colonic Mucosal Neoplasia显示文摘 | Alan Moss Michael J. Bourke Stephen J. Williams Luke F. Hourigan Gregor Brown William Tam Rajvinder Singh Simon Zanati Robert Y. Chen Karen Byth | 2011 | Gastroenterology2011，，7： | 1 |
| 15 | Impact of a computer-based teaching module on characterization of diminutive colon polyps by using narrow-band imaging by non-experts in academic and community practice: a video-based study显示文摘 | Amit Rastogi Deepthi S. Rao Neil Gupta Scott W. Grisolano Daniel C. Buckles Elena Sidorenko John Bonino Takahisa Matsuda Evelien Dekker Tonya Kaltenbach Rajvinder Singh Sachin Wani Prateek Sharma Mojtaba S. Olyaee Ajay Bansal James E. East | 2014 | Gastrointestinal Endoscopy2014，，3： | 1 |
| 16 | Update on narrow band imaging in disorders of the upper gastrointestinal tract显示文摘 | Rajvinder Singh Shok Y. Lee Nimal Vijay Prateek Sharma Noriya Uedo | 2014 | Digestive Endoscopy2014，，2： | 1 |
| 17 | Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence显示文摘The role of endoscopic procedures,in both diagnostic and therapeutic purposes is continually expanding and evolving rapidly.In this context,endoscopists will encounter patients prescribed on anticoagulant and antiplatelet medications frequently.This poses an increased risk of intraprocedural and delayed gastrointestinal bleeding.Thus,there is now greater importance on optimal pre,peri and post-operative management of anticoagulant and/or antiplatelet therapy to minimise the risk of post-procedural bleeding,without increasing the risk of a thromboembolic event as a consequence of therapy interruption.Currently,there are position statements and guidelines from the major gastroenterology societies.These are available to assist endoscopists with an evidenced-based systematic approach to anticoagulant and/or antiplatelet management in endoscopic procedures,to ensure optimal patient safety.However,since the publication of these guidelines,there is emerging evidence not previously considered in the recommendations that may warrant changes to our current clinical practices.Most notably and divergent from current position statements,is a growing concern regarding the use of heparin bridging therapy during warfarin cessation and its associated risk of increased bleeding,suggestive that this practice should be avoided.In addition,there is emerging evidence that anticoagulant and/or antiplatelet therapy may be safe to be continued in cold snare polypectomy for small polyps(<10 mm). | Andrew Chan Hamish Philpott Amanda H Lim Minnie Au Derrick Tee Damian Harding Mohamed Asif Chinnaratha Biju George Rajvinder Singh | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，11： | 0 |
| 18 | Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region显示文摘BACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus(BE),making standardization challenging.AIM To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists.METHODS Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis,surveillance and management of BE.RESULTS Five hundred sixty-nine of 1016(56.0%)respondents completed the survey,with most respondents from Japan(n=310,54.5%)and China(n=129,22.7%).Overall,the preferred endoscopic landmark of the esophagogastric junction was squamocolumnar junction(42.0%).Distal palisade vessels was preferred in Japan(59.0%vs 10.0%,P<0.001)while outside Japan,squamo-columnar junction was preferred(59.5%vs 27.4%,P<0.001).Only 16.3%of respondents used Prague C and M criteria all the time.It was never used by 46.1%of Japanese,whereas 84.2%outside Japan,endoscopists used it to varying extents(P<0.001).Most Asian endoscopists(70.8%)would survey long-segment BE without dysplasia every two years.Adherence to Seattle protocol was poor with only 6.3%always performing it.73.2%of Japanese never did it,compared to 19.3%outside Japan(P<0.001).The most preferred(74.0%)treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis.For BE with low-grade dysplasia,6-monthly surveillance was preferred in 61.9%within Japan vs 47.9%outside Japan(P<0.001).CONCLUSION Diagnosis and management of BE varied within Asia,with stark contrast between Japan and outside Japan.Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction,which is incorrect.Most also did not consistently use Prague criteria,and Seattle protocol.Lack of standardization,education and research are possible reasons. | Guan Sen Kew Alex Yu Sen Soh Yeong Yeh Lee Takuji Gotoda Yan-Qing Li Yan Zhang Yiong Huak Chan Kewin Tien Ho Siah Daniel Tong Simon Ying Kit Law Andrew Ruszkiewicz Ping-Huei Tseng Yi-Chia Lee Chi-Yang Chang Duc Trong Quach Chika Kusano Shobna Bhatia Justin Che-Yuen Wu Rajvinder Singh Prateek Sharma Khek-Yu Ho | 2021 | World Journal of Gastrointestinal Oncology2021，13，4： | 0 |
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