MEDICA 2012 PREVIEW


‘A major study from the US, based on almost 155,000 patients, showed that sigmoidoscopies can help to reduce the incidence of colorectal cancer and the number of fatalities caused by this tumour.’


tumour patients already have metastases in this organ when the primary tumour is diagnosed. Prostate cancer is another example of an area of application. Such image fusion systems are being offered, for example, by MEDICA exhibitors such as GE, which has already been active in the market since 2008 with the ultrasound device LOGIQ E9, Siemens (Acuson S3000) and also Toshiba (Aplio 500 Smart Fusion).


Diagnosis of intestinal cancer Another technique which is advancing early detection of intestinal cancer involves the use of endoscopy. There is broad agreement regarding its advantages. The familiar problem is that too few people access the so-called ‘diagnostic gold standard’, that is, the complete colonoscopy by means of white light endoscopy, partially due to misgivings about the uncomfortable examination. Consequently, the search for techniques that find broader acceptance has been going on for several years now. Capsule endoscopy is just one familiar example of such a technique. One option is to restrict the


endoscopic examination to a flexible sigmoidoscopy, which is supposed to be less disagreeable. Recently, a major study from the US, based on almost 155,000 patients, showed that sigmoidoscopies can help to reduce the incidence of colorectal cancer and the number of fatalities caused by this tumour (New England Journal of Medicine 2012; 366: 2345-2357). According to the authors of the study, led by Professor Robert Schoen (University of Pittsburgh), the tumour incidence was reduced by 21% within an average time of almost 12 years, in absolute figures from 15.2 to 11.9 malignant tumours per 10,000 person- years. The mortality rate was reduced by 26% (from 3.2 to 2.9 per 10,000 person- years). This outcome was based solely on a reduction of the fatalities caused by distal colorectal cancer (50%). More acceptance (and possibly lower


costs) and, of course, a higher rate of detected adenomas are further goals being pursued by the new colonoscopy techniques. One such a technique is water and CO2


colonoscopy, according to Dr Jutta Herzog and assistant professor Dr Axel


NOVEMBER 2012


Eickhoff from the Hanau Hospital. In comparison to conventional, painful ambient air colonoscopy, it significantly reduces the amount of pain and enables the examination of non-sedated or lightly sedated patients without higher costs or significantly longer set-up times (Gastroenterologe 2012; 7: 134-8).


3D laparoscopy 3D-HD laparoscopy is also considered an improvement over existing techniques. It not only delivers brilliant, razor-sharp images, but also enables the surgeon to work with great concentration for longer periods than before. “The 3D technique simplifies the surgeon’s work,” said Spanish abdominal surgeon, Dr Antonio M. Lacy Fortuny, one of the pioneers in this field. Those doctors, in particular, who are still in need of practice can benefit from the 3D technique after a few examinations. At present, the technique is especially popular, for example, in obesity surgery, which has been experiencing a boom for the last few years in the US and also in Europe. Such 3D systems are being offered by the US company Viking Systems (Viking 3DHD Vision System), which is exhibiting at MEDICA 2012. At MEDICA 2012, topics like modern


imaging technologies and innovative approaches to therapy in general will be addressed by several congress events, including: Diagnosis and therapy of gastrointestinal tumours (No. 113/Prof. Dr. Zoller, 14 November, CCD. Pavillion, starting 10:00 pm); Differential deployment of imaging (No. 125/ Prof. Dr. Antoch, 14 November, CCD. South, starting 14:30 pm); What’s new in prevention of intestinal cancer (No. 317/ Presentation: Prof. Dr. Riemann, 16. November, starting 13:15 pm, CCD. South).


‘Image fusion means less radiation exposure for patients and obviates the need for contrast agent, which is toxic to the kidneys.’


Healthcare IT While the markets for complete hospital information systems and surgery IT are undergoing a period of stagnation and are characterised by concentration and consolidation processes on the supplier side, the area of ‘eHealth’ is booming at the moment, a field on which MEDICA has already focused for several years. This includes, for example, compact mobile IT systems for use at the point of care, telemedicine applications for rapid exchange of information between the doctors that are treating a particular patient and so-called ‘home care’ solutions for remote monitoring, for instance of chronically ill or elderly patients. Industry experts expect the telemedicine market to see strong growth in the years ahead, with analysts predicting annual growth rates as high as 10% in this field up until 2020.


THE CLINICAL SERVICES JOURNAL 35


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