| Autor: |
Sint Nicolaas, J., de Jonge, V., van Baalen, O., Kubben, F. J. M., Moolenaar, W., Stolk, M. F. J., Kuipers, E. J., van Leerdam, M. E. |
| Předmět: |
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| Zdroj: |
Endoscopy; Jul2013, Vol. 45 Issue 7, p545-552, 8p |
| Abstrakt: |
Background and study aims: The assessment of indications for follow-up colonoscopy may help to improve the allocation of available endoscopy resources. The aim of this study was to assess the timing of early follow-up colonoscopy and surveillance utilization in relation to adenoma detection rate (ADR) at follow-up. Methods: An assessment of the timing and yield of follow-up colonoscopies was performed in patients with non-inflammatory bowel disease (IBD) in a Dutch multicenter study. The primary outcome was the number of patients with a prior (index) colonoscopy. The necessity for follow-up procedures was assessed using the ADR. Results: Of 4800 consecutive patients undergoing a colonoscopy, 1249 non-IBD patients had undergone an index colonoscopy. Of these, follow-up procedures were performed within 1 year in 27% (331/1249). Excluding incomplete colonoscopy, incomplete polypectomy, or poor bowel preparation on index, the ADR on early follow-up was 4% for symptomatic and 26% for asymptomatic patients. Among the asymptomatic patients with a follow-up colonoscopy at >1 year (n=463), an ADR of 23% (108/463) was found. In 27% of these patients, the observed surveillance intervals were in accordance with American Gastroenterological Association (AGA) surveillance recommendations; 60% were classified as over-utilization and 13% as under-utilization according to the AGA. Optimal utilization follow-up colonoscopies had higher ADRs on follow-up compared with overutilized procedures (31% vs. 17%; P<0.001). Conclusions: Follow-up colonoscopy in symptomatic patients within a year has limited value in terms of adenoma detection. A considerable proportion of surveillance colonoscopies are performed too early according to current guidelines, resulting in low detection rates. Both aspects can be targeted for optimal usage in endoscopic capacity. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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