Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials

Autor: Frederik Emil Juul, Kjetil Garborg, Eugen Nesbakken, Magnus Løberg, Paulina Wieszczy, Joaquín Cubiella, Mette Kalager, Michael F Kaminski, Rune Erichsen, Hans-Olov Adami, Monika Ferlitsch, Siv K B Furholm, Ann G Zauber, Enrique Quintero, Marek Bugajski, Øyvind Holme, Evelien Dekker, Rodrigo Jover, Michael Bretthauer
Přispěvatelé: Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism
Rok vydání: 2022
Předmět:
Zdroj: Juul, F E, Garborg, K, Nesbakken, E, Løberg, M, Wieszczy, P, Cubiella, J, Kalager, M, Kaminski, M F, Erichsen, R, Adami, H O, Ferlitsch, M, Furholm, S K B, Zauber, A G, Quintero, E, Bugajski, M, Holme, Ø, Dekker, E, Jover, R & Bretthauer, M 2023, ' Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas : Results from the EPoS trials ', Gut, vol. 72, no. 5, pp. 951-957 . https://doi.org/10.1136/gutjnl-2022-327696
Gut. BMJ Publishing Group
ISSN: 1468-3288
0017-5749
DOI: 10.1136/gutjnl-2022-327696
Popis: ObjectiveHigh-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance.DesignWe retrieved data of all patients with low-risk adenomas (one or two tubular adenomas ResultsThe study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%).ConclusionThere is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.Trial registration numberNCT02319928.
Databáze: OpenAIRE
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