Routine lower gastrointestinal endoscopy for radiographically confirmed acute diverticulitis. In whom and when is it indicated?
| Autor: | Marc Batlle García, Miguel Pera Román, Miguel Ángel Pantaleón Sánchez, Luis Barranco Priego, Marco Antonio Alvarez-Gonzalez, Xavier Bessa Caserras, Agustín Seoane Urgorri, Faust Riu Pons, Diana Zaffalon, Josep María Dedeu Cusco |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Colonoscopy Quality indicators RC799-869 Endoscopy Gastrointestinal 03 medical and health sciences 0302 clinical medicine Medicine Humans Major complication Diverticulitis Gastrointestinal endoscopy Aged Retrospective Studies Gynecology medicine.diagnostic_test Acute diverticulitis business.industry Gastroenterology General Medicine Diseases of the digestive system. Gastroenterology Middle Aged Colonic neoplasm medicine.disease Uncomplicated diverticulitis Tomography x ray computed 030220 oncology & carcinogenesis Acute Disease Colonic Neoplasms 030211 gastroenterology & hepatology Female business Tomography X-Ray Computed |
| Zdroj: | Revista Española de Enfermedades Digestivas v.110 n.9 2018 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Revista Espanola de Enfermedades Digestivas, Vol 110, Iss 9, Pp 571-576 (2018) Revista Española de Enfermedades Digestivas, Volume: 110, Issue: 9, Pages: 571-576, Published: SEP 2018 |
| ISSN: | 1130-0108 |
| Popis: | espanolIntroduccion: las guias internacionales recomiendan la colonoscopia de rutina tras un episodio de diverticulitis aguda para descartar la presencia de neoplasia avanzada. Sin embargo, tras la incorporacion en los ultimos anos de la tomografia axial computarizada dicha recomendacion ha quedado en entredicho, sobre todo en lo que se refiere a la diverticulitis no complicada. Por otro lado, la colonoscopia es una tecnica que comporta riesgos y costes adicionales. Objetivo: conocer la rentabilidad diagnostica, calidad y seguridad de la colonoscopia en la diverticulitis aguda. Metodos: estudio retrospectivo de todos los pacientes diagnosticados de diverticulitis aguda por tomografia computarizada (TC) entre los anos 2005 y 2013, a los que posteriormente se les realizo una colonoscopia. Resultados: doscientos dieciseis pacientes diagnosticados de diverticulitis aguda por TC (58 diverticulitis complicada [27%] y 158 diverticulitis no complicada [73%]) fueron incluidos. Se detecto neoplasia avanzada en 12 pacientes (5,6% [complicada/no complicada 11,7/3,2%, p = 0,02]). No se observaron complicaciones mayores. La calidad fue baja (completa: 88%; preparacion eficaz: 75%; reseccion de polipos EnglishIntroduction: international guidelines recommend a routine colonoscopy to rule out advanced neoplasm after an acute diverticulitis event. However, in recent years, this recommendation has been called into question following the advent of computerized tomography (CT), particularly with regard to uncomplicated diverticulitis. Furthermore, colonoscopy is associated with a risk and additional costs. Objective: to understand the diagnostic yield, quality and safety of colonoscopy in the setting of acute diverticulitis. Methods: this was a retrospective study of all patients diagnosed with acute diverticulitis via CT between 2005 and 2013, who subsequently underwent a colonoscopy. Results: two hundred and sixteen patients diagnosed with acute diverticulitis via CT were enrolled. These included 58 cases with complicated diverticulitis (27%) and 158 with uncomplicated diverticulitis (73%). An advanced neoplasm was found in 12 patients (5.6%); 11.7% were complicated and 3.2% were uncomplicated (p = 0.02). No major complications were identified. The quality was low but improved over time; the complete procedure rate was 88%, an effective preparation was achieved in 75% and excision of polyps |
| Databáze: | OpenAIRE |
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