Allgemeine Innere Medizin, Städtisches Klinikum Lüneburg, Lüneburg, Germany.
Dtsch Arztebl Int. 2010 Jan;107(3):30-9. doi: 10.3238/aerztebl.2010.0030. Epub 2010 Jan 15.
The indications for follow-up endoscopy have not been established in all diseases that can be diagnosed by endoscopy.
Selective review of the literature and a survey of national guidelines.
In confirmed erosive or non-erosive reflux disease, follow-up endoscopy is indicated only in the presence of complications or Barrett's esophagus. In the case of gastric ulcer or complicated duodenal ulcer, monitoring by endoscopy is mandatory. There is no consensus regarding the indication for follow-up biopsy in confirmed endemic sprue. In an acute episode of confirmed ulcerative colitis, endoscopy is indicated only if the treatment depends on the findings. In confirmed Crohn's disease, this procedure is indicated only in the presence of complications, if the findings are unclear, and before elective intestinal surgery. Those at risk of hereditary colorectal carcinoma without polyposis should undergo colonoscopy annually, starting 5 years before the youngest age of occurrence in their family or at the age of 25 years, whichever comes first.
With particular reference to further gastrointestinal diseases discussed in the main text, this review unfortunately shows that many of the indications for follow-up endoscopy remain to be ascertained. Controlled studies are needed to establish with sufficient certainty what really helps our patients.
并非所有可通过内镜诊断的疾病都明确了内镜随访的适应证。
对文献进行选择性复习，并对国家指南进行调查。
在确诊的糜烂性或非糜烂性反流病中，只有存在并发症或 Barrett 食管时才行内镜随访。在胃溃疡或复杂十二指肠溃疡的情况下，内镜监测是强制性的。在确诊的热带口炎性腹泻中，对确认活检的适应证尚无共识。在确诊的溃疡性结肠炎急性发作中，只有在治疗依赖于内镜所见时才进行内镜检查。在确诊的克罗恩病中，只有在存在并发症、内镜所见不明确或在择期肠手术前才进行该操作。无息肉遗传性结直肠癌高危人群应每年行结肠镜检查，起始时间为家族中最早发病年龄前 5 年或 25 岁，以先到者为准。
特别参考正文讨论的进一步的胃肠道疾病，本综述遗憾地显示，许多内镜随访的适应证仍有待确定。需要进行对照研究以确定哪些方法能真正有助于我们的患者。
