Division of Gastroenterology and Hepatology, University of California, San Francisco, USA.
Am J Gastroenterol. 2011 Dec;106(12):2058-62. doi: 10.1038/ajg.2011.238.
Published guidelines for timing of follow-up colonoscopy assume that the entire colon mucosa is visualized and provide no guidance in the case of poor preparations. We aimed to determine how preparation quality during screening colonoscopy affects gastroenterologists' recommendations on the timing of follow-up colonoscopy.
Gastroenterologists were shown representative images of four colonoscopies with differing colon-preparation quality. For each set of images they were asked to recommend when a hypothetical patient with no polyps or malignancy on screening examination should return for a subsequent colonoscopy. For the same patient, gastroenterologists were asked to give recommendations based on a preparation-quality grading scale.
The survey was completed by 239 gastroenterologists. Nearly all recommended 10-year follow-up colonoscopy for the best-appearing preparation. For the three imperfect preparations there was considerable variability in recommendations; follow-up timing ranged from 1-2 days to 10 years for identical preparations. Similar variability was seen in recommendations based on a preparation-quality grading scale. Endoscopists generally recommended progressively shorter-interval follow-up as colon preparation worsened, with median recommended follow-up of 10, 5, 1, and 0.25 years for the four sets of images. No association was seen between personal demographics or practice characteristics and follow-up recommendations.
When colon preparation is imperfect, gastroenterologists provide highly variable recommendations regarding timing of follow-up colonoscopy.
发表的随访结肠镜检查时间指南假设整个结肠黏膜都能被可视化，并且在准备不佳的情况下没有提供任何指导。我们旨在确定在筛查结肠镜检查中准备质量如何影响胃肠病学家对后续结肠镜检查时间的建议。
向胃肠病学家展示了四个结肠镜检查的代表性图像，这些图像的结肠准备质量不同。对于每组图像，他们被要求建议在筛查检查中没有息肉或恶性肿瘤的假设患者应该何时进行后续结肠镜检查。对于同一位患者，胃肠病学家被要求根据准备质量分级量表给出建议。
共有 239 名胃肠病学家完成了这项调查。几乎所有的人都建议最好的准备情况下进行 10 年的随访结肠镜检查。对于三种不完美的准备情况，建议存在相当大的差异；相同的准备情况下，随访时间从 1-2 天到 10 年不等。基于准备质量分级量表的建议也存在类似的可变性。随着结肠准备情况的恶化，内镜医生通常建议进行更短间隔的随访，对于四组图像，建议的随访中位时间分别为 10、5、1 和 0.25 年。个人人口统计学或实践特征与随访建议之间没有关联。
当结肠准备不完美时，胃肠病学家对后续结肠镜检查的时间提供了高度可变的建议。
