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[大肠腺瘤的内镜下息肉切除术:监测患者以重新评估结肠镜检查监测间隔]

[Endoscopic polypectomy of colorectal adenomas: Monitoring patients in order to review the colonoscopic surveillance interval].

作者信息

Couso Laura M Avila, Lubrano Pablo, Castelluccio Silvina, Coghlan Eduardo, Topor Javier, Peters Ricardo, Solar Carlos González del

出版信息

Acta Gastroenterol Latinoam. 2014;44(3):216-22.

Abstract

OBJECTIVE

To determine the risk of advanced adenomas at surveillance colonoscopy after polipectomy. To review the colonoscopic surveillance interval and to compare the prevalence of adenomas in patients with low-risk and high-risk adenomas at screening colonoscopies.

METHODS

A cohort retrospective study. It was used a database of colonoscopies performed between 1999 and 2012. Seven hundred and sixty patients who had adenomas at first colonoscopy were included (465 males and 295 females, mean age 62 years old). They were divided into two groups: group A, low-risk adenomas, and group B, high-risk adenomas. In each group, it was compared the presence of adenomas in videocolonoscopies performed at 3 and 5 years.

RESULTS

At the first colonoscopy 409 patients (53.8%) belonged to group A and 351 (46.2%) than group B. In both groups the risk of new advanced adenomas in endoscopic surveillance at 5years was similar to the control at 3 years. Comparing both groups, the risk of new advanced adenomas in endoscopic surveillance at 3 years in group B was 1.96 times greater than in group A (P = 0.012).

CONCLUSIONS

At present, surveillance endoscopy is performed before the suggested interval. In both groups there were no statistically significant differences between surveillance control at 3 or 5 years. However, 62% of patients in group B have developed new advanced adenomas in endoscopic surveillance at 3 years. Therefore, it is recommended the endoscopic control with this interval.

摘要

目的

确定息肉切除术后监测性结肠镜检查时进展性腺瘤的风险。回顾结肠镜监测间隔,并比较筛查性结肠镜检查中低风险和高风险腺瘤患者的腺瘤患病率。

方法

一项队列回顾性研究。使用了1999年至2012年间进行结肠镜检查的数据库。纳入760例首次结肠镜检查发现腺瘤的患者(男性465例,女性295例,平均年龄62岁)。他们被分为两组:A组,低风险腺瘤;B组,高风险腺瘤。在每组中,比较3年和5年时视频结肠镜检查中腺瘤的存在情况。

结果

在首次结肠镜检查时,409例患者(53.8%)属于A组,351例(46.2%)属于B组。两组在5年内镜监测中新发进展性腺瘤的风险与3年时的对照组相似。比较两组,B组在3年内镜监测中新发进展性腺瘤的风险比A组高1.96倍(P = 0.012)。

结论

目前,监测性内镜检查在建议间隔之前进行。两组在3年或5年的监测对照之间无统计学显著差异。然而,B组62%的患者在3年内镜监测中出现了新发进展性腺瘤。因此,建议采用此间隔进行内镜检查。

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