Parihar Vikrant, Sopheno-Falco Julia, Maheshwari Pardeep, O'Moran Neil, Graziadei Vivien, O'Grady Walshe Aishling, O'Dwyer Orla, Kumar Lakshman, Fennessy Sean, Breslin Niall, Ryan Barbara M, McNamara Deirdre
Department of Gastroenterology AMNCH, Dublin, Ireland.
Trinity College Dublin, Dublin, Ireland.
Gastrointest Tumors. 2019 Feb;5(3-4):82-89. doi: 10.1159/000494351. Epub 2018 Nov 22.
The European guidelines for colorectal cancer screening state that snare resection should remove any polyps ≥5 mm. This study aimed to investigate if these new guidelines are adhered to in clinical practice.
This study consists of patients who underwent colonoscopies in Tallaght Hospital, Dublin (AMNCH), between 2012 and 2015. The size of the polyp, the method of removal, and the subspecialty and grade of the endoscopists were all recorded.
6,000 colonoscopies were reviewed and 687 (12.5%) of these patients were found to have polyps. In 655 (95%) colonoscopies, the caecum was positively identified. In all, 371 (54%) of the polyps detected were < 5 mm; resection via forceps was carried out in 405 cases (59%). Overall, 16% ( = 45) of the polyps > 5 mm underwent resection with forceps, showing that the new European guidelines are not being tightly adhered to.
This study found an 84% compliance with polypectomy resection guidelines which is an improvement on previous studies. However, endoscopist grade significantly affected compliance and may reflect overall competency, highlighting the need for specific training in snare polypectomy techniques.
欧洲结直肠癌筛查指南指出,圈套切除应切除任何直径≥5毫米的息肉。本研究旨在调查临床实践中是否遵循了这些新指南。
本研究纳入了2012年至2015年期间在都柏林塔拉赫特医院(圣母儿童医院)接受结肠镜检查的患者。记录息肉大小、切除方法以及内镜医师的亚专业和级别。
共审查了6000例结肠镜检查病例,其中687例(12.5%)患者发现有息肉。在655例(95%)结肠镜检查中,成功识别出盲肠。总共检测到的息肉中,371例(54%)直径<5毫米;405例(59%)采用活检钳切除。总体而言,16%(即45例)直径>5毫米的息肉采用活检钳切除,这表明新的欧洲指南未得到严格遵循。
本研究发现息肉切除术指南的依从率为84%,较之前的研究有所提高。然而,内镜医师级别显著影响依从性,这可能反映了总体能力,突出了圈套息肉切除术技术专项培训的必要性。