Department of Surgery, Queen Elizabeth Hospital, Woolwich, London, UK.
Sci Rep. 2019 Dec 27;9(1):20127. doi: 10.1038/s41598-019-56641-2.
International guidelines recommend colonoscopy following hospitalisation for acute diverticulitis. There is a paucity of evidence supporting the efficacy of colonoscopy in this context, particularly for patients with CT-diagnosed uncomplicated left-sided diverticulitis. This study aims to investigate the frequency that colorectal cancer (CRC) and advanced adenomas (AA) are identified during follow-up colonoscopy after hospitalisation with CT-proven left-sided diverticulitis for the first time in a UK population. In this single-centre retrospective-cohort study all patients presenting with CT-diagnosed uncomplicated left-sided diverticulitis between 2014 and 2017 were identified. The incidence of histologically confirmed CRC and AA identified at follow-up colonoscopy 4-6 weeks following discharge was assessed. 204 patients with CT proven uncomplicated left-sided diverticulitis underwent follow-up colonoscopy. 72% were female and the median age was 63 years. There were no major complications. 22% of patients were found to have incidental hyperplastic polyps or adenomas with low-grade dysplasia. No CRC or AA were found. Routine colonoscopy following acute diverticulitis in this cohort did not identify a single CRC or AA and could arguably have been omitted. This would significantly reduce cost and pressure on endoscopy departments, in addition to the pain and discomfort that is commonly associated with colonoscopy.
国际指南建议因急性憩室炎住院后进行结肠镜检查。然而，在这种情况下，支持结肠镜检查效果的证据很少，特别是对于 CT 诊断为单纯左侧憩室炎的患者。本研究旨在调查在英国人群中，首次因 CT 诊断为单纯左侧憩室炎住院后，在 4-6 周的随访结肠镜检查中发现结直肠癌（CRC）和高级腺瘤（AA）的频率。在这项单中心回顾性队列研究中，确定了 2014 年至 2017 年间所有因 CT 诊断为单纯左侧憩室炎而就诊的患者。评估了在出院后 4-6 周的随访结肠镜检查中，经组织学证实的 CRC 和 AA 的发生率。204 例 CT 证实为单纯左侧憩室炎的患者接受了随访结肠镜检查。72%为女性，中位年龄为 63 岁。无主要并发症。22%的患者发现有偶然发现的增生性息肉或低级别异型增生的腺瘤。未发现 CRC 或 AA。在该队列中，急性憩室炎后常规结肠镜检查未发现单个 CRC 或 AA，因此可以被省略。这将显著降低成本和内窥镜部门的压力，此外还可以减轻与结肠镜检查相关的疼痛和不适。
