Asheer Zain Elabedin, Bisgaard Thue, Mjåland Odd, Angenete Eva, Bulut Orhan, Souzani Katarina Levic
Dan Med J. 2021 Jan 15;68(2):A07200559.
Following endoscopic removal of malignant colorectal polyps, patients may undergo completion radical resection or surveillance. The optimal surveillance strategy remains unknown. This study included colorectal departments in Scandinavian countries with a focus on follow-up periods and examination modalities for patients with endoscopically removed malignant polyps with a resection margin > 1 mm.
This study was conducted as an internet-based survey. A questionnaire was sent to all Scandinavian surgical departments performing > 20 colorectal procedures annually. Questions differed between follow-up on rectal and colonic malignant polyps with presence or absence of histological risk factors. The follow-up period was defined as short (one year), intermediate (three years) or long (five years).
The majority of the departments used a long (five years) (38-59%) or intermediate (three years) (26-38%) follow-up programme. In patients with rectal malignant polyps and presence of histological risk factors, a significant difference was observed in the use of endoscopy according to length of follow-up. No difference in the use of the different modalities was seen according to length of follow-up in patients with colonic malignant polyps.
The follow-up on patients with endoscopically removed malignant polyps and a surveillance strategy varies both in terms of length and performed modalities. Future studies should compare long-term patient outcomes in departments employing different follow-up strategies.
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not relevant.
在内镜切除恶性大肠息肉后,患者可能需要进行根治性切除或接受监测。最佳监测策略仍不明确。本研究纳入了斯堪的纳维亚国家的结直肠科,重点关注内镜切除的切缘>1mm的恶性息肉患者的随访期和检查方式。
本研究以网络调查的形式开展。向斯堪的纳维亚地区每年进行超过20例结直肠手术的所有外科科室发送了一份调查问卷。根据是否存在组织学危险因素,对直肠和结肠恶性息肉随访的问题有所不同。随访期分为短期(一年)、中期(三年)或长期(五年)。
大多数科室采用长期(五年)(38%-59%)或中期(三年)(26%-38%)的随访方案。在有组织学危险因素的直肠恶性息肉患者中,根据随访时间长短,在内镜检查的使用上观察到显著差异。在结肠恶性息肉患者中,根据随访时间长短,不同检查方式的使用未见差异。
内镜切除恶性息肉患者的随访和监测策略在随访时间长短和执行方式上均有所不同。未来的研究应比较采用不同随访策略的科室中患者的长期预后。
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不相关。