结直肠息肉管理的循证临床实践指南。
Evidence-based clinical practice guidelines for management of colorectal polyps.
机构信息
Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Management of Colorectal Polyps", the Japanese Society of Gastroenterology (JSGE), 6F Shimbashi i-MARK Bldg., 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan.
Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Minami-ku, KasumiHiroshima, 734-8551, Japan.
出版信息
J Gastroenterol. 2021 Apr;56(4):323-335. doi: 10.1007/s00535-021-01776-1. Epub 2021 Mar 12.
BACKGROUND
The Japanese Society of Gastroenterology (JSGE) published ''Daicho Polyp Shinryo Guideline 2014'' in Japanese and a part of this guideline was published in English as "Evidence-based clinical practice guidelines for management of colorectal polyps" in the Journal of Gastroenterology in 2015. A revised version of the Japanese-language guideline was published in 2020, and here we introduce a part of the contents of revised version.
METHODS
The guideline committee discussed and drew up a series of clinical questions (CQs). Recommendation statements for the CQs were limited to items with multiple therapeutic options. Items with established conclusions that had 100% agreement with previous guidelines (background questions) and items with no (or old) evidence that are topics for future research (future research questions: FRQs) were given descriptions only. To address the CQs and FRQs, PubMed, ICHUSHI, and other sources were searched for relevant articles published in English from 1983 to October 2018 and articles published in Japanese from 1983 to November 2018. The Japan Medical Library Association was also commissioned to search for relevant materials. Manual searches were performed for questions with insufficient online references.
RESULTS
The professional committee created 18 CQs and statements concerning the current concept and diagnosis/treatment of various colorectal polyps, including their epidemiology, screening, pathophysiology, definition and classification, diagnosis, management, practical treatment, complications, and surveillance after treatment, and other colorectal lesions (submucosal tumors, nonneoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumors/carcinomas).
CONCLUSIONS
After evaluation by the moderators, evidence-based clinical practice guidelines for management of colorectal polyps were proposed for 2020. This report addresses the therapeutic related CQs introduced when formulating these guidelines.
背景
日本胃肠病学会（JSGE）以日文发布了《大型息肉诊疗指南 2014》，其中一部分内容以英文发表于 2015 年《胃肠病学杂志》的“结直肠息肉诊治的循证临床实践指南”。该指南的日语文本于 2020 年进行了修订，本文介绍了修订版的部分内容。
方法
指南委员会讨论并拟定了一系列临床问题（CQs）。对于 CQs 的推荐意见仅限于有多种治疗选择的项目。对于具有与以往指南完全一致的结论（背景问题）且没有（或陈旧）证据的项目，则仅作说明（未来研究问题：FRQs）。为解决 CQs 和 FRQs，检索了从 1983 年 10 月至 2018 年 10 月发表的英文相关文献，以及从 1983 年 11 月至 2018 年 11 月发表的日文相关文献，使用 PubMed、ICHUSHI 等数据库和日本医学图书馆协会。对于在线参考文献不足的问题，进行了手动检索。
结果
专业委员会制定了 18 个 CQs 和有关各种结直肠息肉（包括其流行病学、筛查、病理生理学、定义和分类、诊断、治疗、实用治疗、并发症和治疗后监测，以及其他结直肠病变（黏膜下肿瘤、非肿瘤性息肉、息肉病、遗传性肿瘤、溃疡性结肠炎相关肿瘤/癌）的当前概念和诊治的陈述。
结论
在主持人评估后，针对 2020 年结直肠息肉诊治提出了循证临床实践指南。本报告介绍了制定这些指南时提出的与治疗相关的 CQs。
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