Zammit Andrew P, Brown Ian, Hooper John D, Clark David A, Riddell Andrew D
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Ann Coloproctol. 2024 Apr;40(2):114-120. doi: 10.3393/ac.2023.00178.0025. Epub 2024 Mar 25.
The estimation of the risk posed by malignant polyps for residual or lymphatic disease plays a central role. This study investigated colorectal surgeons' assessment of these risks associated with malignant polyps.
A cross-sectional questionnaire was electronically administered to colorectal surgeons in Australia and New Zealand in October 2022. The questionnaire contained 17 questions on demographics, when surgeons consider colorectal resection appropriate, and the risk assessment for 5 hypothetical malignant polyps.
The mean risk of residual or lymphatic disease that would prompt surgeons to recommend colonic resection was 5%. However, this increased to a mean risk of 10% if the malignant polyp was located in the rectum, and the only resection option was abdominoperineal resection with end-colostomy. There was high concordance between the estimated risk of residual or lymphatic disease by colorectal surgeons and the Association of Coloproctology of Great Britain and Ireland (ACPGBI) guidelines for the 5 hypothetical malignant polyps, with the ACPGBI estimated risk lying within the 95% confidence interval for 4 of the 5 malignant polyps. Nonetheless, 96.6% of surgeons felt that an online risk calculator would improve clinical practice.
Colorectal surgeons in Australia and New Zealand accurately estimated the risk posed by malignant polyps. An online risk calculator may assist in better conveying risk to patients.
评估恶性息肉导致残留或淋巴疾病的风险起着核心作用。本研究调查了结直肠外科医生对这些与恶性息肉相关风险的评估。
2022年10月，通过电子方式向澳大利亚和新西兰的结直肠外科医生发放了一份横断面调查问卷。该问卷包含17个问题，涉及人口统计学、外科医生认为何时进行结直肠切除术合适，以及对5个假设的恶性息肉的风险评估。
会促使外科医生建议进行结肠切除术的残留或淋巴疾病的平均风险为5%。然而，如果恶性息肉位于直肠，且唯一的切除选择是腹会阴联合切除术并结肠造口术，那么这一平均风险会升至10%。结直肠外科医生对残留或淋巴疾病的估计风险与英国和爱尔兰结直肠外科学会（ACPGBI）针对5个假设恶性息肉的指南之间具有高度一致性，在5个恶性息肉中，有4个的ACPGBI估计风险处于95%置信区间内。尽管如此，96.6%的外科医生认为在线风险计算器会改善临床实践。
澳大利亚和新西兰的结直肠外科医生准确估计了恶性息肉带来的风险。在线风险计算器可能有助于更好地向患者传达风险。
