Is There any Benefit of Making Early Follow-up of Colonoscopic Polypectomy According to Recommendations?

Abstract

Backgrounds and Aim: After the colonoscopic polypectomy, patients were followed-up according to international guidelines. In this study, we aimed to determine whether there was compliance with follow-up intervals as specified by the guidelines. Also, we researched whether there is any beneficial effect of reduced follow-up intervals for detecting AAP and/or colon carcinoma. Material and Methods: Patients who had a colonoscopy between January 2008 and December 2015 in Türkiye Yüksek İhtisas Training and Research Hospital, Gastroenterology Department, Endoscopy Unit were enrolled in the study. Patients who had detected adenoma on their first colonoscopy were divided into two groups: Group A and Group B. In Group A, colonoscopic surveillance was performed earlier according to the current guideline, and in Group B, colonoscopic surveillance was performed properly according to the current guideline. Between the two groups, the detection rate of AAP and/or colon carcinoma were compared. Results: Overall, 270 patients (mean age: 56.8 years) were included in the study. At their first colonoscopies, 759 polyps, 528 adenomas, and 95 AAPs were detected. In our clinical practice, the interval between the first and second colonoscopy was 21 months. Group A had 228 patients (84.1%), and Group B had 42 patients (15.9%). Between the two groups, the detection rates of AAP and cancer could be compared. Between the two groups, the presence of AAP (6.6% vs. 11.9%; p = 0.2) and colon carcinoma (0.4% vs. 0%; p = 1.0) was not different. Conclusion: Compared with current guidelines, reduced follow-up intervals between the first and second colonoscopies are not associated with conferring additional beneficial effects to patients.

Keywords

• Colonoscopy,polyp,screening

Kolonoskopik Polipektomi Takip Aralığını Önerilenden Erken Yapmanın Yararı Var mı?

Öz

Giriş ve Amaç: Kolonoskopik polipektomi yapıldıktan sonra hastalar uluslararası kılavuzlarca önerilen takip aralıklarına göre izlenir. Bu çalışmada klinik pratikte, kılavuzlarca belirlenmiş olan takip aralıklarına uyulup uyulmadığı ve takip aralığını kısaltmanın advanced adenomatöz polip (AAP) ve/veya kolon kanseri saptanması üzerine önleyici etkisi olup olmadığının araştırılması amaçlanmıştır.

Gereç ve Yöntem: Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi Gastroenteroloji Kliniği Endoskopi Ünitesinde Ocak 2008-Aralık 2015 tarihleri arasında kolonoskopi yapılan 2178 hastanın verileri retrospektif olarak incelendi. İlk kolonoskopideadenom saptanan olgular, kılavuzların belirttiğinden daha erken takip kolonoskopisi yapılan (Grup A) ve kılavuzların önerdiği sürede takip kolonoskopisi yapılanlar (Grup B) şeklinde 2 gruba ayrılarak AAP ve kanser varlığı açısından karşılaştırıldı.

Bulgular: Çalışmaya başlangıç kolonoskopi esnasında yaş ortalaması 56,8 olan 270 olgu dahil edildi. Bu hastaların ilk kolonoskopisinde 759 polip, 582 adenom ve 95 AAP tespit edildi. Klinik uygulamamızda ilk kolonoskopi ile ikinci kolonoskopi arası ortanca süre 21 aydı. Olguların 228 (%84,1)’i Grup A, 42 (%15,9)’si ise Grup B’de idi. İki grup arasında takip kolonoskopi esnasında AAP (%6,6 vs. %11,9, p=0,2) veya kanser (%0,4 vs. %0 p=1.0) varlığı açısından anlamlı bir fark bulunmadı.

Sonuç:İlk kolonoskopide polip saptanan hastalara kılavuzlara göre belirtilen süreden daha kısa aralıklarda takip kolonoskopi yapmanın anlamlı düzeyde ek bir faydası gösterilememiştir.

Anahtar Kelimeler

• Polip,tarama,kolonoskopi

Kaynakça

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