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Rates of repeated c...
Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials
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Juul, FE (författare)
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Garborg, K (författare)
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Nesbakken, E (författare)
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Loberg, M (författare)
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Wieszczy, P (författare)
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Cubiella, J (författare)
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Kalager, M (författare)
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Kaminski, MF (författare)
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Erichsen, R (författare)
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- Adami, HO (författare)
- Karolinska Institutet
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Ferlitsch, M (författare)
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Furholm, SKB (författare)
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Zauber, AG (författare)
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Quintero, E (författare)
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Bugajski, M (författare)
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Holme, O (författare)
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Dekker, E (författare)
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Jover, R (författare)
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Bretthauer, M (författare)
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(creator_code:org_t)
- 2022-10-28
- 2023
- Engelska.
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Ingår i: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 72:5, s. 951-957
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http://kipublication...
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https://doi.org/10.1...
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Abstract
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- High-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance.DesignWe retrieved data of all patients with low-risk adenomas (one or two tubular adenomas <10 mm with low-grade dysplasia) and high-risk adenomas (3–10 adenomas, ≥1 adenoma ≥10 mm, high-grade dysplasia or villous components) in the European Polyp Surveillance trials fulfilling certain logistic and methodologic criteria. We analysed variations in number of colonoscopies needed to achieve high-quality colonoscopy and enter polyp surveillance by endoscopy centre, and by endoscopists who enrolled ≥30 patients.ResultsThe study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%).ConclusionThere is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.Trial registration numberNCT02319928.
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Juul, FE
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Garborg, K
-
Nesbakken, E
-
Loberg, M
-
Wieszczy, P
-
Cubiella, J
-
visa fler...
-
Kalager, M
-
Kaminski, MF
-
Erichsen, R
-
Adami, HO
-
Ferlitsch, M
-
Furholm, SKB
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Zauber, AG
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Quintero, E
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Bugajski, M
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Holme, O
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Dekker, E
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Jover, R
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Bretthauer, M
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visa färre...
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Karolinska Institutet