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• W2922241470 abstract "Purpose: Post adenoma resection surveillance colonoscopy intervals are recommended based on the evidence while balancing the outcome, risk and the cost. In respect to that ASGE & ACG task force published guidelines (GIE. Vol 63, No.4:2006 S1). 1-2 tubular adenomas of <1cm = 5-10yr, 3-10 adenomas or villous adenoma, >1cm or with high grade dysplasia = 3yr, >10 adenomas = <3 yrs, and sessile adenoma >2cm or polyps removed in piecemeal = 2-6 month. The aim of our study is to review adherence to the published guidelines in the current clinical practice of direct access endoscopy. Methods: This is a retrospective chart review of patients who had colonoscopy at our institution. Colonoscopies with post adenoma resection indication were identified and included in the study only where index colonoscopy reports and resected polyps' histopathology were available. The polypectomy details - number, size & histology were recorded from the index colonoscopy report and the appropriate interval recommendation was estimated using the published guidelines. This was compared to the actual interval between the procedures. Results: 400 colonoscopies were performed in a 30 day period (July-August 2009) at our institution and 134 were for post adenoma resection surveillance. Index colonoscopy reports were available in 55 cases only. 44% had sooner and 29% had later than indicated surveillance colonoscopies, impacting safety and the cost. Majority of the patients were referred directly for colonoscopies by non-gastroenterologists. However, the polyp detection rate at surveillance colonoscopy was 64% and 60% were adenomas translating to a 60% adenoma recurrence rate, which is concerning when the current surveillance guidelines are applied. On the other hand it is possible that the recent advances in endoscopic technology have made it possible to detect the adenomas better. Results are in the enclosed Table. Conclusion: In the current era of direct access colonoscopy, adherence to the current ASGE and ACG task force post adenoma resection surveillance colonoscopy intervals may be better achieved by suggesting the next surveillance colonoscopy recommendation as a part of the colonoscopy procedure report by the performing endoscopist. In an era when many institutions are adopting an open access ordering system, disseminating the guidelines and educating the referring providers may improve adherence and minimize colonoscopy procedure related risk and cost. More studies with large cohorts are necessary to estimate better the adenoma recurrence rate after index colonoscopy and polypectomy to define reliable surveillance intervals, especially in the setting of endoscopic technological advances recently.Table: [1476]" @default.
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• W2922241470 date "2010-10-01" @default.
• W2922241470 modified "2023-09-26" @default.
• W2922241470 title "Recurrence Rate after Adenoma Resection, and Surveillance Intervals: Adherence to ASGE and ACG Task Force Colonoscopy Guidelines in the Era of Direct Access Endoscopy" @default.
• W2922241470 doi "https://doi.org/10.14309/00000434-201010001-01476" @default.
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