المؤلفون: Christine M. Bakker, Evelien Dekker, Lonne W.T. Meulen, Alouisa J. P. van de Wetering, Eric T.P. Keulen, Ad A.M. Masclee, Hao Ran Cheng, Silvia Sanduleanu-Dascalescu, Chantal V. Hoge, Bjorn Winkens, Roel M M Bogie, Rogier de Ridder, Ankie Reumkens, Jan-Willem Straathof, Quirine E. W. van der Zander

المساهمون: Interne Geneeskunde, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: NUTRIM - R2 - Liver and digestive health, FHML Methodologie & Statistiek, RS: CAPHRI - R6 - Promoting Health & Personalised Care, MUMC+: MA Maag Darm Lever (9)

المصدر: Endoscopy International Open
Endoscopy international open, 8(3), E257-E265. Georg Thieme Verlag
Endoscopy International Open, Vol 08, Iss 03, Pp E257-E265 (2020)

مصطلحات موضوعية: Original article, medicine.medical_specialty, ENDOSCOPY, Colorectal cancer, medicine.medical_treatment, Colonoscopy, SMALL COLORECTAL POLYPS, CLASSIFICATION, COLONOSCOPY SURVEILLANCE, Optical diagnosis, IMPLEMENTATION, Medicine, HISTOLOGY, Pharmacology (medical), POLYPECTOMY, lcsh:RC799-869, medicine.diagnostic_test, business.industry, General surgery, Guideline, COLON POLYPS, medicine.disease, Polypectomy, EUROPEAN-SOCIETY, Endoscopy, Colon polyps, Diminutive, DEFINITION, lcsh:Diseases of the digestive system. Gastroenterology, business

الوصف: Background and study aims Implementation of optical diagnosis of diminutive polyps may potentially increase the efficacy and cost-effectiveness of colonoscopies. To adopt such strategy in clinical practice, the Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) thresholds provide the basis to be met: ≥ 90 % negative predictive value (NPV) for diagnosis of adenomatous histology and ≥ 90 % agreement on surveillance intervals. We evaluated this within the Dutch Bowel Cancer Screening Program (BCSP). Patients and methods Endoscopic and histological data were collected from participants of the national bowel cancer screening program with an unfavorable fecal immunochemical test referred for colonoscopy between February 2014 and August 2015 at four endoscopy centers. The “resect and discard” scenario was studied, resecting diminutive polyps without histological evaluation. Agreement between optical diagnosis and histological diagnosis was measured for surveillance intervals according to Dutch, European and American post-polypectomy surveillance guideline. Results Fifteen certified endoscopists participated in this study and included 3028 diminutive polyps. In 2,330 patients both optical and histological diagnosis were available. Optical diagnosis of diminutive polyps showed NPV of 84 % (95 % CI 80–87) for adenomatous histology in the rectosigmoid. Applying the ‘resect and discard’ strategy resulted in 90.6 %, 91.2 %, 90.9 % agreement on surveillance intervals for the Dutch, European and American guideline respectively. Conclusion Our data representing current clinical practice in the Dutch BCSP practice on optical diagnosis of diminutive polyps showed that accuracy of predicting histology remains challenging, and risk of incorrect optical diagnosis is still significant. Therefore, it is too early to safely implement these strategies.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4f6603a1ac969df7a6a99472fcd094d3Test
https://doi.org/10.1055/a-1072-4853Test

المؤلفون: Stefan Schubert, Michael Blaker, Gillaume Bonnaud, Imke Behnken, Michael Klemt-Kropp, T. Klugmann, Eric T.P. Keulen, Michael Mross, Thierry Ponchon, Meredin Stoltenberg, Ralf Kiesslich, Marcel J M Groenen, Wilfred Landry

المصدر: Endoscopy International Open, Vol 05, Iss 04, Pp E282-E290 (2017)
Endoscopy International Open

مصطلحات موضوعية: medicine.medical_specialty, Original article, medicine.medical_treatment, Colon cleansing, Colonoscopy, Pharmacology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Clinical endpoint, medicine, media_common.cataloged_instance, Ascending colon, Pharmacology (medical), Dosing, European union, lcsh:RC799-869, media_common, medicine.diagnostic_test, business.industry, Regimen, Tolerability, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, lcsh:Diseases of the digestive system. Gastroenterology, business

الوصف: Background and study aims The success of any colonoscopy procedure depends upon the quality of bowel preparation. We evaluated the efficacy and safety of a new tailored dosing (TD) regimen compared with the approved PICOPREP day-before dosing regimen (DBD) in the European Union. Patient and methods Patients (≥ 18 years) undergoing colonoscopy were randomised (2:1) to TD (Dose 1, 10 – 18 hours; Dose 2, 4 – 6 hours before colonoscopy) or DBD (Dose 1 before 8:00AM on the day before colonoscopy; Dose 2, 6 – 8 hours after Dose 1). The primary endpoint of overall colon cleansing efficacy was based on total Ottawa Scale (OS) scores (0 – 14, excellent-worst). The key secondary endpoint was a binary endpoint based on the ascending colon OS (success 0 or 1, failure [≥ 2]). Convenience and satisfaction were evaluated similar to the primary and key secondary endpoints. Safety and tolerability were also evaluated. Results Use of the PICOPREP TD regimen resulted in a statistically significant reduction in the mean total Ottawa Scale score compared to the PICOPREP DBD regimen (–3.93, 95 % confidence intervals [CI]: – 4.99, – 2.97; P Conclusion The TD regimen was superior to the DBD regimen for overall and ascending colon cleansing efficacy. ClinicalTrials.gov Identifier: NCT02239692

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ad9f86e685815d3f1b0764e9577ccf2Test
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-102433Test