Colonic Polyps, Endoscopic Assessment, Endoscopic Surveillance, NBI
Conditions
Brief summary
Nowadays, post-polypectomy surveillance intervals are determined by combining endoscopic and pathologic data. Real-time imaging technologies, have shown promising results in discriminating adenomatous from non-adenomatous polyps. The resect and discard strategy for small polyps (based on real-time assessment of the histology and on the endoscopic resection without pathological examination) has been shown to be cost-effective in simulation models. No data exist about the impact of this strategy in clinical practice. The aim of present study was to assess whether the systematic use, in the everyday clinical practice, of the resect and discard strategy allows to correctly manage patients with small colonic polyps.
Interventions
OTHERendoscopic assessment of colonic polyps
Sponsors
Valduce Hospital
Study design
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* consecutive adult outpatients undergoing colonoscopy for routine clinical indications
Exclusion criteria
* surveillance interval was not necessarily directed by endoscopic findings (history of colorectal cancer, inflammatory bowel disease, hereditary polyposis syndromes, hereditary non-polyposis colorectal cancer) * colonoscopy was performed without NBI technology * at least one lesion \> 10 mm or \< 10 mm but with morphologic features suspect for malignancy (depressed or ulcerated lesions) was detected * bowel preparation was inadequate * caecal intubation was not accomplished * polyps could not be resected for concomitant anticoagulation treatment, 7) polyps were resected but not retrieved for pathology.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome of the study was to assess the agreement between endoscopy- and histology-determined surveillance strategies after small adenoma resection. | — |
Secondary
| Measure | Time frame |
|---|---|
| sensitivity of the endoscopic assessment (WL coupled with NBI) of small (<10 mm) adenomas | — |
| operative characteristics for the diagnosis of diminutive (< 5 mm) adenomas | — |
| the feasibility of non histologic evaluation, represented by the proportion of polyps in which a in-vivo diagnosis of adenoma can be made with high confidence | — |
| specificity of the endoscopic assessment | — |
| accuracy of the endoscopic assessment | — |
Countries
Italy
Outcome results
None listed