Setting up a regional expert panel for complex colorectal polyps

Zwager, Liselotte W.; Bastiaansen, Barbara A.; Dekker, Evelien; Fockens, Paul; Appels, M.I.E.; Bruin, G.J. de; Depla, A.C.T.M.; Huibregtse, Inge L.; Kuiper, Teaco; Liberov, Boris; Mallant-Hent, Rosalie C.; Marsman, Willem A.; Ramsoekh, Dewkoemar; Spek, Bas W. van der; Vlug, Malaika S.; Weyenberg, Stijn J.B. Van; Wientjes, Caroline

doi:10.1016/j.gie.2022.02.003

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…Eleven centers participated and 88 patients were evaluated by the panel. Overall, 43.2% of consulting endoscopist changed their initial management strategy after consultation, and in 56 cases (63.3%), the patient was referred to another endoscopy center[ 64 ].…”

Section: Is It Truly Efficient In Real Practice To Refer Complex Poly...mentioning

confidence: 99%

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

Bustamante-Balén

2022

World J Gastroenterol

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Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological lesions. Currently, endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical results. However, several studies from different geographic areas agree that many benign colon lesions are still referred for surgery. Moreover, the referral rate to surgery is not decreasing over the years, despite the theoretical improvement of endoscopic resection techniques. This article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral rate. It will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic resection. And finally, we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions.

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Section: Is It Truly Efficient In Real Practice To Refer Complex Poly...mentioning

confidence: 99%

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

Bustamante-Balén

2022

World J Gastroenterol

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“…Over the past decade, there has been a paradigm shift in the management of complex polyps from surgical resection to endoscopic mucosal resection (EMR), usually by an advanced endoscopist 7 8 9 10 . Currently, there is clinical equipoise regarding how long a delay is appropriate between detection of the complex polyp by a general endoscopist and EMR by an advanced endoscopist.…”

Section: Introductionmentioning

confidence: 99%

“…8 were less than 1 cm in size, leaving 268 EMRs eligible for the study. Overall, 60 (22.4%) EMR cases were delayed due to the COVID-19 pandemic whereas 208 (77.6%) EMR cases were performed prior to the service reduction and served as the control group (Table1).…”

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confidence: 99%

Extended delay in endoscopic mucosal resection is not associated with adverse outcomes: Findings from the COVID-19 pandemic

et al. 2023

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Background & Aims: The aim of this study was to investigate the impact of delayed endoscopic mucosal resection (EMR) of colorectal polyps on health outcomes. Methods: A bidirectional cohort study was completed. A baseline group consisting of all EMRs performed with a 15-month period before a province wide government mandated cessation of EMR procedures due to the global pandemic was compared to EMRs impacted by the shutdown, defined as the COVID-19 delayed group. The primary outcome was the incidence of malignant polyps. Secondary outcomes included technical success, polyp recurrence at follow up colonoscopy, advanced polyp histology, probability of meeting endoscopic criteria for adequate resection for malignant polyps, metastatic colorectal cancer, and complications. Results: A total of 268 EMR procedures were included in the study cohort, of which 208 formed the baseline group and 60 were in the COVID-19 delayed group. The median (IQR) age was 72 (13.0) and 113 (41.2%) were females. The median (IQR) wait time was 92 (87.8) days in the baseline group and 191 (127.8) days in the COVID-19 delayed group (p<0.001). Overall, there were no significant differences in the incidence of malignant polyps, technical success, polyp recurrence on follow-up colonoscopy, advanced polyp histology, adequate endoscopic resection for malignant polyps, metastatic colorectal cancer, or complications between the two groups (p>0.05 for all outcomes). Conclusions: A longer wait time for EMR of colorectal polyps, increasing from a median of 92 to 191 days, was not associated with worse outcomes.

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Second opinions foster better outcomes

Grimm

Kroch

2022

Gastrointestinal Endoscopy

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Setting up a regional expert panel for complex colorectal polyps

Cited by 5 publications

References 23 publications

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

Extended delay in endoscopic mucosal resection is not associated with adverse outcomes: Findings from the COVID-19 pandemic

Second opinions foster better outcomes

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