基于位置和基于息肉的切除和丢弃策略的局限性

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY
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引用次数: 0

摘要

背景和目的基于位置的切除和丢弃(LBRD)和基于息肉的切除和丢弃(PBRD)是最近提出的将结肠镜筛查和监测成本降至最低的两种策略。我们的研究将这些策略应用于我们的结肠镜检查数据库,以确定这些策略在我们的筛查和监测结肠镜检查人群中的适用性。方法我们总共分析了 6024 例在加州大学欧文分校进行的选择性筛查、监测或诊断性结肠镜检查。我们将 LBRD 和 PBRD 建议与 2020 年美国多协会工作组 (USMSTF) 更长和更短的监测间隔建议进行了比较。主要结果是达到美国消化内镜学会设定的 90% 一致阈值。结果LBRD 策略与更长和更短的 2020 年 USMSTF 建议指南的一致性分别达到 88.0% 和 71.6%。PBRD策略仅适用于65.4%的手术,其余手术仍需进行病理评估。在适用的手术中,PBRD 策略与较长和较短的 USMSTF 建议指南的一致性分别达到 94.2% 和 38.6%。结论只有在使用较长的 USMSTF 建议时,PBRD 策略才能达到 90% 的保留率并纳入有价值的内镜创新阈值,但在使用较短的监测间隔时,一致性降至 38.6%,而这在美国是常用的。虽然切除和剔除可减少对病理的依赖,但这两种策略并不能达到在我们的人群中取代病理检查微小息肉所需的一致性水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Limitations of the Location-Based and Polyp-Based Resect and Discard Strategies

BACKGROUND AND AIMS

Location-based resect and discard (LBRD) and polyp-based resect and discard (PBRD) are 2 recently proposed strategies to minimize the cost of colonoscopy screening and surveillance. Our study applied these strategies to our colonoscopy database retrospectively to determine the applicability of these strategies in our screening and surveillance colonoscopy population.

METHODS

In total, 6024 elective screening, surveillance, or diagnostic colonoscopies performed at the University of California, Irvine, were analyzed. We compared the LBRD and PBRD recommendations with longer and shorter 2020 United States Multi-Society Task Forces (USMSTF) surveillance interval recommendations. The primary outcome was the achievement of the 90% agreement threshold set by the American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable Endoscopic Innovations.

RESULTS

The LBRD strategy achieved 88.0% and 71.6% concordance with the longer and shorter 2020 USMSTF recommendation guidelines, respectively. The PBRD strategy only applied to 65.4% of procedures, with the remaining procedures still requiring pathologic evaluation. Among the applicable procedures, the PBRD strategy achieved 94.2% and 38.6% concordance with the longer and shorter USMSTF recommendation guidelines, respectively.

CONCLUSION

The PBRD strategy met the 90% preservation and incorporation of valuable endoscopic innovations threshold only when using the longer USMSTF recommendations, but concordance dropped to 38.6% when using the shorter surveillance intervals, which are commonly used in the United States. Although resect and discard may decrease reliance on pathology, these 2 strategies do not achieve the level of concordance required to replace the use of pathology for diminutive polyps in our population.

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CiteScore
2.10
自引率
50.00%
发文量
60
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