Appropriateness of colonoscopy in Europe (EPAGE II). Chronic diarrhea and known inflammatory bowel disease.

Details

Serval ID
serval:BIB_91367BC72ED5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Appropriateness of colonoscopy in Europe (EPAGE II). Chronic diarrhea and known inflammatory bowel disease.
Journal
Endoscopy
Author(s)
Schusselé Filliettaz S., Juillerat P., Burnand B., Arditi C., Windsor A., Beglinger C., Dubois R.W., Peytremann-Bridevaux I., Pittet V., Gonvers J.J., Froehlich F., Vader J.P.
Working group(s)
EPAGE II Study Group
Contributor(s)
Agréus L., Beglinger C., Bytzer P., Delvaux M., Eckardt V., Fairclough PD., Lacaine F., Le Moine O., Lorenzo-Zúñiga V., Minoli G., Numans ME., Oertli D., O'Malley J., Windsor A.
ISSN
1438-8812 (Electronic)
ISSN-L
0013-726X
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
41
Number
3
Pages
218-226
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for investigation of chronic diarrhea, management of patients with known inflammatory bowel disease (IBD), and for colorectal cancer (CRC) surveillance in such patients, and to report report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II.
METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding the evaluation of chronic diarrhea, the management of IBD, and colorectal cancer surveillance in IBD was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions.
RESULTS: According to the literature, colonoscopic evaluation may be justified for patients aged > 50 years with recent-onset chronic diarrhea or with alarm symptoms. Surveillance colonoscopy for CRC should be offered to all patients with extensive ulcerative colitis or colonic Crohn's disease of 8 years' duration, and to all patients with less extensive disease of 15 years' duration. Intervals for surveillance colonoscopy depend on duration of evolution, initial diagnosis, and histological findings. The EPAGE II criteria also confirmed the appropriateness of diagnostic colonoscopy for diarrhea of > 4 weeks' duration. They also suggest that, in addition to assessing extent of IBD by colonoscopy, further colonoscopic examination is appropriate in the face of persistent or worsening symptoms. Surveillance colonoscopy in IBD patients was generally appropriate after a lapse of 2 years. In the presence of dysplasia at previous colonoscopy, it was not only appropriate but necessary.
CONCLUSIONS: Despite or perhaps because of the limitations of the available published studies, the panel-based EPAGE II (http://www.epage.ch) criteria can help guide appropriate colonoscopy use in the absence of strong evidence from the literature.
Keywords
Chronic Disease, Colonoscopy, Colorectal Neoplasms/pathology, Diarrhea/pathology, Europe, Guidelines as Topic, Humans, Inflammatory Bowel Diseases/pathology
Pubmed
Web of science
Open Access
Yes
Create date
04/08/2009 10:10
Last modification date
20/08/2019 15:54
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