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

Détails

ID Serval
serval:BIB_91367BC72ED5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Appropriateness of colonoscopy in Europe (EPAGE II). Chronic diarrhea and known inflammatory bowel disease.
Périodique
Endoscopy
Auteur(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.
Collaborateur(s)
EPAGE II Study Group
Contributeur(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
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
41
Numéro
3
Pages
218-226
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Résumé
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.
Mots-clé
Chronic Disease, Colonoscopy, Colorectal Neoplasms/pathology, Diarrhea/pathology, Europe, Guidelines as Topic, Humans, Inflammatory Bowel Diseases/pathology
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/08/2009 10:10
Dernière modification de la notice
08/05/2019 22:01
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