Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort.
| Title: | Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort. |
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| Authors: | Cerdán Santacruz C; Colorectal Surgery Unit, General Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain.; Universidad de Lleida, Lleida, Spain.; Muriel Álvarez P; Liver, Biliary Tract and Pancreatic Surgery Unit, General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain. pmuriel.lleida.ics@gencat.cat.; Institut de Recerca Biomédica de Lleida, Experimental Surgery Department, Av. Prat de la Riba 44, 4º 5ª, Lleida, Spain. pmuriel.lleida.ics@gencat.cat.; Roig Ferreruela G; Universidad de Lleida, Lleida, Spain.; Merichal Resina M; General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.; Pinillos Somalo AI; General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.; Mestres Petit N; Colorectal Surgery Unit, General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.; Universidad de Lleida, Lleida, Spain.; Institut de Recerca Biomédica de Lleida, Experimental Surgery Department, Av. Prat de la Riba 44, 4º 5ª, Lleida, Spain.; Sierra Grañón JE; Colorectal Surgery Unit, General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.; Olsina Kissler JJ; Liver, Biliary Tract and Pancreatic Surgery Unit, General Surgery Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.; Universidad de Lleida, Lleida, Spain.; Institut de Recerca Biomédica de Lleida, Experimental Surgery Department, Av. Prat de la Riba 44, 4º 5ª, Lleida, Spain. |
| Source: | Surgical endoscopy [Surg Endosc] 2021 Dec; Vol. 35 (12), pp. 6819-6826. Date of Electronic Publication: 2021 Jan 04. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1992- : New York : Springer; Original Publication: [Berlin] : Springer International, c1987- |
| MeSH Terms: | Diverticulitis, Colonic*/diagnostic imaging ; Diverticulitis, Colonic*/epidemiology ; Colonic Neoplasms* ; Diverticulitis*; Acute Disease ; Colonoscopy ; Humans ; Middle Aged ; Retrospective Studies |
| Abstract: | Background: Although included in some guidelines, the recommendation of interval colonoscopy after an acute diverticulitis (AD) episode has recently been questioned. In this study, we evaluated the incidence of colon cancer during the follow-up of an episode of AD.; Methods: A retrospective review was carried out of patients with conservatively treated AD at our Institution (January 2011 to December 2018) with or without endoscopic study. Patients who had no colonoscopy performed were followed for two years. The demographic, clinical, radiological, follow-up and anatomopathological records were analysed. We determined CT scan validity for the differential diagnosis of CC and AD; sensibility, specificity, predictive values and likelihood ratios were calculated. Patients lost to follow-up and patients who had had colonoscopy in the previous three years were excluded.; Results: This study included 285 patients with a mean age of 59 years. A total of 225 interval colonoscopies were performed and 60 patients without colonoscopy were followed up. There were 19 CC (6.7%) diagnosed, 14 with interval colonoscopy and 5 during follow-up; 8 (42.1%) happened in patients who had had an episode of uncomplicated AD. Although CT scan accuracy is high, 87.7%, positive and negative likelihood ratios were low, 4.67 and 0.64, respectively.; Conclusions: Interval colonoscopy should still be advisable after an episode of AD. The rationale for this statement is based on a non-negligible rate of hidden CC and an important uncertainty in the differential diagnosis.; (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.) |
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| Contributed Indexing: | Keywords: Acute diverticulitis; Colon cancer; Interval colonoscopy |
| Entry Date(s): | Date Created: 20210105 Date Completed: 20220105 Latest Revision: 20220105 |
| Update Code: | 20260130 |
| DOI: | 10.1007/s00464-020-08187-y |
| PMID: | 33398588 |
| Database: | MEDLINE |
Journal Article