Frequency of Errors in Colorectal Lesion Description and Management Prior to Referral to A Tertiary Center.

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastrointestinal endoscopy Pub Date : 2024-10-29 DOI:10.1016/j.gie.2024.10.056

Yervant Ichkhanian, Rachel E Lahr, John J Guardiola, Douglas K Rex

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Abstract

Background and aims: Accurate reporting of polyp characteristics is crucial for effective resource allocation in endoscopic resection referrals. We present our experience with pre-referral management of challenging colorectal lesions.

Methods: We reviewed a prospectively collected database of consecutive referrals for endoscopic resection of challenging colorectal lesions. The database included details of prior colonoscopies. We assessed pre-referral management using established guidelines.

Results: Among 1,826 referred lesions in 1826 patients, size estimates were missing for 421 (24%) lesions; 56 (3.2%) were found twice as large as previously estimated, while 65 (3.7%) were half the previous estimate. Morphological descriptions were absent for 376 (22%) polyps. Tattooing was performed for 822 (47%) lesions, with 247 (30%) placed correctly. Of the 1,103 (77%) polyps biopsied, only 11 (1.1%) were classified as high-risk by the referring endoscopist.

Conclusions: Errors in pre-referral management of challenging colorectal lesions are frequent. Improved adherence to national guidelines could enhance practice.

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转诊至三级中心前结肠直肠病变描述和处理错误的频率。

背景和目的：准确报告息肉特征对于有效分配内镜切除转诊资源至关重要。我们介绍了对具有挑战性的结直肠病变进行转诊前管理的经验：方法：我们回顾了前瞻性收集的连续转诊数据库，这些转诊患者均接受了具有挑战性的结直肠病变内镜切除术。该数据库包括先前结肠镜检查的详细信息。我们根据既定指南对转诊前的管理进行了评估：在 1826 名患者的 1826 个转诊病灶中，421 个（24%）病灶的大小估计值缺失；56 个（3.2%）病灶的大小是之前估计值的两倍，65 个（3.7%）病灶的大小是之前估计值的一半。376个（22%）息肉没有形态学描述。对 822 个（47%）病灶进行了纹身，其中 247 个（30%）纹身位置正确。在进行活检的 1,103 个（77%）息肉中，只有 11 个（1.1%）被转诊内镜医师列为高危息肉：结论：在转诊前处理具有挑战性的结直肠病变时经常出现错误。加强对国家指南的遵守可以提高诊疗水平。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.