PDF(Pubmed)
Abstract：
Introduction In 2020, the British Society of Gastroenterologists (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI), and Public Health England (PHE) published joint guidelines regarding post-polypectomy surveillance. This study aimed to establish clinician adherence at the Royal Devon University Healthcare NHS Foundation Trust to the 2020 guidelines compared to the now-retired 2010 guidelines. Materials and Methods Data on 152 patients treated under the 2010 guidelines and 133 patients treated under the 2020 guidelines were collected retrospectively from the hospital\'s colonoscopy database. Data were analysed to determine whether patients who had a colonoscopy fulfilled BSG/ACPGBI/PHE guidelines for follow-up. Costs were estimated using the price of colonoscopy in the NHS National Schedule. Results Approximately 41.4% (63/152) of patients were adherent to the 2010 guidelines while 66.2% (88/133) of patients were adherent to the 2020 guidelines. The difference in adherence rate was 24.7% (95% confidence interval 13.5% - 35.9%, p<0.0001). Nearly 37% (35/95) of patients who would have been followed up under the 2010 guidelines did not receive any follow-up as a result of the 2020 guidelines. This represents a cost saving of £36,892.28 per year in our hospital. Approximately 47% (28/60) of patients treated under the 2020 guidelines had surveillance colonoscopy planned when the guidelines recommended no follow-up. If every clinician were fully adherent to the 2020 guidelines, then a further £29,513.82 per year would have been saved. Discussion and Conclusion Following the introduction of the 2020 guidelines, adherence to polyp surveillance guidelines increased in our hospital. However, nearly half of the colonoscopies were performed unnecessarily due to non-adherence. Furthermore, our results demonstrate that the 2020 guidelines have decreased the need for follow-up.
摘要：
介绍2020年，英国胃肠病学家协会（BSG），大不列颠及爱尔兰结肠直肠学协会（ACPGBI），英国公共卫生部(PHE)发布了关于息肉切除术后监测的联合指南.这项研究旨在与现已退休的2010年指南相比，在皇家德文郡大学医疗保健NHS基金会信托基金中建立临床医生对2020年指南的依从性。材料与方法从医院的结肠镜检查数据库中回顾性收集了根据2010年指南治疗的152例患者和根据2020年指南治疗的133例患者的数据。分析数据以确定接受结肠镜检查的患者是否符合BSG/ACPGBI/PHE随访指南。成本是使用NHS国家时间表中的结肠镜检查价格估算的。结果约41.4%(63/152)的患者遵守2010年指南，而66.2%(88/133)的患者遵守2020年指南。依从率差异为24.7%(95%置信区间13.5%-35.9%,p<0.0001)。根据2010年指南进行随访的患者中有近37％（35/95）由于2020年指南而未接受任何随访。这意味着我们医院每年节省36,892.28英镑的成本。大约47%(28/60)根据2020年指南治疗的患者在指南建议不进行随访时计划进行结肠镜检查。如果每个临床医生都完全遵守2020年指南，那么每年还可以节省29,513.82英镑。讨论与结论2020年指南出台后，我们医院对息肉监测指南的依从性增加.然而,近一半的结肠镜检查由于不依从性而不必要地进行.此外，我们的结果表明,2020年指南减少了随访的需要.
