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The safety of same-day CT colonography following incomplete colonoscopy with polypectomy
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DOI：10.1177/2050640615577881.png)
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Abstract
En 中文
Background: Concerns about the risk of bowel perforation for same-day computed tomography colonography (CTC) following an incomplete colonoscopy with polypectomy may lead to unnecessarily postponing the CTC. Objective: The objective of this article is to describe the complications including colon perforations associated with same-day CTC in a cohort who had polypectomies but an incomplete colonoscopy. Design: We conducted a retrospective study. Setting: Our study took place in a single, tertiary referral center. Patients: We studied consecutive patients who had CTC the same day as an incomplete colonoscopy with polypectomy. Interventions: Interventions included optical colonoscopy (OC), endoscopic polypectomies, and same-day CTC. Main outcome measurements: Our main outcome measurements included perforation rate with long-term follow-up. Results: A total of 3% of patients undergoing colonoscopy from January 2008 to December 2012 had same-day CTC following incomplete OC, and 72 polypectomies were performed in 34 (or 17%) of these patients. Incomplete colonoscopies were due to colon tortuosity and looping (25), severe angulations (five), colon mass (two), colon stenosis (one), bradycardia (one). Fifty-three percent of the OCs were screening for colon neoplasia, 29% diagnostic and 18% were surveillance of colon polyps. Most polyps were <= 5 mm, and found in the left colon. There were no reported complications or perforations associated with same-day CTCs during short-and long-term follow-up. Limitations: Limitations of our analysis included retrospective single-center design, small number of patients for the occurrence, referral to same-day CTC was not standardized, inability to establish safety of CTC for specific scenarios such as after complex polypectomies, strictures, or advanced IBD. Conclusions: Radiologists' apprehension to perform a CTC the same day as an incomplete colonoscopy following polypectomies because of perceived risk of perforation may be unfounded. More data are needed to determine the safety of same-day CTC in patients with high-risk findings during colonoscopy such as a stricture, severe IBD, and after complex polypectomies.
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Medical subject headings (MeSH): colonography
computed tomographic
colonoscopy
endoscopy
digestive system
colonic polyps
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