TY - JOUR
T1 - Endoscopic management of patients with high-risk colorectal colitis-associated neoplasia
T2 - a Delphi study
AU - Bak, Michiel T J
AU - Albéniz, Eduardo
AU - East, James E
AU - Coelho-Prabhu, Nayantara
AU - Suzuki, Noriko
AU - Saito, Yutaka
AU - Matsumoto, Takayuki
AU - Banerjee, Rupa
AU - Kaminski, Michal F
AU - Kiesslich, Ralf
AU - Coron, Emmanuel
AU - de Vries, Annemarie C
AU - van der Woude, C Janneke
AU - Bisschops, Raf
AU - Hart, Ailsa L
AU - Itzkowitz, Steven H
AU - Pioche, Mathieu
AU - Moons, Leon M G
AU - Oldenburg, Bas
N1 - Publisher Copyright:
© 2023 American Society for Gastrointestinal Endoscopy
PY - 2023/4
Y1 - 2023/4
N2 - BACKGROUND AND AIMS: Current guidelines recommend endoscopic resection of visible and endoscopically resectable colorectal colitis-associated neoplasia (CAN) in patients with inflammatory bowel disease (IBD). However, patients with high-risk CAN (HR-CAN) are often not amenable to conventional resection techniques, and a consensus approach for the endoscopic management of these lesions is presently lacking. This Delphi study aims to reach consensus among experts on the endoscopic management of these lesions.METHODS: A 3-round modified Delphi process was conducted to reach consensus among worldwide IBD and/or endoscopy experts (n = 18) from 3 continents. Consensus was considered if ≥75% agreed or disagreed. Quality of evidence was assessed by the criteria of the Cochrane Collaboration group.RESULTS: Consensus was reached on all statements (n = 14). Experts agreed on a definition for CAN and HR-CAN. Consensus was reached on the examination of the colon with enhanced endoscopic imaging before resection, the endoscopic resectability of an HR-CAN lesion, and endoscopic assessment and standard report of CAN lesions. In addition, experts agreed on type of resections of HR-CAN (< 20 mm, >20 mm, with or without good lifting), endoscopic success (technical success and outcomes), histologic assessment, and follow-up in HR-CAN.CONCLUSIONS: This is the first step in developing international consensus-based recommendations for endoscopic management of CAN and HR-CAN. Although the quality of available evidence was considered low, consensus was reached on several aspects of the management of CAN and HR-CAN. The present work and proposed standardization might benefit future studies.
AB - BACKGROUND AND AIMS: Current guidelines recommend endoscopic resection of visible and endoscopically resectable colorectal colitis-associated neoplasia (CAN) in patients with inflammatory bowel disease (IBD). However, patients with high-risk CAN (HR-CAN) are often not amenable to conventional resection techniques, and a consensus approach for the endoscopic management of these lesions is presently lacking. This Delphi study aims to reach consensus among experts on the endoscopic management of these lesions.METHODS: A 3-round modified Delphi process was conducted to reach consensus among worldwide IBD and/or endoscopy experts (n = 18) from 3 continents. Consensus was considered if ≥75% agreed or disagreed. Quality of evidence was assessed by the criteria of the Cochrane Collaboration group.RESULTS: Consensus was reached on all statements (n = 14). Experts agreed on a definition for CAN and HR-CAN. Consensus was reached on the examination of the colon with enhanced endoscopic imaging before resection, the endoscopic resectability of an HR-CAN lesion, and endoscopic assessment and standard report of CAN lesions. In addition, experts agreed on type of resections of HR-CAN (< 20 mm, >20 mm, with or without good lifting), endoscopic success (technical success and outcomes), histologic assessment, and follow-up in HR-CAN.CONCLUSIONS: This is the first step in developing international consensus-based recommendations for endoscopic management of CAN and HR-CAN. Although the quality of available evidence was considered low, consensus was reached on several aspects of the management of CAN and HR-CAN. The present work and proposed standardization might benefit future studies.
UR - http://www.scopus.com/inward/record.url?scp=85150861404&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2022.12.005
DO - 10.1016/j.gie.2022.12.005
M3 - Article
C2 - 36509111
SN - 0016-5107
VL - 97
SP - 767-779.e6
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 4
ER -