ArticleTechniques in coloproctology2017
The impact of the national bowel screening program in the Netherlands on detection and treatment of endoscopically unresectable benign polyps.
Article in Techniques in coloproctology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Combined endoscopic-laparoscopic surgery (CELS) can avoid segmental colectomy in endoscopically unremovable colonic polyps: a cohort study over 10 years.Surgical endoscopy · 2022Observational
- Morbidity and mortality after major large bowel resection of non-malignant polyp among participants in a population-based screening program.Journal of medical screening · 2021Article
- Laparoscopic wedge resection as an alternative to laparoscopic oncological colon resection for benign endoscopically unresectable colon polyps.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Combined endo-laparoscopic surgery for difficult benign colorectal polyps.Journal of gastrointestinal oncology · 2020Review
- International evaluation of circumferential resection margins after rectal cancer resection: insights from the Swedish and Dutch audits.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2020Article
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7 authors.
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Abstract
backgroundIn January 2014, a national bowel cancer screening program started in the Netherlands. The program is being implemented in phases until 2019. Due to this program, an increase in patients referred for a colorectal resection for benign, but endoscopically unresectable polyps, is expected. So far, most resections are performed according to oncological principles despite no pre-operative histological diagnosis of malignancy. The aim of this study was to analyze the increase in referred patients during the first year of the screening program and to compare pathological results and clinical outcome of resections of patients undergoing resection for benign polyps before and after implementation of screening.
methodsPatients referred for colorectal resection without biopsy-proven cancer between January 2009 and January December 2014 were identified from a prospectively maintained database. Patients with endoscopically macroscopic features of carcinoma were excluded.
resultsSeventy-six patients were included. Forty-seven patients (61.8%) were operated on in the 5 years prior to implementation of the screening program, and 29 patients (38.2%) were operated during the first year of implementation of the screening program. The overall malignancy rate before the introduction of the program was 14.1 and 6.6% after it had started (p = .469). All resections were performed laparoscopically; the conversion rate was 3.9% (n = 3). The overall mortality rate was 2.7% (n = 2), major complications (Clavien-Dindo > 3b) occurred in 11.8% (n = 9) of patients. The anastomotic leakage rate was 3.9% (n = 3).
conclusionsThe number of patients referred for benign polyps tripled after introduction of the screening program. With an overall major morbidity and mortality rate of 11.8%, it seems valid to discuss whether an endoscopic excision with advanced techniques with or without laparoscopic assistance would be preferable in this patient group, accepting a 6.6% reoperation rate for additional oncological resection with lymph node sampling in patients in whom a malignancy is found on histological analysis of the complete polyp.
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