Outcomes of complex colorectal polyps managed by multi-disciplinary team strategies-a multi-centre observational study.
Author
Parker, JGupta, S
Shenbagaraj, L
Harborne, P
Ramaraj, R
Karandikar, S
Mottershead, M
Barbour, J
Mohammed, N
Lockett, M
Lyons, A
Vega, R
Torkington, J
Dolwani, S
Publication date
2023-02-03Subject
Surgery
Metadata
Show full item recordAbstract
Purpose: Team management strategies for complex colorectal polyps are recommended by professional guidelines. Multi-disciplinary meetings are used across the UK with limited information regarding their impact. The aim of this multi-centre observational study was to assess procedures and outcomes of patients managed using these approaches. Method: This was a retrospective, observational study of patients managed by six UK sites. Information was collected regarding procedures and outcomes including length of stay, adverse events, readmissions and cancers. Results: Two thousand one hundred ninety-two complex polyps in 2109 patients were analysed with increasing referrals annually. Most presented symptomatically and the mean polyp size was 32.1 mm. Primary interventions included endoscopic therapy (75.6%), conservative management (8.3%), colonic resection (8.1%), trans-anal surgery (6.8%) or combined procedures (1.1%). The number of primary colonic resections decreased over the study period without a reciprocal increase in secondary procedures or recurrence. Secondary procedures were required in 7.8%. The median length of stay for endoscopic procedures was 0 days with 77.5% completed as day cases. Median length of stay was 5 days for colonic resections. Overall adverse event and 30-day readmission rates were 9.0% and 3.3% respectively. Malignancy was identified in 8.8%. Benign polyp recurrence occurred in 13.1% with a median follow up of 30.4 months. Screening detected lesions were more likely to undergo bowel resection. Colonic resection was associated with longer stays, higher adverse events and more cancers on final histology. Conclusion: Multi-disciplinary team management of complex polyps is safe and effective. Standardisation of organisation and quality monitoring is needed to continue positive effects on outcomes and services.Citation
Parker J, Gupta S, Shenbagaraj L, Harborne P, Ramaraj R, Karandikar S, Mottershead M, Barbour J, Mohammed N, Lockett M, Lyons A, Vega R, Torkington J, Dolwani S. Outcomes of complex colorectal polyps managed by multi-disciplinary team strategies-a multi-centre observational study. Int J Colorectal Dis. 2023 Feb 3;38(1):28. doi: 10.1007/s00384-022-04299-0Type
ArticleAdditional Links
https://link.springer.com/journal/384PMID
36735059Publisher
Springerae974a485f413a2113503eed53cd6c53
10.1007/s00384-022-04299-0