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.
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.
Authors: Peter B Cotton; Valerie L Durkalski; Benoit C Pineau; Yuko Y Palesch; Patrick D Mauldin; Brenda Hoffman; David J Vining; William C Small; John Affronti; Douglas Rex; Kenyon K Kopecky; Susan Ackerman; J Steven Burdick; Cecelia Brewington; Mary A Turner; Alvin Zfass; Andrew R Wright; Revathy B Iyer; Patrick Lynch; Michael V Sivak; Harold Butler Journal: JAMA Date: 2004-04-14 Impact factor: 56.272
Authors: D D Maglinte; R C Strong; R W Strate; L D Caudill; P A Dyer; S M Chernish; R F Graffis Journal: AJR Am J Roentgenol Date: 1982-10 Impact factor: 3.959
Authors: Cristiano Spada; Cesare Hassan; Davide Bellini; David Burling; Giovanni Cappello; Cristina Carretero; Evelien Dekker; Rami Eliakim; Margriet de Haan; Michal F Kaminski; Anastasios Koulaouzidis; Andrea Laghi; Philippe Lefere; Thomas Mang; Sebastian Manuel Milluzzo; Martina Morrin; Deirdre McNamara; Emanuele Neri; Silvia Pecere; Mathieu Pioche; Andrew Plumb; Emanuele Rondonotti; Manon Cw Spaander; Stuart Taylor; Ignacio Fernandez-Urien; Jeanin E van Hooft; Jaap Stoker; Daniele Regge Journal: Eur Radiol Date: 2021-05 Impact factor: 5.315