Evidence-based clinical practice guidelines for management of colorectal polyps
Evidence-based clinical practice guidelines for management of colorectal polyps
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DOI：
10.1007/s00535-014-1021-4
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发表时间：
2015-03-01
影响因子：
6.3
通讯作者：
Shimosegawa, Tooru
中科院分区：
文献类型：
--
作者：
Tanaka, Shinji;Saitoh, Yusuke;Shimosegawa, Tooru
近年来，在日本，大肠息肉的发病率一直在上升。因此，目前通过结肠镜进行诊断和治疗的大肠息肉病例大量增加，需要制定治疗后的内窥镜管理和监视的临床指南。三个委员会[日本专家提出临床问题（CQ）和陈述的专业委员会，通过改良德尔菲法进行评级陈述的专家评估委员会，和主持人组成的评价委员会]。10位结直肠息肉管理专家从PubMed和二级数据库中获得的1983年至2011年9月期间发表的文章中提取了特定的临床声明，并制定了CQ和声明。基本上，发言是根据GRADE系统进行的。专家小组使用改良的德尔菲方法对临床陈述进行单独评级，其中在9分制量表上获得中位数得分大于7分的临床陈述被认为是有效的。专业委员会创建了91个CQ和陈述，用于当前各种结肠直肠息肉的概念和诊断/治疗，包括流行病学，筛查，病理生理学，定义和分类，诊断，治疗/管理，实际治疗，并发症和治疗后的监测，以及其他结直肠病变（粘膜下肿瘤，非肿瘤性息肉，息肉病，遗传性肿瘤，溃疡性结肠炎相关肿瘤/癌）。经过主持人的评估，2014年结直肠息肉管理的循证临床指南已经提出。
Recently in Japan, the morbidity of colorectal polyp has been increasing. As a result, a large number of cases of colorectal polyps that are diagnosed and treated using colonoscopy has now increased, and clinical guidelines are needed for endoscopic management and surveillance after treatment.Three committees [the professional committee for making clinical questions (CQs) and statements by Japanese specialists, the expert panelist committee for rating statements by the modified Delphi method, and the evaluating committee by moderators] were organized. Ten specialists for colorectal polyp management extracted the specific clinical statements from articles published between 1983 and September 2011 obtained from PubMed and a secondary database, and developed the CQs and statements. Basically, statements were made according to the GRADE system. The expert panel individually rated the clinical statements using a modified Delphi approach, in which a clinical statement receiving a median score greater than seven on a nine-point scale from the panel was regarded as valid.The professional committee created 91CQs and statements for the current concept and diagnosis/treatment of various colorectal polyps including epidemiology, screening, pathophysiology, definition and classification, diagnosis, treatment/management, practical treatment, complications and surveillance after treatment, and other colorectal lesions (submucosal tumors, nonneoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumor/carcinoma).After evaluation by the moderators, evidence-based clinical guidelines for management of colorectal polyps have been proposed for 2014.