VAN DOMPSELER, MARTIJN (2020) BEHANDELCONSEQUENTIES VAN CT COLOGRAFIE VOOR PATIËNTEN BIJ WIE WORDT AFGEZIEN VAN COLOSCOPIE. thesis, Medicine.
Full text available on request.Abstract
Background: To exclude advanced adenoma (AA) and colorectal cancer (CRC) in vulnerable patients CT colonography (CTC) is a safe alternative to endoscopy (colonoscopy or sigmoidoscopy). When major abnormalities are found, endoscopy and sometimes colorectal surgery and chemoradiation is indicated. This retrospective cohort study is intended to uncover how often and for whom CTC has treatment consequences. Methods: Of 1245 patients who received CTC, 965 were included in a database. From medical records researchers extracted information about comorbidity, diagnostic yield and therapeutic consequences of CTC as well as associated complications and mortality. Results: Of patients with AA or CRC detected on CTC, 38,6% was not referred for endoscopy. Of patients with endoscopically proven AA or CRC, 22,7% did not get any treatment. Complications of surgery occurred in 39,5%, half of them were severe complications. Within two years follow-up 17,4% of the study population died, most of them because of age or comorbidity. Higher ASAclassification and Charlson Comorbidity Index were significant associated with death. Few medical data were associated with diagnostic consequences, treatment and complication risks. Conclusion: For many vulnerable patients an abnormal CTC has no treatment consequences. However, commonly used comorbidity scorings insufficiently differentiate between patients with and without treatment consequences. This study highlights the importance of thorough medical evaluation in advance of planning a CTC. Doctors should make a shared decision with their patients if making a CTC is desirable after informing them about diagnostic yield of CTC, followed by recommendations about possible diagnostic and therapeutic consequences, complication risks and mortality in relation to the comorbidity of the patient.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | DE VOS TOT NEDERVEEN CAPPEL, DR. WOUTER and VAN WESTREENE, DR. HENDERIK |
| Faculty: | Medical Sciences |
| Date Deposited: | 11 Sep 2023 13:07 |
| Last Modified: | 11 Sep 2023 13:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3681 |
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