Surveillance Colonoscopy after Appendicectomy in Patients over the Age of 40: Targeted Audit of Outcomes and Variability in Practice.
Introduction: Recent evidence suggests the need to proceed with a surveillance colonoscopy in patients above the age of 40 years who undergo appendicectomy for acute appendicitis, given the higher risk of an underlying colonic tumor. After anecdotally observing a substantial variability in terms of adaptation of these recommendations by the on-call surgical teams, we performed a clinical audit regarding our relevant endoscopic follow-up compliance rates to identify areas for improvement of our practise. Materials Methods: We performed a retrospective review of the electronic records of all patients above 40 years who had appendicectomy for acute appendicitis within a 3-year period in our institution, assessing as primary outcome the actual performance of a follow-up colonoscopy and the detected endoscopic findings. Results: Our results demonstrated that more than 80% of our patients did not have an endoscopic follow-up, as suggested by the current evidence. In addition, with respect to the subspecialisation of the parent surgical team, it seems that non-colorectal teams had lower compliance regarding the arrangement of endoscopic surveillance, when compared to specialist colorectal team. Conclusions: Emergency surgical teams need to be further educated with respect to the current practise recommendations concerning the appropriate endoscopic follow-up after the performance of appendicectomy for acute appendicitis. Establishment of dedicated bundles of postoperative care, as well as clear relevant guidance from the gastrointestinal/emergency surgery societies would be of great value in this direction.
['Seretis|Charalampos|C|', 'Gill|Jagjit|J|', 'Lim|Paul|P|', 'Archer|Lucy|L|', 'Seretis|Fotios|F|', 'Yahia|Shuker|S|']
D000208:Acute Disease D000367:Age Factors D001062:Appendectomy D001064:Appendicitis D003110:Colonic Neoplasms D003113:Colonoscopy D055088:Early Detection of Cancer D006801:Humans D008485:Medical Audit D011159:Population Surveillance D012189:Retrospective Studies
appendicitiscancercolonoscopypolyp