Multi-disciplinary decision-making strategies may reduce the need for secondary surgery in complex colonic polyps - a systematic review and pooled analysis

Parker, Jody, Gupta, Sunnia, Torkington, Jared and Dolwani, Sunil ORCID: https://orcid.org/0000-0002-3113-5472 2021. Multi-disciplinary decision-making strategies may reduce the need for secondary surgery in complex colonic polyps - a systematic review and pooled analysis. Colorectal Disease 23 (12) , pp. 3101-3112. 10.1111/codi.15901

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Abstract

Aim The recognition of complex colonic polyps is increasing. Management varies considerably and the impact of this on clinical outcomes is unclear. The aim of this systematic review was to assess the impact of group decision-making strategies and defined selection criteria on the treatment outcomes of complex colonic polyps. Method A systematic literature review identified studies reporting complex polyp treatment outcomes and describing their decision-making strategies. Databases searched included PubMed, Web of Science, CINAHL and Scopus. Articles were identified by two blinded reviewers using defined inclusion criteria. The review protocol was registered on PROSPERO and performed in line with PRISMA guidelines. Results There were 303 identified articles describing treatment outcomes of complex colonic polyps. Only nine of these fully described the decision-making strategy and met the inclusion criteria. Adverse events ranged from 1.3% to 10% across the studies. Unsuspected malignancy and secondary surgery rates ranged from 2.4% to 15.4% and 3.3% to 43.9%, respectively. Grouping of articles into a hierarchy of decision-making strategies demonstrated a sequential reduction in secondary surgery rates with improving strategies. There were no differences in comparisons of adverse event or unsuspected malignancy rates. Conclusions There is limited description of decision-making strategies and variability in reporting of studies describing complex polyp treatment outcomes. The use of multidisciplinary decision-making and defined selection criteria may reduce the need for secondary surgical intervention in complex colonic polyps, but further evidence is required to draw definite conclusions.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Wiley
ISSN:	1462-8910
Date of First Compliant Deposit:	15 September 2021
Date of Acceptance:	23 August 2021
Last Modified:	29 Nov 2024 16:15
URI:	https://orca.cardiff.ac.uk/id/eprint/144138

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