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Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis
BACKGROUND: Endoscopic assessment of disease activity is a key parameter in the management of ulcerative colitis. Whether sigmoidoscopy alone is sufficient to evaluate the disease activity in ulcerative colitis lacks studies. METHODS: We retrospectively analyzed the medical records and endoscopic re...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882296/ https://www.ncbi.nlm.nih.gov/pubmed/35220941 http://dx.doi.org/10.1186/s12876-022-02178-0 |
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author | Park, Su Bum Kim, Seong-Jung Lee, Jun Lee, Yoo Jin Baek, Dong Hoon Seo, Geom Seog Kim, Eun Soo Kim, Sang-Wook Kim, So Yeong |
author_facet | Park, Su Bum Kim, Seong-Jung Lee, Jun Lee, Yoo Jin Baek, Dong Hoon Seo, Geom Seog Kim, Eun Soo Kim, Sang-Wook Kim, So Yeong |
author_sort | Park, Su Bum |
collection | PubMed |
description | BACKGROUND: Endoscopic assessment of disease activity is a key parameter in the management of ulcerative colitis. Whether sigmoidoscopy alone is sufficient to evaluate the disease activity in ulcerative colitis lacks studies. METHODS: We retrospectively analyzed the medical records and endoscopic results of patients with ulcerative colitis followed by colonoscopy in seven tertiary hospitals between January 2012 and December 2018. Endoscopic disease activity was scored using the Mayo endoscopic subscore (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for each segment from the colonoscopy images. Concordance was evaluated by comparing the highest MES and UCEIS in the rectosigmoid and proximal regions to confirm the usefulness of sigmoidoscopy. RESULTS: A total of 500 colonoscopic examinations from 333 patients were enrolled. Only in 7.6% [k(kappa): 0.893, r(Spearman): 0.906, p < 0.001] and 8.6% [k(kappa): 0.890, r(Spearman): 0.914; p < 0.001] of cases, MES and UCEIS scored more severely in the proximal colon. Comparison of active disease (MES ≥ 2) in the rectosigmoid area and the entire colon showed a high concordance rate [k(kappa): 0.899, r(Spearman): 0.904, p < 0.001]. Endoscopic healing (MES = 0) also showed a high concordance rate [k(kappa): 0.882, r(Spearman): 0.887, p < 0.001]. In 38 cases (7.6%) of patients with a higher MES in the proximal area, it was significantly higher in patients with previous extensive colitis. CONCLUSIONS: Sigmoidoscopy and colonoscopy showed a high concordance rate. Therefore, sigmoidoscopy is considered a sufficient substitute for colonoscopy. However, colonoscopy should be considered in patients with previous extensive colitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02178-0. |
format | Online Article Text |
id | pubmed-8882296 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88822962022-02-28 Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis Park, Su Bum Kim, Seong-Jung Lee, Jun Lee, Yoo Jin Baek, Dong Hoon Seo, Geom Seog Kim, Eun Soo Kim, Sang-Wook Kim, So Yeong BMC Gastroenterol Research BACKGROUND: Endoscopic assessment of disease activity is a key parameter in the management of ulcerative colitis. Whether sigmoidoscopy alone is sufficient to evaluate the disease activity in ulcerative colitis lacks studies. METHODS: We retrospectively analyzed the medical records and endoscopic results of patients with ulcerative colitis followed by colonoscopy in seven tertiary hospitals between January 2012 and December 2018. Endoscopic disease activity was scored using the Mayo endoscopic subscore (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for each segment from the colonoscopy images. Concordance was evaluated by comparing the highest MES and UCEIS in the rectosigmoid and proximal regions to confirm the usefulness of sigmoidoscopy. RESULTS: A total of 500 colonoscopic examinations from 333 patients were enrolled. Only in 7.6% [k(kappa): 0.893, r(Spearman): 0.906, p < 0.001] and 8.6% [k(kappa): 0.890, r(Spearman): 0.914; p < 0.001] of cases, MES and UCEIS scored more severely in the proximal colon. Comparison of active disease (MES ≥ 2) in the rectosigmoid area and the entire colon showed a high concordance rate [k(kappa): 0.899, r(Spearman): 0.904, p < 0.001]. Endoscopic healing (MES = 0) also showed a high concordance rate [k(kappa): 0.882, r(Spearman): 0.887, p < 0.001]. In 38 cases (7.6%) of patients with a higher MES in the proximal area, it was significantly higher in patients with previous extensive colitis. CONCLUSIONS: Sigmoidoscopy and colonoscopy showed a high concordance rate. Therefore, sigmoidoscopy is considered a sufficient substitute for colonoscopy. However, colonoscopy should be considered in patients with previous extensive colitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12876-022-02178-0. BioMed Central 2022-02-27 /pmc/articles/PMC8882296/ /pubmed/35220941 http://dx.doi.org/10.1186/s12876-022-02178-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Park, Su Bum Kim, Seong-Jung Lee, Jun Lee, Yoo Jin Baek, Dong Hoon Seo, Geom Seog Kim, Eun Soo Kim, Sang-Wook Kim, So Yeong Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title | Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title_full | Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title_fullStr | Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title_full_unstemmed | Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title_short | Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
title_sort | efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882296/ https://www.ncbi.nlm.nih.gov/pubmed/35220941 http://dx.doi.org/10.1186/s12876-022-02178-0 |
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