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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
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.
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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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