Il problema dei "missed cancers" del colon-retto - Sied

118Franco Radaelli et al > "Missed cancers" del colon rettoLRevisione della Letteratura> rassegna biennaleConclusioniAnche se gli studi considerati sono stati condotti conmetodologie diverse e con finalità diverse e non sonotra loro paragonabili possiamo concludere che lacolonscopia, sebbene considerata il “gold standard”per la diagnosi delle neoplasie coliche, presenta evidentilimiti di sensibilità. Lesione neoplastiche avanzatee cancri possono sfuggire all’esame, e questovale soprattutto per le lesioni localizzate a destra,nei segmenti prossimali. La colonscopia è una proceduraoperatore-dipendente; interventi finalizzati almiglioramento della qualità dell’esame sono necessariper massimizzare l’efficacia della colonscopia,ridurre l’incidenza di CCR ed incrementare l’efficienzadei programmi di screening. Le “lesioni perse” sonosicuramente un errore e/o una colpa ma dovremmoforse concentrarci anche sul tentativo di trasformarliin indicatori di qualità e stabilire valori soglia al di sottodel quale possano essere (con tutto il dispiacere possibile)realisticamente accettati.CorrispondenzaFranco RadaelliUOC GastroenterologiaOspedale ValduceVia Dante, 11 - 22100 ComoTel. + 39 031 324111Fax + 39 031 308047e-mail: francoradaelli@virgilio.itBibliografia1. van Rijn JC, Reitsma JB, Stoker J, Bossuyt PM, van Deventer SJ,Dekker E. Polyp miss rate determined by tandem colonoscopy: asystematic review. Am J Gastroenterol 2006;101:343-50.2. Hersabach D, Barrioz T, Lapalus MG, Coumaros D, Bauret P,Potier P, Sautereau D, Boustière C, Grimaud JC, Barthélémy C,Sée J, Serraj I, D'Halluin PN, Branger B,Ponchon T. Miss rate forcolorectal neoplastic polyps: a prospective multicenter study ofback-to-back video colonoscopies. 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