La coloscopie en France en 2008: résultats de l’enquête de deux jours d’endoscopie en France View Full Text


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Article Info

DATE

2010-03

AUTHORS

J. M. Canard, D. Heresbach, J.-C. Letard, R. Laugier, et le CA de la SFED

ABSTRACT

Obtenir une évaluation du nombre et des motifs des endoscopies digestives basses en 2008, en France. Il s’agit d’une enquête prospective réalisée par l’envoi d’un questionnaire auprès de l’ensemble des gastroentérologues (n = 3 125) français, leur demandant de renseigner leur activité endoscopique sur une période donnée; 1 039 cahiers de réponses complètes et analysables ont été recueillis chez 1 039 gastroentérologues, soit 7 247 endoscopies réalisées chez 6 250 patients. Un million cent quarante-sept mille neuf cent cinquante et une coloscopies ont été réalisées en 2008, soit 2,5 % ou 30 000 coloscopies en moins par rapport à 2006. L’ensemble des endoscopies digestives basses a diminué de 5,2 %, en passant de 1 323 200 en 2006 à 1 253 002 en 2008. Le principal geste endoscopique thérapeutique est la polypectomie qui demeure stable, avec 311 757 coloscopies avec polypectomie, soit 27 % des 1 148 000 coloscopies. Six cent huit mille des 1 253 002 (54 %) endoscopies digestives basses, soit 57 % des coloscopies, sont réalisées dans le cadre d’un dépistage primaire ou secondaire pour surveillance et contrôle après polypectomie ou suivi des cancers colorectaux (CCR) traités. Les coloscopies, réalisées dans les 24 mois qui suivent une coloscopie antérieure, représentent 8 % des 1 147 951 coloscopies totales, soit 91 023 examens, alors qu’au total 46 % des patients ont déjà eu une coloscopie totale préalable, dont 68 % depuis plus de trois ans. Au cours de 1 254 000 endoscopies basses enlevant 951 535 polypes sur la base du plus gros polype, 77 % endoscopies basses enlevaient au moins un polype qui faisait moins de 10 mm ou, respectivement, 29 et 48 %, mesurant entre 5 et 10 mm et moins de 5 mm. Dix ans après la première enquête réalisée, en 1998, par la SFED, le taux de participation des gastroentérologues est, en 2008, le plus élevé. Le nombre de coloscopies réalisées en 2008 est inférieur à celui réalisé en 2006, ce qui témoigne de la rationalisation de la pratique de la coloscopie et du respect par les gastroentérologues des indications ainsi que des différentes mesures mises en place pour la diffusion des recommandations. L’Acbus sur la coloscopie, fixé à 0,5 %, ne semble pas réaliste, car en pratique 8%des coloscopies étaient réalisées dans les deux ans suivant une coloscopie antérieure mais en particulier pour des motifs indiscutables (préparation insuffisante de l’examen ou risque hémorragique dû à l’absence d’arrêt des anticoagulants justifiant la reprise du patient pour résection du polype), pour 3,5 % des cas. More... »

PAGES

58-65

Journal

TITLE

Acta Endoscopica

ISSUE

2

VOLUME

40

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10190-010-0028-9

DOI

http://dx.doi.org/10.1007/s10190-010-0028-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1004005517


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