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It is not worthwhile to perform ileoscopy on all patients
1Oldchurch Hospital, Waterloo Road, Romford, RM7 OBE, UK. k_y_yoong@hotmail.com
Surgical Endoscopy
|January 25, 2006
Summary
Routine ileoscopy during colonoscopy is not cost-effective. Only a small percentage of ileoscopies yield abnormal findings that alter patient management, suggesting selective use is warranted.
Area of Science:
- Gastroenterology
- Endoscopy
Background:
- The clinical utility of routine ileoscopy during colonoscopy remains debated.
- Previous studies focused on diagnostic yield but not its impact on patient management.
Purpose of the Study:
- To evaluate the value of ileoscopy in altering clinical management for patients undergoing colonoscopy.
Main Methods:
- Retrospective review of 2,149 colonoscopies performed between January 2002 and December 2003.
- Analysis of terminal ileum intubation, biopsy findings, and histopathology reports.
- Review of patient records to determine changes in management following abnormal ileal biopsies.
Main Results:
- Ileoscopy was performed in 16.1% of patients (346/2,149).
- Abnormal findings on terminal ileum biopsies occurred in 4.6% of ileoscopies (16/346).
- Management changes were noted in only 50% of patients with abnormal ileoscopy findings.
Conclusions:
- Ileoscopy should be reserved for cases with specific indications where findings are likely to alter patient management.
- Routine ileoscopy in all patients undergoing colonoscopy is not cost-effective.