Usefulness of serial biopsies in patients undergoing colonoscopy in the view of the endoscopist in relation to the referring physician (Atena Editora)

Abstract

Colonoscopy is a diagnostic method used since 1970 that allows evaluation and screening of colorectal diseases. Patients with chronic diarrhea and normal mucosa on colonoscope examination, serial biopsies can provide relevant information to aid in the diagnosis and appropriate treatment. In recent years, we have observed a significant increase in the number of requests for serial biopsies in colonoscopy. A total of 3,577 colonoscopic exams were performed from 01/01/2019 to 04/30/2021, with 298 (8.3%) colonoscopies with serial biopsies being performed, after exclusions we selected 222 patients and divided into two groups. In group I, 140 (63.1%) patients underwent serial biopsies at the request of the assistant physician, of whom 119 (85%) had no changes in the endoscopic examination, 83 (59%) had no histological changes. In group II, with 82 (36.9%) patients undergoing serial biopsies at the discretion of the endoscopist, of these 30 patients (37%) there were no endoscopic changes and in 19 (23%) there were no histological changes. In group II, the serial biopsies took into account the clinical context and the endoscopic findings, in view of which a greater number of alterations were found, both in the colonoscopic and histological findings. This demonstrates that the endoscopist's decision to perform serial biopsies during colonoscopy has a higher diagnostic yield.