SETTING UP A REGIONAL EXPERT PANEL FOR COMPLEX COLORECTAL POLYPS

Aims Advanced endoscopic resection techniques for complex colorectal polyps have evolved significantly over the past decade, leading to a management shift from surgical to endoscopic resection as the preferred treatment. However in practice, interhospital consultation and access to the required expertise for appropriate referral management remain challenging and under-used. In order to support regional care for patients with complex colorectal polyps, facilitate peer consultations and lower thresholds for referrals, an expert panel consultation platform was initiated in the northwestern region of the Netherlands.

Methods We initiated a regional expert panel in the northwestern region of the Netherlands for patients with complex colorectal polyps and studied the implementation, adaption and clinical impact. All panel consultations between June 2019 and May 2021 were analyzed and user satisfaction among panel members was evaluated.

Results Eighty-eight patients with complex colorectal polyps from eleven of fifteen participating centers (73.3%) were discussed in our panel. The most common reason for panel consultation was suspicion of invasive cancer in 36.4% (n=32). After panel consultation, 43.2% (n=38) of the consulting endoscopists changed their initial treatment strategy, and in 63.6% (n=56) patients were referred to another endoscopy center. Of 26 cases submitted with a primary proposal for surgical treatment, surgery was avoided in seven (26.9%). User satisfaction was rated high in majority of participating centers (91.7%).

Conclusions Our study shows that implementation and consultation of a regional expert panel can be a valuable tool to guide and optimize treatment of complex colorectal polyps and facilitate interhospital referrals in a regional network.

Publication History

Article published online:
14 April 2022