Gastroenterology Unit, Valduce Hospital, Como, Italy.
Dig Liver Dis. 2013 Jan;45(1):28-32. doi: 10.1016/j.dld.2012.07.018. Epub 2012 Aug 21.
BACKGROUND/AIM: A nation-wide survey of colonoscopy practice carried out in 2004 showed disappointing data on colonoscopy quality in Italy. Present study was aimed prospectively at re-evaluating quality indicators of colonoscopy and their changes over a five-year-period.
The main features of each Endoscopy Unit and performance indicators on consecutive colonoscopies performed in a 2-week period were recorded. Variation of colonoscopy quality was assessed by comparing caecal-intubation and polyp-detection rates in present survey with those collected five-years before; statistical analysis was restricted to centres participating in both data collections.
6158 colonoscopies from 116 centres were evaluated; unadjusted caecal-intubation rate was 83.0%, with 21.6% centres reporting a value >90%; mean polyp-detection rate was 32.0% (range 9.6-71.2% across centres). To assess variation of performance indicators, 4452 procedures from 77 centres were compared to 3589 procedures performed five-years before, in the same centres. A significant difference between the two rounds of data collections was observed for both caecal-intubation (82.6% versus 80.9%, p=0.043) and polyp-detection (31.3% versus 28.1%, p=0.002). However, 52 centres maintained a caecal-intubation rate constantly <90%.
Present data show that colonoscopy in Italy is still far below quality standards and that a significant improvement of practice did not occur over the last five years. Strategies to enhance colonoscopy quality should be pursued by professional societies.
背景/目的：2004 年进行的一项全国范围内的结肠镜检查实践调查显示，意大利的结肠镜检查质量数据令人失望。本研究旨在前瞻性地重新评估结肠镜检查的质量指标及其在五年期间的变化。
记录每个内镜科室的主要特征以及在两周内连续进行的结肠镜检查的性能指标。通过将本次调查中盲肠插管率和息肉检出率与五年前收集的数据进行比较，评估结肠镜检查质量的变化；统计分析仅限于参与两次数据收集的中心。
评估了来自 116 个中心的 6158 例结肠镜检查；未经调整的盲肠插管率为 83.0%，21.6%的中心报告值>90%；平均息肉检出率为 32.0%（各中心范围为 9.6-71.2%）。为评估性能指标的变化，将来自 77 个中心的 4452 例与相同中心五年前进行的 3589 例进行比较。在两轮数据收集之间观察到盲肠插管（82.6%比 80.9%，p=0.043）和息肉检出（31.3%比 28.1%，p=0.002）均有显著差异。然而，52 个中心的盲肠插管率始终保持在<90%以下。
目前的数据表明，意大利的结肠镜检查仍远未达到质量标准，在过去五年中，实践并未显著改善。专业协会应采取策略来提高结肠镜检查的质量。
