The Wolfson Unit for Endoscopy, St. Mark's Hospital and Academic Institute, Imperial College London, London, United Kingdom.
Gastrointest Endosc. 2013 Mar;77(3):395-400. doi: 10.1016/j.gie.2012.10.007. Epub 2012 Dec 1.
Colonoscopy reduces colorectal cancer mortality and morbidity principally by the detection and removal of colon polyps. It is important to retrieve resected polyps to be able to ascertain their histologic characteristics.
The aim of the study was to evaluate the cause of polyp retrieval failure.
Bowel cancer screening colonoscopy data were collected prospectively.
The Bowel Cancer Screening Program in the National Health Service.
Screening participants were referred to our screening center after a positive fecal occult blood test result.
A total of 4383 polyps were endoscopically removed from 1495 patients from October 2006 to February 2011.
The number, size, shape, and location of polyps; polyp removal method; quality of bowel preparation; total examination time; and insertion and withdrawal times in collected data were examined retrospectively.
The polyp retrieval rate was 93.9%, and the failure rate was 6.1%, thus 267 polyps were not retrieved. In univariate analysis, factors affecting polyp retrieval failure were small polyp size, sessile polyps, and cold snare polypectomy (P < .001). Polyp retrieval was less successful in the proximal colon (P = .002). In multivariate analysis, polyp size and method of removal were independent risk factors for polyp retrieval failure (P < .001).
Retrospective study.
Small polyp size and cold snare removal were found to be significantly associated with polyp retrieval failure. It was difficult to retrieve small, sessile, and proximal colon polyps. Optical diagnosis could be an efficacious option as a surrogate for histologic diagnosis for these lesions in the near future.
结肠镜检查通过检测和切除结肠息肉，主要降低结直肠癌的死亡率和发病率。切除息肉后，重要的是要取回这些息肉，以便确定其组织学特征。
本研究旨在评估息肉回收失败的原因。
收集了国家卫生服务局（NHS）结直肠癌筛查结肠镜检查的数据。
结直肠癌筛查计划。
阳性粪便潜血试验结果的筛查参与者被转诊至我们的筛查中心。
从 2006 年 10 月至 2011 年 2 月，对 1495 名患者共切除了 4383 个息肉。
在收集的数据中，对息肉的数量、大小、形状和位置、息肉切除方法、肠道准备质量、总检查时间、插入和退出时间进行了回顾性检查。
息肉回收率为 93.9%，失败率为 6.1%，因此有 267 个息肉未被回收。单因素分析显示，影响息肉回收失败的因素有息肉小、息肉无蒂和冷圈套息肉切除术（P<0.001）。近端结肠的息肉回收成功率较低（P=0.002）。多因素分析显示，息肉大小和切除方法是息肉回收失败的独立危险因素（P<0.001）。
回顾性研究。
息肉小、冷圈套切除是与息肉回收失败显著相关的因素。对于小的、无蒂的、近端结肠的息肉，回收较为困难。在不久的将来，光学诊断可能是这些病变进行组织学诊断的有效替代方法。
