高清 i-Scan 技术可使非专家和专家内镜医师检测结肠病变的准确性相当。

High-definition with i-Scan gives comparable accuracy for detecting colonic lesions by non-expert and expert endoscopists.

机构信息

Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy.

出版信息

Dig Liver Dis. 2013 Jun;45(6):481-6. doi: 10.1016/j.dld.2012.12.014. Epub 2013 Jan 29.

DOI:10.1016/j.dld.2012.12.014

PMID:23375148

Abstract

BACKGROUND

Lesion detection rate during colonoscopy may be influenced by the endoscopist's experience. EPK-i system colonoscopy (i-Scan) can improve mucosal and vascular visualization for detecting lesions.

AIM

To compare mucosal lesions detection rate and the withdrawal time of the instrument among non-expert and expert endoscopists.

METHODS

Colonoscopy records of all consecutive patients undergoing first HD+ with i-Scan- or SWL-equipped colonoscopy for colorectal cancer screening over a twelve-month period were evaluated, in a "post hoc" analysis.

RESULTS

542 colonoscopies (389 HD+ with i-Scan; 153 SWL): expert and non-expert endoscopists did respectively 272 and 117 HD+ with i-Scan and 83 and 70 SWL colonoscopies. Expert endoscopists did more i-Scan colonoscopies than non-experts (p=0.006). In the SWL procedures, the experts detected mucosal lesions in more colonoscopies than non-experts (61/22 vs. 23/47, p=0.0001) and found a significantly higher mean number of lesions (1.34 vs. 0.47; p=0.0001). Experts detected more or less the same mean number of lesions with both imaging techniques, while among non-experts detection with HD+ with i-Scan was significantly better than with SWL imaging (1.39 vs. 0.47; p=0.0001).

CONCLUSIONS

HD+ with i-Scan imaging enables less skilled endoscopists to achieve results comparable to those of experienced ones in detecting mucosal lesions.

摘要

背景

结肠镜检查中的病变检出率可能受到内镜医师经验的影响。EPK-i 系统结肠镜检查（i-Scan）可改善黏膜和血管可视化，从而提高病变检出率。

目的

比较非专家和专家内镜医师黏膜病变检出率和仪器退镜时间。

方法

对 12 个月内接受首次配备 i-Scan 或 SWL 的高清+（HD+）i-Scan 或 SWL 结肠镜筛查结直肠癌的所有连续患者的结肠镜检查记录进行回顾性分析。

结果

共进行了 542 例结肠镜检查（389 例 HD+配备 i-Scan；153 例 SWL）：专家和非专家内镜医师分别进行了 272 例和 117 例 HD+配备 i-Scan 结肠镜检查，83 例和 70 例 SWL 结肠镜检查。专家行 i-Scan 结肠镜检查的数量多于非专家（p=0.006）。在 SWL 操作中，专家在更多的结肠镜检查中发现黏膜病变（61/22 比 23/47，p=0.0001），发现的平均病变数量也显著更高（1.34 比 0.47；p=0.0001）。专家使用两种成像技术检测到的平均病变数量大致相同，而非专家使用 HD+配备 i-Scan 的检测效果明显优于 SWL 成像（1.39 比 0.47；p=0.0001）。