Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancer Med. 2013 Jun;2(3):391-402. doi: 10.1002/cam4.73. Epub 2013 Apr 20.
Measures shown to improve the adenoma detection during colonoscopy (excellent bowel preparation, cecal intubation, cap fitted colonoscope to examine behind folds, patient position change to optimize colon distention, trained endoscopy team focusing on detection of subtle flat lesions, and incorporation of optimum endoscopic examination with adequate withdrawal time) are applicable to clinical practice and, if incorporated are projected to facilitate comprehensive colonoscopy screening program for colon cancer prevention. To determine adenoma and serrated polyp detection rate under conditions designed to optimize quality parameters for comprehensive screening colonoscopy. Retrospective analysis of data obtained from a comprehensive colon cancer screening program designed to optimize quality parameters. Academic medical center. Three hundred and forty-three patients between the ages of 50 years and 75 years who underwent first screening colonoscopy between 2009 and 2011 among 535 consecutive patients undergoing colonoscopy. Comprehensive colonoscopy screening program was utilized to screen all patients. Cecal intubation was successful in 98.8% of patients. The Boston Bowel Preparation Scale for quality of colonoscopy was 8.97 (95% confidence interval [CI]; 8.94, 9.00). The rate of adenoma detection was 60% and serrated lesion (defined as serrated adenomas or hyperplastic polyps proximal to the splenic flexure) detection was 23%. The rate of precancerous lesion detection (adenomas and serrated lesions) was 66%. The mean number of adenomas per screening procedure was 1.4 (1.2, 1.6) and the mean number of precancerous lesions (adenomas or serrated lesions) per screening procedure was 1.6 (1.4, 1.8). Retrospective study and single endoscopist experience. A comprehensive colonoscopy screening program results in high-quality screening with high detection of adenomas, advanced adenomas, serrated adenomas, and multiple adenomas.
旨在提高结肠镜检查中腺瘤检出率的措施（良好的肠道准备、盲肠插管、套有帽的结肠镜检查褶皱后的肠段、改变患者体位以优化结肠扩张、由专注于检测细微扁平病变的训练有素的内镜团队进行、以及将最佳内镜检查与足够的退镜时间结合）适用于临床实践，如果实施，预计将有助于为结肠癌预防实施全面的结肠镜筛查计划。目的是在旨在优化全面筛查结肠镜检查质量参数的条件下确定腺瘤和锯齿状息肉的检出率。从设计用于优化质量参数的综合结肠癌筛查计划中获得的数据进行的回顾性分析。学术医疗中心。2009 年至 2011 年间，在 535 例连续接受结肠镜检查的患者中，有 343 名 50 至 75 岁的患者接受了首次筛查性结肠镜检查。所有患者均接受全面结肠镜筛查计划筛查。98.8%的患者盲肠插管成功。波士顿肠道准备量表（Boston Bowel Preparation Scale）评估结肠镜检查质量得分为 8.97（95%置信区间[CI]；8.94，9.00）。腺瘤检出率为 60%，锯齿状病变（定义为脾曲近端的锯齿状腺瘤或增生性息肉）检出率为 23%。癌前病变检出率（腺瘤和锯齿状病变）为 66%。每例筛查的平均腺瘤数为 1.4（1.2，1.6），每例筛查的平均癌前病变数（腺瘤或锯齿状病变）为 1.6（1.4，1.8）。回顾性研究和单内镜医生经验。全面的结肠镜筛查计划可实现高质量的筛查，可高度检出腺瘤、高级别腺瘤、锯齿状腺瘤和多个腺瘤。
