Byrd R L, Boggs H W, Slagle G W, Cole P A
Schumpert Medical Center, LSU Medical Center, Shreveport.
Dis Colon Rectum. 1989 Dec;32(12):1023-5. doi: 10.1007/BF02553873.
In an effort to determine the reliability of colonoscopy the authors retrospectively reviewed preoperative colonoscopic findings and compared them with the postoperative pathologic specimen reports. Only lesions greater than 0.5 cm were included in the comparison. Over a 13-year period, 429 patients with colorectal cancer underwent preoperative colonoscopy. Four hundred thirteen (97 percent) of the colonoscopic examinations correlated with the pathologic specimen, but, in 16 cases (3 percent), lesions were missed. In total, 17 adenomatous polyps and 3 cancers were found in the surgical specimens that were not documented at colonoscopy. Eighteen patients had total preoperative colonoscopy and total abdominal colectomy, which makes for a reliable model to judge the accuracy of colonoscopy. In these 18 patients, 17 of the pathologic specimens correlated with the endoscopic findings, which yields an accuracy rate of 94 percent. Blind areas in the colon, plus misjudgment that the scope had reached the cecum, are responsible for the majority of colonoscopic errors.
为了确定结肠镜检查的可靠性，作者回顾性地分析了术前结肠镜检查结果，并将其与术后病理标本报告进行比较。仅将大于0.5厘米的病变纳入比较。在13年期间，429例结直肠癌患者接受了术前结肠镜检查。413例（97%）结肠镜检查结果与病理标本相符，但有16例（3%）病变被漏诊。在手术标本中总共发现了17个腺瘤性息肉和3处癌症，这些在结肠镜检查中均未记录。18例患者接受了全术前结肠镜检查和全腹结肠切除术，这构成了一个判断结肠镜检查准确性的可靠模型。在这18例患者中，17例病理标本与内镜检查结果相符，准确率为94%。结肠的盲区以及对结肠镜已到达盲肠的错误判断是导致大多数结肠镜检查失误的原因。
