Barnes Jewish Hospital, Washington University, St. Louis, MO, USA.
Division of Gastroenterology, Washington University, 660 S. Euclid Avenue, Campus Box 8124, St. Louis, MO, USA.
Dig Dis Sci. 2018 Nov;63(11):3120-3125. doi: 10.1007/s10620-018-5100-x. Epub 2018 May 3.
The association between withdrawal time and adenoma detection has been established; however, the effect of cecal insertion time on adenoma detection remains unclear.
To determine the association between cecal insertion time and adenoma detection.
This study completed a retrospective analysis of data collected in 4 prospective randomized-controlled trials related to screening and surveillance colonoscopy at a single tertiary care from 2010 to 2016. The primary outcome was cecal insertion time and its association with mean number of adenomas per patient and adenoma detection rate (ADR).
1303 patients met inclusion criteria (average age 59.7 ± 8.7 years; 759 females (58.3%), and 763 Caucasians (58.6%). Mean cecal insertion time was significantly longer in patients who were female (p < 0.001), received moderate sedation (p = 0.001), had fellow involvement (p < 0.001), older (p = 0.002), and lower Boston bowel preparation scale (p < 0.001). Withdrawal time was found to increase as mean cecal insertion time increased (p < 0.001). The mean cecal insertion time was not different in patients with or without adenomas (p = 0.94). Cecal insertion time did not correlate with the mean number of adenomas or advanced adenomas per patient (p > 0.05), which was also true on Poisson regression analysis. Adenomas and advanced adenomas per patient were found to decrease when cecal insertion to withdrawal time ratios were greater than 1 (p < 0.001).
Prolonged cecal insertion time was not associated with a decrease in ADR, mean number of adenomas or advanced adenomas per patient. When withdrawal times were longer than cecal insertion times, the number of adenomas and advanced adenomas detected per patient was significantly improved.
已经证实了退镜时间与腺瘤检出率之间的关联；然而，盲肠进镜时间对腺瘤检出率的影响尚不清楚。
确定盲肠进镜时间与腺瘤检出率之间的关系。
本研究对 2010 年至 2016 年在一家三级保健机构进行的 4 项与筛查和监测结肠镜检查相关的前瞻性随机对照试验中收集的数据进行了回顾性分析。主要结局是盲肠进镜时间及其与每位患者平均腺瘤数和腺瘤检出率（ADR）的关系。
1303 名患者符合纳入标准（平均年龄 59.7±8.7 岁；759 名女性（58.3%），763 名白种人（58.6%）。女性患者的盲肠进镜时间明显长于男性（p<0.001）、接受中度镇静（p=0.001）、有同事参与（p<0.001）、年龄较大（p=0.002）、波士顿肠道准备量表评分较低（p<0.001）。随着盲肠进镜时间的增加，退镜时间也随之增加（p<0.001）。有或无腺瘤的患者的盲肠进镜时间无差异（p=0.94）。盲肠进镜时间与每位患者的平均腺瘤数或高级别腺瘤数无相关性（p>0.05），泊松回归分析也是如此。当盲肠进镜时间与退镜时间之比大于 1 时，每位患者的腺瘤和高级别腺瘤数均减少（p<0.001）。
盲肠进镜时间延长与 ADR、每位患者的平均腺瘤数或高级别腺瘤数无关。当退镜时间长于盲肠进镜时间时，每位患者检出的腺瘤和高级别腺瘤数显著提高。
