Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Gastroenterology University Hospital Llandough, Cardiff, UK.
United European Gastroenterol J. 2019 Feb;7(1):125-129. doi: 10.1177/2050640618809263. Epub 2018 Oct 18.
Colorectal lesions are generally evaluated during the withdrawal phase of colonoscopy. Minimising the risk of missed lesions is crucial to determine an appropriate future surveillance colonoscopy interval.
This study aimed to evaluate the clinical significance of detecting sigmoid colon lesions during the insertion phase.
This retrospective study included 172 consecutive patients undergoing colonoscopy between October 2017 and April 2018. The total number of detected polyps, mean polyps per procedure, mean polyps per positive procedure, and histological and clinical characteristics of detected lesions were recorded. The primary endpoint was the difference in sigmoid colon polyp detection rates during insertion and withdrawal.
A total of 172 colonoscopies were performed for each patient and 322 lesions were detected. Sixty-two (19%) polyps were detected during insertion, 312 (97%) during withdrawal, and 52 (16%) during both insertion and withdrawal. Although all polyps except for those in the sigmoid colon could be detected during withdrawal, 10 of 87 (11%) polyps in the sigmoid colon could only be detected during insertion.
In this study, attempts to detect polyps, even in the insertion phase, showed the clinical significance to decrease the risk of missed adenomatous polyps in the sigmoid colon.
结直肠病变通常在结肠镜检查的退镜阶段进行评估。将漏诊病变的风险降到最低对于确定适当的未来结肠镜监测间隔至关重要。
本研究旨在评估在插入阶段检测乙状结肠病变的临床意义。
本回顾性研究纳入了 2017 年 10 月至 2018 年 4 月期间连续进行的 172 例结肠镜检查患者。记录了总的息肉检出数、每次检查的平均息肉数、每次阳性检查的平均息肉数，以及检出病变的组织学和临床特征。主要终点是插入和退镜时乙状结肠息肉检出率的差异。
每位患者均进行了 172 次结肠镜检查，共检出 322 个病变。62 个（19%）息肉在插入时检出，312 个（97%）在退镜时检出，52 个（16%）在插入和退镜时均检出。尽管除乙状结肠外的所有息肉均可在退镜时检出，但在乙状结肠的 10 个息肉（11%）只能在插入时检出。
在这项研究中，即使在插入阶段尝试检测息肉，也显示出了降低乙状结肠腺瘤性息肉漏诊风险的临床意义。
