Chu Yanliu, Zhang Juan, Wang Ping, Li Tian, Jiang Shuyi, Zhao Qinfu, Liu Feng, Gao Xiaozhong, Qiao Xiuli, Wang Xiaofeng, Song Zhenhe, Liang Heye, Yue Jing, Linghu Enqiang
Department of Hepatology and Gastroenterology, Chinese PLA General Hospital, Beijing.
Department of Gastroenterology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong Province, China.
Medicine (Baltimore). 2020 Oct 16;99(42):e22738. doi: 10.1097/MD.0000000000022738.
BACKGROUND & GOALS: We observed that the number of colorectal polyps found intraoperatively was often higher than that encountered preoperatively during elective colonoscopic polypectomy. To evaluate whether more polyps can be detected when they are purposely sought than when they are routinely examined during colonoscopy.
Patients undergoing colonoscopy were randomized into groups A and B. Before colonoscopy was performed, endoscopists were instructed to seek polyps for group A purposely but not for group B. Polypectomy was electively completed. In groups A and B, the cases of elective polypectomy were named groups AR and BR, including groups AR-1 and BR-1, during the first colonoscopy and groups AR-2 and BR-2 during the second colonoscopy for polypectomy, respectively. The following data were calculated: the number of polyps detected (NPD) and the polyp detection rate (PDR) in all cases and the number of polyps missed (NPM) and partial polyp miss rate (PPMR) in the cases of colorectal polyps.
A total of 419 cases were included in group A, 421 in group B, 43 in group AR, and 35 in group BR. No significant differences in PDR were found between groups A and B and in PPMR between groups AR-1 and BR-1 (P > .05), although PPMR in group AR-1 was higher than in group AR-2 (P < .05), similar results were found in PPMR between groups BR-1 and BR-2 (P < .05).
Purposely seeking for colorectal polyps did not result in more polyps detected compared with routine colonoscopy.
我们观察到,在择期结肠镜息肉切除术中,术中发现的大肠息肉数量通常高于术前。旨在评估与结肠镜常规检查相比,特意寻找息肉时是否能检测到更多息肉。
接受结肠镜检查的患者被随机分为A组和B组。在进行结肠镜检查前,要求内镜医师特意为A组寻找息肉,而不为B组寻找。选择性地完成息肉切除术。在A组和B组中,择期息肉切除术的病例在第一次结肠镜检查时分别命名为AR组和BR组,包括AR-1组和BR-1组,在第二次息肉切除结肠镜检查时分别为AR-2组和BR-2组。计算以下数据:所有病例中检测到的息肉数量(NPD)和息肉检出率(PDR),以及大肠息肉病例中漏诊的息肉数量(NPM)和部分息肉漏诊率(PPMR)。
A组共纳入419例,B组421例,AR组43例,BR组35例。A组和B组之间的PDR以及AR-1组和BR-1组之间的PPMR均无显著差异(P>0.05),尽管AR-1组的PPMR高于AR-2组(P<0.05),BR-1组和BR-2组之间的PPMR也有类似结果(P<0.05)。
与常规结肠镜检查相比,特意寻找大肠息肉并不会检测到更多的息肉。