Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Expert Rev Gastroenterol Hepatol. 2023 Jan-Jun;17(6):589-602. doi: 10.1080/17474124.2023.2212159. Epub 2023 May 10.
Screening-related colonoscopy is a vital component of screening initiatives to both diagnose and prevent colorectal cancer (CRC), with prevention being reliant upon early and accurate detection of pre-malignant lesions. Several strategies, techniques, and interventions exist to optimize endoscopists' adenoma detection rates (ADR).
This narrative review provides an overview of the importance of ADR and other colonoscopy quality indicators. It then summarizes the available evidence regarding the effectiveness of the following domains in terms of improving ADR: endoscopist factors, pre-procedural parameters, peri-procedural parameters, intra-procedural strategies and techniques, antispasmodics, distal attachment devices, enhanced colonoscopy technologies, enhanced optics, and artificial intelligence. These summaries are based on an electronic search of the databases Embase, PubMed, and Cochrane performed on 12 December 2022.
Given the prevalence and associated morbidity and mortality of CRC, the quality of screening-related colonoscopy quality is appropriately prioritized by patients, endoscopists, units, and payers alike. Endoscopists performing colonoscopy should be up to date regarding available strategies, techniques, and interventions to optimize their performance.
筛查相关的结肠镜检查是筛查计划的重要组成部分，旨在诊断和预防结直肠癌（CRC），而预防则依赖于早期和准确地检测出癌前病变。有几种策略、技术和干预措施可以优化内镜医生的腺瘤检出率（ADR）。
本文叙述性综述概述了 ADR 及其他结肠镜检查质量指标的重要性。然后总结了以下领域在提高 ADR 方面的有效性的现有证据：内镜医生因素、术前参数、围手术期参数、手术期间的策略和技术、抗痉挛药物、远端附件装置、增强结肠镜检查技术、增强光学和人工智能。这些总结基于 2022 年 12 月 12 日对 Embase、PubMed 和 Cochrane 数据库进行的电子检索。
鉴于 CRC 的普遍存在及其相关的发病率和死亡率，筛查相关的结肠镜检查质量受到患者、内镜医生、单位和支付方的高度重视。进行结肠镜检查的内镜医生应了解最新的策略、技术和干预措施，以优化其表现。
