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食管胃十二指肠镜检查中观察时间与局灶性病变检出率的关系:一项单中心、回顾性研究。

Relationship between observation time and detection rate of focal lesions in Esophagogastroduodenoscopy: a single-center, retrospective study.

机构信息

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, 169 Donghu-ro, Wuchang-gu, 430071, Wuhan, China.

Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

BMC Gastroenterol. 2024 Feb 15;24(1):75. doi: 10.1186/s12876-024-03157-3.

Abstract

BACKGROUND

Current studies have shown that longer observation time can improve neoplastic detection rate. This study aimed to clarify whether endoscopists with longer observation times can detect more focal lesions.

METHODS

Based on the mean examination time for Esophagogastroduodenoscopy (EGD) without biopsy, endoscopists were divided into fast and slow groups, and the detection rate of focal lesions was compared between the two groups. Univariate analysis, multivariate analysis and restricted cubic spline were used to explore the factors of focal lesion detection rate.

RESULTS

Mean examination time of EGD without biopsy was 4.5 min. The cut-off times used were 5 min. 17 endoscopists were classified into the fast (4.7 ± 3.6 min), and 16 into the slow (7.11 ± 4.6 min) groups. Compared with fast endoscopists, slow endoscopists had a higher detection rate of focal lesions (47.2% vs. 51.4%, P < 0.001), especially in the detection of gastric lesions (29.7% vs. 35.9%, P < 0.001). In univariate and multivariate analyses, observation time, patient age and gender, expert, biopsy rate, and number of images were factors in FDR. There is a nonlinear relationship between observation time and FDR.

CONCLUSION

Longer examination time improves the detection rate of focal lesions. Observation time is an important quality indicator of the EGD examination.

摘要

背景

目前的研究表明,延长观察时间可以提高肿瘤检出率。本研究旨在阐明观察时间较长的内镜医师是否能检测到更多的局灶性病变。

方法

根据无活检食管胃十二指肠镜检查(EGD)的平均检查时间,将内镜医师分为快速组和慢速组,比较两组局灶性病变的检出率。采用单因素分析、多因素分析和限制性立方样条分析探讨局灶性病变检出率的影响因素。

结果

无活检 EGD 的平均检查时间为 4.5 分钟。使用的截止时间为 5 分钟。17 名内镜医师被分为快速组(4.7±3.6 分钟),16 名内镜医师被分为慢速组(7.11±4.6 分钟)。与快速内镜医师相比,慢速内镜医师局灶性病变的检出率更高(47.2%比 51.4%,P<0.001),尤其是胃局灶性病变的检出率(29.7%比 35.9%,P<0.001)。在单因素和多因素分析中,观察时间、患者年龄和性别、专家、活检率以及图像数量是 FDR 的影响因素。观察时间与 FDR 之间存在非线性关系。

结论

延长检查时间可提高局灶性病变的检出率。观察时间是 EGD 检查的一个重要质量指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7368/10870502/6a56ed339e64/12876_2024_3157_Fig1_HTML.jpg

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