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巴西一家私立四级医院行结肠镜筛查的质量指标评价。

EVALUATION OF QUALITY INDICATORS OF SCREENING COLONOSCOPY PERFORMED IN A PRIVATE QUARTERNARY HOSPITAL IN BRAZIL.

机构信息

Instituto D´Or de Pesquisa e Ensino, Hospital Vila Nova Star, Gastrointestinal Endoscopy Division - São Paulo (SP), Brazil.

Universidade de São Paulo, Faculty of Medicine, Gastrointestinal Endoscopy Unit, Department of Gastroenterology - São Paulo (SP), Brazil.

出版信息

Arq Bras Cir Dig. 2024 Aug 12;37:e1815. doi: 10.1590/0102-6720202400022e1815. eCollection 2024.

Abstract

BACKGROUND

Colorectal cancer is the third most common type of cancer in Brazil, despite the availability of screening methods that reduce its risk. Colonoscopy is the only screening method that also allows therapeutic procedures. The proper screening through colonoscopy is linked to the quality of the exam, which can be evaluated according to quality criteria recommended by various institutions. Among the factors, the most used is the Adenoma Detection Rate, which should be at least 25% for general population.

AIMS

To evaluate the quality of the screening colonoscopies performed in a quarternary private Brazilian hospital.

METHODS

This is a retrospective study evaluating the quality indicators of colonoscopies performed at a private center since its inauguration. Only asymptomatic patients aged over 45 years who underwent screening colonoscopy were included. The primary outcome was the Adenoma Detection Rate, and secondary outcomes included polyps detection rate and safety profile. Subanalyses evaluated the correlation of endoscopic findings with gender and age and the evolution of detection rates over the years.

RESULTS

A total of 2,144 patients were include with a mean age of 60.54 years-old. Polyps were diagnosed in 68.6% of the procedures. Adenoma detection rate was 46.8%, with an increasing rate over the years, mainly in males. A low rate of adverse events was reported in 0.23% of the cases, with no need for surgical intervention and no deaths.

CONCLUSIONS

This study shows that high quality screening colonoscopy is possible when performed by experienced endoscopists and trained nurses, under an adequate infrastructure.

摘要

背景

尽管有降低风险的筛查方法,结直肠癌仍是巴西第三大常见癌症类型。结肠镜检查是唯一允许进行治疗程序的筛查方法。通过结肠镜检查进行适当的筛查与检查质量有关,可根据各机构推荐的质量标准进行评估。在这些因素中,使用最广泛的是腺瘤检出率,其对于一般人群应至少达到 25%。

目的

评估巴西一家四级私立医院进行的筛查性结肠镜检查的质量。

方法

这是一项回顾性研究,评估了一家私立中心自成立以来的结肠镜检查质量指标。仅纳入无症状、年龄超过 45 岁、接受筛查性结肠镜检查的患者。主要结局为腺瘤检出率,次要结局包括息肉检出率和安全性概况。亚分析评估了内镜检查结果与性别和年龄的相关性以及检测率随时间的变化。

结果

共纳入 2144 例患者,平均年龄为 60.54 岁。68.6%的检查中诊断出息肉。腺瘤检出率为 46.8%,且随着时间的推移呈上升趋势,主要见于男性。报告了 0.23%的低不良事件发生率,无手术干预,无死亡病例。

结论

本研究表明,当由经验丰富的内镜医生和经过培训的护士在适当的基础设施下进行时,可实现高质量的筛查性结肠镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/280a/11318960/3f1481d7b4be/0102-6720-abcd-37-e1815-gf01.jpg

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