Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.
Postgraduate College, Jinzhou Medical University, Jinzhou, China.
Cancer Control. 2024 Jan-Dec;31:10732748241272482. doi: 10.1177/10732748241272482.
Sedated colonoscopy has been increasingly selected. However, the effect of sedated colonoscopy on polyp/adenoma detection rate (PDR/ADR) remains controversial among studies.
In this retrospective study, the medical records of 11 504 consecutive patients who underwent colonoscopy at our department from July 1, 2021 to December 31, 2022 were collected. Patients were divided into sedated and unsedated groups according to the use of intravenous sedation during colonoscopy. Overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR were calculated. By adjusting for age, gender, body mass index, inpatient, screening/surveillance, cecal intubation time, colonoscopy withdrawal time ≥6 min, and an endoscopist's experience ≥5 years, multivariate logistic regression analyses were performed to evaluate the association of sedated colonoscopy with overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR, where the absence of PDR/ADR was used as reference. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated.
Overall, 2275 patients were included, of whom 293 and 1982 underwent sedated and unsedated colonoscopy, respectively. Multivariate logistic regression analyses showed that sedated colonoscopy was independently associated with lower overall PDR/ADR (OR = 0.640, 95% CI = 0.460-0.889, = 0.008), right-side colon PDR/ADR (OR = 0.591, 95% CI = 0.417-0.837, = 0.003), single PDR/ADR (OR = 0.659, 95% CI = 0.436-0.996, = 0.048), and multiple PDR/ADR (OR = 0.586, 95% CI = 0.402-0.855, = 0.005), but not transverse or left-side colon PDR/ADR.
Sedated colonoscopy may not be beneficial in terms of overall PDR/ADR, right-side colon PDR/ADR, and number of polyps/adenomas. Thus, it should be selectively recommended. Additionally, it should be necessary to explore how to improve the quality of sedated colonoscopy.
镇静结肠镜检查的应用日益增多。然而，镇静结肠镜检查对息肉/腺瘤检出率（PDR/ADR）的影响在不同研究中仍存在争议。
本回顾性研究纳入了 2021 年 7 月 1 日至 2022 年 12 月 31 日在我科行结肠镜检查的 11504 例连续患者的病历资料。根据结肠镜检查过程中是否使用静脉镇静，将患者分为镇静组和非镇静组。计算总体 PDR/ADR、右半结肠、横结肠和左半结肠 PDR/ADR、单发和多发 PDR/ADR。通过调整年龄、性别、体重指数、住院、筛查/监测、盲肠插管时间、结肠镜退镜时间≥6min、内镜医师经验≥5 年，采用多变量逻辑回归分析评估镇静结肠镜检查与总体 PDR/ADR、右半结肠、横结肠和左半结肠 PDR/ADR、单发和多发 PDR/ADR的相关性，以无 PDR/ADR 作为参考。计算比值比（OR）及其 95%置信区间（CI）。
共有 2275 例患者纳入研究，其中 293 例和 1982 例分别接受了镇静和非镇静结肠镜检查。多变量逻辑回归分析显示，镇静结肠镜检查与总体 PDR/ADR 降低独立相关（OR=0.640，95%CI=0.460-0.889，=0.008）、右半结肠 PDR/ADR（OR=0.591，95%CI=0.417-0.837，=0.003）、单发 PDR/ADR（OR=0.659，95%CI=0.436-0.996，=0.048）和多发 PDR/ADR（OR=0.586，95%CI=0.402-0.855，=0.005）相关，但与横结肠或左半结肠 PDR/ADR 无关。
镇静结肠镜检查在总体 PDR/ADR、右半结肠 PDR/ADR 和息肉/腺瘤数量方面可能没有益处，因此应选择性推荐。此外，有必要探索如何提高镇静结肠镜检查的质量。
