Thoufeeq Mo, Mohanan Vikram, Nishad Nilanga, Toh Eu-Wing, Shiha Mohamed G
Gastroenterology, Sheffield Teaching Hospitals National Health Service (NHS) Foundation Trust, Sheffield, GBR.
Gastroenterology, Kettering General Hospital, Kettering, GBR.
Cureus. 2025 Apr 15;17(4):e82317. doi: 10.7759/cureus.82317. eCollection 2025 Apr.
Proximal sessile serrated lesions (PSSL) are increasingly recognized as significant precursors of interval colon cancer. We aimed to assess the PSSL detection rates during non-screening colonoscopies and whether there are associations between PSSL detection rate and the established colonoscopy key performance indicators (KPI).
We retrospectively collected data of all non-screening colonoscopies performed by independent endoscopists at a large teaching hospital between June and December 2019. Data regarding endoscopists' KPIs, including polyp detection rate (PDR), cecal intubation rate (CIR), and colonoscopy withdrawal time (CWT), were retrieved from the national endoscopy database. SSL resected proximal to the splenic flexure were identified by an expert pathologist. Associations between PSSL detection rate and the different KPIs were assessed using Spearman's test.
A total of 2956 colonoscopies performed by 33 endoscopists were included. The mean PSSL detection rate was 0.7% (SD 1.5), the mean PDR was 37.1% (SD 17), the mean CIR was 91.3% (SD 6), and the mean CWT was nine minutes (SD 2). There was marked variability in PSSL detection rates between endoscopists (range 0 - 6.5%). PSSL detection rate positively correlated with CWT (r=0.34, p=0.04) but not with the other KPIs.
The wide variability in PSSL detection between endoscopists is concerning of high miss rates and despite achieving the national benchmarks for the established KPIs, many endoscopists still had low PSSL detection rates. Therefore, PSSL detection rate should be considered as an independent KPI.
近端无蒂锯齿状病变（PSSL）越来越被认为是间隔期结肠癌的重要前体病变。我们旨在评估非筛查性结肠镜检查期间PSSL的检出率，以及PSSL检出率与既定结肠镜关键绩效指标（KPI）之间是否存在关联。
我们回顾性收集了2019年6月至12月期间一家大型教学医院独立内镜医师进行的所有非筛查性结肠镜检查数据。从国家内镜数据库中检索有关内镜医师KPI的数据，包括息肉检出率（PDR）、盲肠插管率（CIR）和结肠镜检查退镜时间（CWT）。脾曲近端切除的SSL由一名专家病理学家进行识别。使用Spearman检验评估PSSL检出率与不同KPI之间的关联。
纳入了33名内镜医师进行的总共2956例结肠镜检查。PSSL的平均检出率为0.7%（标准差1.5），平均PDR为37.1%（标准差17），平均CIR为91.3%（标准差6），平均CWT为9分钟（标准差2）。内镜医师之间的PSSL检出率存在显著差异（范围为0 - 6.5%）。PSSL检出率与CWT呈正相关（r = 0.34，p = 0.04），但与其他KPI无关。
内镜医师之间PSSL检出率的广泛差异令人担忧漏诊率高，尽管达到了既定KPI的国家基准，但许多内镜医师的PSSL检出率仍然较低。因此，PSSL检出率应被视为一项独立的KPI。
