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Effect of Endocuff use on colonoscopy outcomes:A systematic review and meta-analysis
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作者 Konstantinos Triantafyllou Paraskevas Gkolfakis +3 位作者 Georgios Tziatzios Ioannis S Papanikolaou Lorenzo Fuccio Cesare Hassan 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第9期1158-1170,共13页
BACKGROUND Endocuff-a plastic device with flexible projections-mounted on the distal tip of the colonoscope,promises improved colonic mucosa inspection.AIM To elucidate the effect of Endocuff on adenoma detection rate... BACKGROUND Endocuff-a plastic device with flexible projections-mounted on the distal tip of the colonoscope,promises improved colonic mucosa inspection.AIM To elucidate the effect of Endocuff on adenoma detection rate(ADR),advanced ADR(AADR)and mean number of adenomas per colonoscopy(MAC).METHODS Literature searches identified randomized-controlled trials evaluating Endocuffassisted colonoscopy(EAC)vs conventional colonoscopy(CC)in terms of ADR,AADR and MAC.The effect size on study outcomes was calculated using fixed or random effect model,as appropriate,and it is shown as relative risk(RR)[95%confidence interval(CI)]and mean difference(MD)(95%CI).The rate of device removal in EAC arms was also calculated.RESULTS We identified nine studies enrolling 6038 patients.All studies included mixed population(screening,surveillance and diagnostic examinations).Seven and two studies evaluated the first and the second-generation device,respectively.EAC was associated with increased ADR compared to CC[RR(95%CI):1.18(1.05-1.32);Ι^2=71%];EAC benefits more endoscopists with ADR≤35%compared to those with ADR>35%[RR(95%CI):1.37(1.08-1.74);Ι^2=49%vs 1.10(0.99-1.24);Ι^2=71%].In terms of AADR and MAC,no difference was detected between EAC and CC[RR(95%CI):1.03(0.85-1.25);Ι^2=15%and MD(95%CI):0.30(-0.17-0.78);Ι^2=99%].Subgroup analysis did not show any difference between the two device generations regarding all three endpoints.In EAC arms,the device had to be removed in 3%(95%CI:2%-5%)of the cases mainly due to tortuous sigmoid or presence of diverticula along it.CONCLUSION EAC increases ADR compared to CC,especially for endoscopists with lower ADR.On the other hand,no significant effect on AADR and MAC was detected. 展开更多
关键词 ADENOMA DETECTION rate COLONOSCOPY ADENOMA DETECTION Endocuff Endocuff-Vision
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结直肠无蒂型锯齿状腺瘤检出率及其相关影响因素
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作者 刘宇虎 詹磊磊 +3 位作者 陈桂权 彭冬 陈靖 张世豪 《热带医学杂志》 CAS 2019年第1期65-67,F0003共4页
目的探讨结直肠无蒂型锯齿状腺瘤(SSA)检出率及其相关影响因素。方法收集2017年1-12月于本院接受肠镜检查的11 345例患者的临床资料进行回顾性分析,计算SSA检出率,采用Logistic回归分析影响SSA检出率的独立相关因素。结果 11 345例患者... 目的探讨结直肠无蒂型锯齿状腺瘤(SSA)检出率及其相关影响因素。方法收集2017年1-12月于本院接受肠镜检查的11 345例患者的临床资料进行回顾性分析,计算SSA检出率,采用Logistic回归分析影响SSA检出率的独立相关因素。结果 11 345例患者临床资料进入筛选,最后纳入7 733例患者,其中男性4 655例,女性3 078例,平均年龄(58.2±8.3)岁;7 733例患者检出息肉者1 678例(2 918枚),息肉检出率为21.70%,其中SSA检出76例(86枚),检出率为0.98%,息肉构成比占4.53%。单因素分析结果显示,肠道清洁度、退镜时间、息肉大小、腺瘤检出率与SSA检出率相关(P<0.05),多因素分析结果显示,腺瘤检出率是SSA检出率的独立预测因子(P<0.05)。结论结直肠腺瘤的患者并发SSA风险更高,临床医生应加强对此类病变的警惕性。 展开更多
关键词 腺瘤 无蒂型锯齿状腺瘤 检出率
Higher dose of simethicone decreases colonic bubbles and increases prep tolerance and quality of bowel prep: Meta-analysis of randomized controlled trials
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作者 Mohammad F Madhoun Maham Hayat Ijlal Akbar Ali 《世界荟萃分析杂志》 2019年第3期110-119,共10页
BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel pr... BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel preparation and adenoma detection rate (ADR). AIM To perform a meta-analysis of trials that have compared simethicone vs placebo during colonoscopy. METHODS A reproducible literature search of multiple medical databases yielded eleven studies (n = 2605) for inclusion. Studies were compared for quality of bowel preparation, bubbles quality, ADR, and tolerability. Two reviewers independently scored the identified studies for methodology and abstracted pertinent data. Pooling was conducted by both fixed-effects and random-effects models. Relative risk (RR) estimates with a 95% confidence interval (CI) were calculated. Heterogeneity was assessed by I-squared index (I2) statistics. RESULTS Patients’ demographic characteristics were comparable in all studies. Of the 2605 patients, 1300 were in the simethicone group, whereas 1305 were in the placebo group. Inadequate bowel preparation was much lower in the simethicone group than in the placebo group [13% vs 24.6%;RR = 0.51 (0.31-0.82);P < 0.0001]. The placebo group was more likely to have significant colonic bubbles than was the simethicone group [35% vs 8%;RR = 1.49 (1.25-1.76);P = 0.0001]. Use of simethicone resulted in a slight, statistically significant increase in ADR compared with the placebo group [26.6% vs 21.6%, RR = 1.07 (1.01-1.13);P = 0.02]. Higher doses of simethicone (> 478 mg) were more likely to result in significant reduction of inadequate bowel preparation, colonic bubbles, and to improve ADR. CONCLUSION Adding simethicone improved the quality of bowel preparation, visualization, tolerability, and, eventually, ADR. 展开更多
关键词 SIMETHICONE Colonoscopy BUBBLES BOWEL preparation Adenoma detection rate
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Adenoma and advanced neoplasia detection rates increase from 45 years of age
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作者 David Karsenti Gaelle Tharsis +7 位作者 Pascal Burtin Franck Venezia Gilles Tordjman Agnès Gillet Joelle Samama Karine Nahon-Uzan Philippe Cattan Maryan Cavicchi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期447-456,共10页
BACKGROUND Colonoscopy is considered a valid primary screening tool for colorectal cancer(CRC).The decreasing risk of CRC observed in patients undergoing colonoscopy is correlated with the adenoma detection rate(ADR).... BACKGROUND Colonoscopy is considered a valid primary screening tool for colorectal cancer(CRC).The decreasing risk of CRC observed in patients undergoing colonoscopy is correlated with the adenoma detection rate(ADR).Due to the fact that screening programs usually start from the age of 50,very few data are available on the risk of adenoma between 40 and 49 years.However,the incidence of CRC is increasing in young populations and it is not uncommon in routine practice to detect adenomas or even advanced neoplasia during colonoscopy in patients under 50 years.AIM To compare the ADR and advanced neoplasia detection rate(ANDR)according to age in a large series of patients during routine colonoscopy.METHODS All consecutive patients who were scheduled for colonoscopy were included.Exclusion criteria were as follows:patients scheduled for partial colonoscopy or interventional colonoscopy(for stent insertion or stenosis dilation).Colonoscopies were performed in our unit by a team of 30 gastroenterologists in 2016.We determined the ADR and ANDR in each age group in the whole population and in the population with an average risk of CRC(excluding patients with personal or family history of advanced adenoma or cancer).RESULTS 6027 colonoscopies were performed in patients with a median age of 57 years(range,15-96).The ADR and ANDR were 28.6%and 9.7%,respectively,in the whole population.When comparing patients aged 40-44(n=382)and 45-49 years(n=515),a strong increase in all parameters from 45 years was observed,with the ADR rising from 9.7%in patients aged 40-44 to 21.2%between 45 and 49(P<0.001)and the ANDR increasing from 3.1%in patients aged 40-44 to 6.4%in those aged 45-49 years(P<0.03).With regard to patients aged 50-54(n=849),a statistically significant increase in the ADR and ANDR was not observed between patients aged 45-49 and those aged 50-54 years.In the population with an average risk of CRC,the ADR and ANDR were still significantly higher in patients aged 45-49 compared with those aged 40-44 years.CONCLUSION This 展开更多
关键词 COLORECTAL cancer SCREENING ADENOMA detection rate COLONOSCOPY COHORT study
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近端锯齿状息肉检岀的单中心回顾性研究
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作者 李青云 肖鹏 +5 位作者 凌亭生 孙洋洋 罗丽君 梁蓉 邓子杰 司徒伟基 《中华消化内镜杂志》 CSCD 北大核心 2019年第2期86-90,共5页
目的探讨结直肠近端锯齿状息肉的检出情况并筛选其危险因素。方法纳入2016年9月至2017年9月香港大学深圳医院内镜中心22位医师完成的9 010例结肠镜检查病例资料,计算腺瘤检出率(ADR)和近端锯齿状息肉检出率(PSDR),并使用Pearson相关系... 目的探讨结直肠近端锯齿状息肉的检出情况并筛选其危险因素。方法纳入2016年9月至2017年9月香港大学深圳医院内镜中心22位医师完成的9 010例结肠镜检查病例资料,计算腺瘤检出率(ADR)和近端锯齿状息肉检出率(PSDR),并使用Pearson相关系数评估两者的相关性,利用logistic回归分析对比不同医师的PSDR。结果22位医师的全部受检者平均ADR为30.07%(20.00%~40.78%),PSDR为4.70%(1.52%~9.28%),男性PSDR为女性的1.38倍(OR=1.38,95%CI:1.13~1.69,P<0.01)。≥50岁受检者3 560例(39.51%),平均ADR为45.01%(28.99%~57.78%),PSDR为6.08%(2.07%~10.56%)。在≥50岁受检者中,ADR与PSDR存在中等相关性(r=0.48,P=0.02),男性PSDR为女性的1.36倍(OR=1.36,95%CI:1.04~1.80,P=0.03)。不同内镜医师是近端锯齿状息肉检出的独立危险因素(P<0.01),与PSDR最高的医师相比,其他医师PSDR的OR值范围为0.16(95%CI:0.06~0.40,P<0.01)到0.83(95%CI:0.53~1.32,P=0.44)。结论近端锯齿状息肉在男性以及50岁以上人群中更为多见,检出率与内镜医师显著相关,不同医师的检出率差异巨大,结肠镜检查存在漏诊锯齿状息肉的风险。 展开更多
关键词 结肠镜检查 腺瘤 锯齿状息肉 近端 检出率
Sessile serrated adenoma detection rate is correlated with adenoma detection rate
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作者 Daisuke Ohki Yosuke Tsuji +15 位作者 Tomohiro Shinozaki Yoshiki Sakaguchi Chihiro Minatsuki Hiroto Kinoshita Keiko Niimi Satoshi Ono Yoku Hayakawa Shuntaro Yoshida Atsuo Yamada Shinya Kodashima Nobutake Yamamichi Yoshihiro Hirata Tetsuo Ushiku Mitsuhiro Fujishiro Masashi Fukayama Kazuhiko Koike 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2018年第3期82-90,共9页
AIM To investigated the association between adenoma detection rate(ADR)and sessile serrated ADR(SSADR)and significant predictors for sessile serrated adenomas(SSA)detection.METHODS This study is a retrospective,single... AIM To investigated the association between adenoma detection rate(ADR)and sessile serrated ADR(SSADR)and significant predictors for sessile serrated adenomas(SSA)detection.METHODS This study is a retrospective,single-center analysis.Total colonoscopies performed by the gastroenterologists at the University of Tokyo Hospital between January and December 2014 were retrospectively identified.Polyps were classified as low-grade or high-grade adenoma,cancer,SSA,or SSA with cytological dysplasia,and the prevalence of each type of polyp was investigated.Predictors of adenoma and SSA detection were examined using logistic generalized estimating equation models.The association between ADR and SSADR for each gastroenterologist was investigated by calculating a correlation coefficient weighted by the number of each gastroenterologist’s examination.RESULTS A total of 3691 colonoscopies performed by 35 gastroenterologists were assessed.Overall,978(26.5%)lowand 84(2.2%)high-grade adenomas,81(2.2%)cancers,66(1.8%)SSAs,and 2(0.1%)SSAs with cytological dysplasia were detected.Overall ADR was 29.5%(men 33.2%,women 23.8%)and overall SSADR was 1.8%(men 1.7%,women 2.1%).In addition,672 low-grade adenomas(68.8%of all the detected lowgrade adenomas),58(69.9%)high-grade adenomas,29(34.5%)cancers,52(78.8%)SSAs,and 2(100%)SSAs with cytological dysplasia were found in the proximal colon.Adenoma detection was the only significant predictor of SSA detection(adjusted OR:2.53,95%CI:1.53-4.20;P<0.001).The correlation coefficient between ADR and SSADR weighted by the number of each gastroenterologist’s examinations was 0.606(P<0.001).CONCLUSION Our results demonstrated that ADR is correlated to SSADR.In addition,patients with adenomas had a higher prevalence of SSAs than those without adenomas. 展开更多
关键词 Sessile serrated ADENOMA Sessile serrated ADENOMA DETECTION RATE ADENOMA DETECTION RATE COLONOSCOPY INTERVAL colorectal cancer
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Colonoscopy attachments for the detection of precancerous lesions during colonoscopy:A review of the literature
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作者 Paraskevas Gkolfakis Georgios Tziatzios +2 位作者 Eleftherios Spartalis Ioannis S Papanikolaou Konstantinos Triantafyllou 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第37期4243-4253,共11页
Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions,it remains an imperfect examination,as it can fail in detecting u... Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions,it remains an imperfect examination,as it can fail in detecting up to almost one fourth of existing adenomas.Among reasons accounting for such failures,is the inability to meticulously visualize the colonic mucosa located either proximal to haustral folds or anatomic curves,including the hepatic and splenic flexures.In order to overcome these limitations,various colonoscope attachments aiming to improve mucosal visualization have been developed.All of them-transparent cap,Endocuff,Endocuff Vision and Endorings-are simply mounted onto the distal tip of the scope.In this review article,we introduce the rationale of their development,present their mode of action and discuss in detail the effect of their implementation in the detection of lesions during colonoscopy. 展开更多
关键词 ADENOMA DETECTION RATE ADENOMA MISS RATE COLONOSCOPY Cup Endocuff Endocuff Vision Endorings
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结直肠腺瘤分布特征及危险因素分析
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作者 周海萍 沈忠磊 +2 位作者 赵坚培 周振东 徐一栋 《中华胃肠外科杂志》 CSCD 北大核心 2018年第6期678-684,共7页
目的了解宁波地区结直肠腺瘤检出率和分布特征,并探讨腺瘤发生的危险因素,从而为结直肠腺瘤的筛查提供参考。 方法对2016年1—12月间在宁波市第二医院接受结肠镜检查的8660例受检者进行横断面调查,调查问卷包括年龄、性别、身高、... 目的了解宁波地区结直肠腺瘤检出率和分布特征,并探讨腺瘤发生的危险因素,从而为结直肠腺瘤的筛查提供参考。 方法对2016年1—12月间在宁波市第二医院接受结肠镜检查的8660例受检者进行横断面调查,调查问卷包括年龄、性别、身高、体质量、吸烟史、饮酒史、糖尿病、高血压、高脂血症、肿瘤家族史、喜食红肉、喜食果蔬、腌制食品进食频率、每日运动量以及有无肠道预警症状。肠镜检查中所发现息肉原则上均予内镜下切除并送病理检查。根据组织学结果将息肉分为非腺瘤性息肉(包括增生性息肉和炎性息肉)和腺瘤性息肉(包括管状腺瘤、绒毛状腺瘤、管状绒毛状腺瘤和锯齿状腺瘤)。分析不同部位腺瘤的病理特征,并应用logistic回归模型确定结直肠腺瘤的危险因素。 结果7077例完成问卷的受检者纳入研究,其中男性3633例,女性3444例,年龄17~83(中位数53)岁。腺瘤检出率为15.6%(1103/7077),其中男性和女性腺瘤检出率分别为21.0%(762/3633)和9.9%(341/3444),差异有统计学意义(P= 0.000)。按年龄段,〈 30岁、30~39岁、40~49岁、50~59岁、60~69岁和≥70岁患者腺瘤检出率分别为6.2%(29/469)、8.0%(87/1086)、12.1%(148/1222)、16.8%(272/1623)、20.4%(326/1601)和22.4%(241/1076),腺瘤检出率均随年龄增长呈上升趋势(P= 0.000)。本组1103例腺瘤患者共检出腺瘤1521枚,其中管状腺瘤1455枚,管状绒毛状腺瘤33枚,绒毛状腺瘤9枚,锯齿状腺瘤24枚;腺瘤位于右半结肠671枚(44.1%),左半结肠593枚(39.0%),直肠257枚(16.9%)。锯齿状腺瘤和高危腺瘤(高级别上皮内瘤变、直径≥10 mm或含有绒毛成分的腺瘤)在右半结肠腺瘤中的比例显著高于左半结肠和直肠[2.5%(17/671)比0.8%(5/593)和0.8%(2/257),P= 0.029;9.2%(62/671)比5.2%(31/593)和6.6%(17/257 展开更多
关键词 结直肠腺瘤 腺瘤检出率 结肠镜 危险因素 筛查
图示法宣教对结肠镜检查患者肠道准备质量影响的研究 预览
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作者 顾勇 杨艳 +4 位作者 孟宏涛 李娜 杨姝洁 任艳芳 马婉容 《中华保健医学杂志》 2018年第5期390-392,共3页
目的 探索和研究图示法宣教对结肠镜检查患者肠道准备质量的影响。方法 选取2016年1月~2017年6月在武警陕西总队医院拟行结肠镜检查的患者260例,按照随机数表法分为图示组和常规组,各130例,采用前瞻性、双盲、对照研究。图示组将涉及... 目的 探索和研究图示法宣教对结肠镜检查患者肠道准备质量的影响。方法 选取2016年1月~2017年6月在武警陕西总队医院拟行结肠镜检查的患者260例,按照随机数表法分为图示组和常规组,各130例,采用前瞻性、双盲、对照研究。图示组将涉及的复杂医学专业知识(肠道准备操作步骤及正确的粪水性状等)用形象简单的图示直观地告知患者,常规组则应用传统的宣教模式交代肠道准备事项,比较两种方法对肠道准备质量的影响。结果 图示组的肠道准备合格率高于常规组(88.5%vs 75.4%,P=0.006),按Boston肠道清洁度评分准则,图示组总评分及左、右侧结肠评分均优于常规组(P 〈0.05),但中间结肠评分两者无明显差异;两组患者进镜时间无差别,但图示组的退镜时间低于常规组(P=0.008)。息肉检出率比较,图示组显著高于常规组(P=0.016)。图示组恶心、腹痛等不良反应发生率更低(P 〈0.05),且睡眠质量更好(72.3%vs 59.2%,P=0.026)。结论 图示法宣教可以提高患者肠道准备质量,并可以明显增加息肉检出率及患者舒适度。 展开更多
关键词 结肠镜 肠道准备 息肉检出率 不良反应
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i-Scan电子染色技术在筛查右半结肠息肉样病变中的应用价值
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作者 李秋敬 林香春 +3 位作者 吴静 王沧海 刘红 刘揆亮 《中华消化内镜杂志》 CSCD 北大核心 2018年第9期620-624,共5页
目的探讨内镜i-Scan模式在右半结肠息肉样病变检出中的价值。方法采用前瞻性、随机、自身对照的研究方法,以2015年1月至12月间在北京世纪坛医院接受结肠镜检查的200例患者为研究对象,常规观察右半结肠后,分别采用白光模式(白光组,9... 目的探讨内镜i-Scan模式在右半结肠息肉样病变检出中的价值。方法采用前瞻性、随机、自身对照的研究方法,以2015年1月至12月间在北京世纪坛医院接受结肠镜检查的200例患者为研究对象,常规观察右半结肠后,分别采用白光模式(白光组,93例)及i-Scan模式(i-Scan组,96例)再次观察右半结肠,比较两组右半结肠息肉及腺瘤的检出情况。结果两次检查i-Scan组人均息肉检出数显著多于白光组(1.469比1.011,P=0.028),第2次退镜多检出息肉的患者多于白光组[37.5%(36/96)比22.6%(21/93),P=0.025],能够检出更多直径〈5mm的息肉[84.0%(42/50)比58.3%(14/24),P=0.016]。i-Scan组人均腺瘤检出数量多于白光组(0.979比0.624,P=0.039),第2次退镜多检出腺瘤的患者多于白光组[24.0%(23/96)比11.8%(11/93),P=0.030],两组多检出腺瘤的大小、部位、形态差异无统计学意义(P〉O.05)。i-Scan组与白光组的息肉检出率分别为61.5%(59/96)、48.4%(45/93)(P=0.071),腺瘤检出率分别为47.9%(46/96)、35.5%(33/93)(P=0.083)。结论内镜i-Scan模式可增加右半结肠息肉及腺瘤的检出,并提高多发息肉及腺瘤患者息肉样病变的检出及小息肉(直径〈5mm)的检出。 展开更多
关键词 肠息肉 内窥镜检查 模式识别 i-Scan模式 息肉检出率
无痛肠镜下腺瘤检出率的影响因素分析
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作者 王辉 李小杉 +2 位作者 杨家悦 杨成 占强 《中国中西医结合消化杂志》 CAS 2018年第9期763-765,共3页
[目的]探讨基于无痛肠镜背景下腺瘤检出率的影响因素。[方法]选取2016年12月~2017年3月在我院消化内镜中心行无痛结肠镜检查的患者255例,对其临床资料进行回顾性分析,分别用χ2检验或Fisher’s精确检验和多元logistic回归对可能影响腺... [目的]探讨基于无痛肠镜背景下腺瘤检出率的影响因素。[方法]选取2016年12月~2017年3月在我院消化内镜中心行无痛结肠镜检查的患者255例,对其临床资料进行回顾性分析,分别用χ2检验或Fisher’s精确检验和多元logistic回归对可能影响腺瘤检出率的因素进行单因素及多因素分析。[结果]255例行无痛肠镜检查的患者,总的腺瘤检出率为20.78%,其中男性为23.53%,女性为18.38%。左半结肠的腺瘤检出率明显高于横结肠及右半结肠(P〈0.001)。单因素分析显示:患者的年龄、退镜时间对腺瘤检出率有显著影响(P〈0.001);多因素分析表明:年龄超过45岁、退镜时间〉3min是腺瘤检出率的独立影响因素。[结论]无痛肠镜检查背景下,患者的年龄、退镜时间与腺瘤检出率存在密切联系。 展开更多
关键词 无痛肠镜 腺瘤检出率 影响因素 退镜时间
痔疮手术患者的结直肠息肉发现相关因素分析 预览
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作者 罗培培 《医药界》 2018年第20期38-39,共2页
目的:探讨我院住院行痔疮患者结肠镜检查的息肉检出率和腺瘤检出率及息肉相关因素,以期望指导临床工作。方法:采用回顾性分析方法,调取2015年01月01日至2017年12月31日间进行痔疮手术患者的资料,按照不同性别、年龄及息肉的大小、部位... 目的:探讨我院住院行痔疮患者结肠镜检查的息肉检出率和腺瘤检出率及息肉相关因素,以期望指导临床工作。方法:采用回顾性分析方法,调取2015年01月01日至2017年12月31日间进行痔疮手术患者的资料,按照不同性别、年龄及息肉的大小、部位、性质进行比较,并比较不同诊疗组结肠镜检查情况,组间率比较采用x2检验。结果:983例痔疮手术病人中403例病人术前完善肠镜检查,发现息肉99例(24.57%),整体息肉检查率与我院所有行肠镜检查患者无统计学差异(P>0.05),男性痔疮手术患者息肉及腺瘤发现率明显高于常规肠镜检查患者,有统计学差异(P<0.01),手术患者中年龄>40岁与≤40组之间存在显著统计学差异(P<0.01),不同诊疗组完成肠镜检查率不完全相同,存在统计学差异(P<0.01).结论:痔疮手术患者结肠息肉及腺瘤的发生率较高,其中男性患者存在显著相关性,年龄大于40患者的息肉发生率明显升高,医生对术前肠镜检查的认识不同,肠镜检查率仍需进一步提高。 展开更多
关键词 痔疮 结直肠息肉 结直肠腺瘤 息肉检出率 肠镜检查
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Colonoscopy procedural volume increases adenoma and polyp detection rates in gastroenterology trainees
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作者 Emad Qayed Ravi Vora +1 位作者 Sara Levy Roberd M Bostick 《世界胃肠内镜杂志:英文版(电子版)》 2017年第11期540-551,共12页
AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroente... AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows’ procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings’ ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing. 展开更多
关键词 屏蔽 colonoscopy Colorectal 癌症 息肉察觉率 Colonoscopy 体积 腺瘤察觉率 肠胃病学训练
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Association of trainee participation with adenoma and polyp detection rates
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作者 Emad Qayed Lauren Shea +1 位作者 Stephan Goebel Roberd M Bostick 《世界胃肠内镜杂志:英文版(电子版)》 2017年第5期204-210,共7页
AIM To investigate whether adenoma and polyp detection rates(ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHOD... AIM To investigate whether adenoma and polyp detection rates(ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS We performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparationquality. RESULTS A total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7%(P = 0.001), and for third year fellows it was 35.4% vs 30.7%(a OR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1%(P = 0.0003) and 45.7% vs 40.1%(a OR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level(P for trend < 0.05).CONCLUSION There is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection. 展开更多
关键词 屏蔽 colonoscopy 腺瘤察觉率 息肉察觉率 肠胃病学训练 Colorectal 癌症
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体位变换对结肠镜检查癌前病变检出率影响的系统评价 被引量:1
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作者 崔璐 乔伟光 智发朝 《临床合理用药杂志》 2017年第14期13-16,18共5页
目的系统评价体位变换对结肠息肉及腺瘤检出率的影响,为临床结肠镜检查提供指导。方法检索Embase、PubMed、The Cochrane library和CBM数据库(检索时间均从建库至2016年10月),根据纳入和排除标准筛选文献,按Cochrane系统评价方法... 目的系统评价体位变换对结肠息肉及腺瘤检出率的影响,为临床结肠镜检查提供指导。方法检索Embase、PubMed、The Cochrane library和CBM数据库(检索时间均从建库至2016年10月),根据纳入和排除标准筛选文献,按Cochrane系统评价方法评价纳入研究的质量,并进行描述性分析。结果共纳入6篇文献,包括3篇随机平行对照试验及3篇随机交叉试验。结果显示,4篇研究表明结肠镜检查退镜过程中体位变换可提高息肉检出率,其中3篇研究提示体位变换可进一步提高腺瘤检出率。2篇随机平行对照试验表明体位变换并不能显著提高腺瘤检出率。结论现有证据表明,在结肠镜检查退镜过程中采取体位变换对息肉及腺瘤检出率的影响尚无定论。因此,在今后更多的高质量研究证明之前,体位变换尚不能常规应用于结肠镜检查。 展开更多
关键词 体位变换 结肠镜 息肉检出率 腺瘤检出率
结直肠平坦型腺瘤肠镜检出的可控影响因素分析 预览
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作者 袁小刚 薛净 +7 位作者 项立 杨兵 林建姣 周永柏 龙子义 陈晓红 黄妙娟 胡红松 《现代消化及介入诊疗》 2017年第5期631-634,共4页
目的探讨结直肠平坦型腺瘤肠镜检出率渊flatadenomadetectionrate,FADR冤的可控影响因素袁以提高结肠镜检查质量遥方法回顾性分析2986例患者的临床内镜资料袁按肠道清洁度及内镜操作医师的特征渊包括操作例数尧专业背景尧操作方式及退... 目的探讨结直肠平坦型腺瘤肠镜检出率渊flatadenomadetectionrate,FADR冤的可控影响因素袁以提高结肠镜检查质量遥方法回顾性分析2986例患者的临床内镜资料袁按肠道清洁度及内镜操作医师的特征渊包括操作例数尧专业背景尧操作方式及退镜时间冤计算出FADR袁再比较各组FADR的差异袁对差异有统计学意义的影响因素进行Logistic回归分析遥结果单因素分析显示肠道清洁度尧操作例数尧操作方式及退镜时间对FADR有显著影响渊P<0.01冤袁而操作医师的专业背景对FADR的影响无统计学意义渊P>0.05冤曰多因素分析结果显示肠道清洁度尧操作例数尧操作方式及退镜时间是FADR的独立影响因素遥结论在良好的肠道准备条件下袁操作医生累积结肠镜操作1000例以上袁采用单人操作法袁保证退镜时间在6min以上可显著提高FADR袁从而有效提高结肠镜检查质量遥 展开更多
关键词 结肠镜 影响因素 平坦型腺瘤 息肉 腺瘤检出率
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上海崇明结直肠癌平均风险人群腺瘤检出率分析 预览
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作者 赖华梅 《临床医药文献杂志(电子版)》 2017年第81期15847-15849,共3页
目的研究上海崇明地区结直肠癌平均风险人群的腺瘤检出率及年龄、性别等分布情况,为我国结直肠癌筛查工作提供线索及数据支持。方法选取我院2014年6月~2017年6月收治的进行“结肠镜健康体检”的患者资料,按照性别、年龄组、检查方式、... 目的研究上海崇明地区结直肠癌平均风险人群的腺瘤检出率及年龄、性别等分布情况,为我国结直肠癌筛查工作提供线索及数据支持。方法选取我院2014年6月~2017年6月收治的进行“结肠镜健康体检”的患者资料,按照性别、年龄组、检查方式、检查医师分别计算各组的腺瘤检出率。组间比较采用x2检验。结果共有1137例符合要求患者,总的ADR为22.25%;女16.0%,男29.3%,差异有统计学意义(P<0.05)。随着年龄的增长,两组ADR逐渐上升。不同检查方式(有痛与无痛肠镜)ADR无差异;随检查医师肠镜操作年限增高,ADR略上升,差异无统计学意义(P>0.05)。结论ADR随年龄增长而提高,男性较女性有更大的腺瘤患病风险。不同检查方式及不同检查医师并不影响腺瘤检出率。 展开更多
关键词 结肠腺瘤 结肠镜检查 腺瘤检出率 普查
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Does deep sedation with propofol affect adenoma detection rates in average risk screening colonoscopy exams?
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作者 Selvi Thirumurthi Gottumukkala S Raju +5 位作者 Mala Pande Joseph Ruiz Richard Carlson Katherine B Hagan Jeffrey H Lee William A Ross 《世界胃肠内镜杂志:英文版(电子版)》 2017年第4期177-182,共6页
AIM To determine the effect of sedation with propofol on adenoma detection rate(ADR) and cecal intubation rates(CIR) in average risk screening colonoscopies compared to moderate sedation.METHODS We conducted a retrosp... AIM To determine the effect of sedation with propofol on adenoma detection rate(ADR) and cecal intubation rates(CIR) in average risk screening colonoscopies compared to moderate sedation.METHODS We conducted a retrospective chart review of 2604 firsttime average risk screening colonoscopies performed at MD Anderson Cancer Center from 2010-2013. ADR and CIR were calculated in each sedation group. Multivariable regression analysis was performed to adjust for potential confounders of age and body mass index(BMI). RESULTS One-third of the exams were done with propofol(n = 874). Overall ADR in the propofol group was significantly higher than moderate sedation(46.3% vs 41.2%, P = 0.01). After adjustment for age and BMI differences, ADR was similar between the groups. CIR was 99% for all exams. The mean cecal insertion time was shorter among propofol patients(6.9 min vs 8.2 min; P < 0.0001).CONCLUSION Deep sedation with propofol for screening colonoscopy did not significantly improve ADR or CIR in our population of average risk patients. While propofol may allow for safer sedation in certain patients(e.g., with sleep apnea), the overall effect on colonoscopy quality metrics is not significant. Given its increased cost, propofol should be used judiciously and without the implicit expectation of a higher quality screening exam. 展开更多
关键词 镇静 PROPOFOL 腺瘤察觉率 盲肠的 intubation COLONOSCOPY 优秀度量标准
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注水式结肠镜检查的优势
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作者 孟令君 杨幼林 《胃肠病学和肝病学杂志》 CAS 2017年第10期1183-1185,共3页
注水结肠镜检查与传统的注气结肠镜相比,能够显著减轻腹痛,提高盲肠插管成功率,提高腺瘤检出率,有利于困难肠镜的肠镜检查,提高成功率,且有利于初学者进行肠镜学习。本文就注水肠镜的特点作一概述。
关键词 注水结肠镜 腹痛 盲肠插管成功率 腺瘤检出率 困难肠镜 肠镜学习
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New device to implement the adenoma detection rate
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作者 Maddalena Zippi Wandong Hong +1 位作者 Pietro Crispino Giampiero Traversa 《世界临床病例杂志》 2017年第7期258-263,共6页
It is well-known that colonoscopy is considered the gold standard for colon cancer prevention.Although performed by experienced endoscopists,the matter remains of polyps missed during this examination.The reasons may ... It is well-known that colonoscopy is considered the gold standard for colon cancer prevention.Although performed by experienced endoscopists,the matter remains of polyps missed during this examination.The reasons may include the size,shape and location of the lesions.Many colorectal cancer screening programs have been proposed to increase the adenoma detection rate.The substantial difference between these methods is whether the improvement in vision,particularly the detection of irregularities of the mucosa,is inside the endoscope electronic components(magnification,wideangle vision,narrow band imaging,flexible spectral imaging colour enhancement,i-Scan)or outside the same,by the use of specific caps(EndoCuff,EndoVision,EndoRings).Endocuff is a plastic device mounted at the end of the scope with a constant vision field of the entire colon.The aim of this study is to explore the potential clinical and technical benefits of Endocuff. 展开更多
关键词 ADENOMA detection RATE Cap-assisted COLONOSCOPY COLORECTAL CANCER Endocuff-assisted COLONOSCOPY Standard colonoscopies
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