Should Assessment of Quality Indicator of Colonoscopy Be Varied Depending on the Colonoscopic Technique Level?

被引:4
作者
Choung, Bum Su [1 ]
Kim, Seong Hun [2 ]
Yoo, Kyung Bo [2 ]
Seo, Seung Young [2 ]
Kim, In Hee [2 ]
Lee, Seung Ok [2 ]
Lee, Soo Teik [2 ]
Kim, Sang Wook [2 ]
机构
[1] Jeonju Hosp, Dept Internal Med, Jeonju, South Korea
[2] Chonbuk Natl Univ, Med Sch & Hosp, Dept Internal Med, Res Inst Clin Med, 634-18 Keumam Dong, Jeonju 561712, Jeonbuk, South Korea
关键词
Colonoscopy; Withdrawal time; Quality assurance; Adenoma detection rates; TO-BACK COLONOSCOPIES; COLORECTAL-CANCER; SCREENING-PROGRAM; WITHDRAWAL TIME; MISS RATE; POLYPECTOMY; ASSURANCE; PREVENTION; ADENOMAS;
D O I
10.1007/s10620-015-3954-8
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The purpose of this research was to evaluate if withdrawal time is a useful index in spite of differences in gastroenterologists' ability and if there are other quality indicators of colonoscopy. A total of 665 consecutive, asymptomatic individuals of average risk between 50 and 75 years of age who underwent screening colonoscopies performed by 12 gastroenterologists were included in this study. The endoscopists were classified to either the experienced group (group A, N = 6) or the under-experienced group (group B, N = 6). The endoscopists were unaware that they were being studied during the two-month study period. In group A, adenoma detection rate was 0.56, while in group B it was 0.43 (P = 0.048). The mean withdrawal time ranged widely from 4.2 to 10.3 min per patient with a mean value of 6.83 for group A and 6.54 for group B. There was a significantly positive relationship between the number of adenomas detected and the withdrawal time for group B (r = 0.827, P = 0.005), but not for group A (r = -0.152, P = 0.584). In the case of group A, the ratio of cecal intubation time to withdrawal time (I/E ratio) less than 1 showed significantly correlated adenoma detection rate compared to I/E ratio greater than 1 (r = -0.308, P = 0.036). In the case of group B, mean I/E ratio was 1.7 and all endoscopists' I/E ratios were greater than 1. For experienced endoscopists, a useful supplementary quality indicator of colonoscopy is to keep intubation/withdrawal time ratio less than 1 and it is necessary for under-experienced endoscopists to try to keep enough withdrawal time.
引用
收藏
页码:731 / 736
页数:6
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