High prevalence of sessile serrated adenomas in contemporary outpatient colonoscopy practice
High prevalence of sessile serrated adenomas in contemporary outpatient colonoscopy practice
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DOI：
10.1111/imj.13329
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Croese, John
中科院分区：
文献类型：
--
作者：
Bettington, Mark;Walker, Neal;Croese, John
背景：无柄锯齿状腺瘤(SSA)是15-20%的结直肠癌的息肉前驱物。关于它们的患病率存在争议，关于是否需要将锯齿状息肉检测率作为结肠镜检查的质量指标的讨论越来越多。目的：评估门诊胃肠病服务中SSA的患病率。方法：这是一项对2013年4月至2014年5月期间未选择的连续进行结肠镜检查的患者的回顾性研究。复习结肠镜检查报告以确定年龄、性别、手术适应症、完成时间、撤退时间、肠道准备的充分性、息肉的数量、大小和位置。所有息肉的病理均由胃肠病理学家集中检查。结果：在研究期间，共有707名患者接受了结肠镜检查。队列的平均年龄为58岁，其中50.6%是女性。66.5%的患者发现息肉(S)。SSA的检出率为20.1%，腺瘤的检出率为48.0%。SSA检测与较长的戒断时间相关。传统的腺瘤发现与年龄、男性、较长的停药时间和粪便潜血试验阳性有关。结论：SSA在胃肠科门诊就诊的患者中非常普遍。识别和切除这些息肉可能有助于预防间歇性结直肠癌。这一结果可以作为高质量结肠镜服务的基准。
Background: Sessile serrated adenomas (SSA) are the polyp precursor of 15-20% of colorectal carcinomas. There is debate about their prevalence and increasing discussion about the need for a serrated polyp detection rate as a quality indicator for colonoscopy.Aims: To assess the prevalence of SSA at an outpatient gastroenterology service.Methods: This is a retrospective study of an unselected consecutive series of patients who had an outpatient colonoscopy between April 2013 and May 2014. The colonoscopy reports were reviewed to identify age, gender, indication for procedure, completion, withdrawal time, adequacy of bowel preparation, number, size and location of polyps. The pathology of all polyps was centrally reviewed by a gastrointestinal pathologist.Results: A total of 707 patients underwent colonoscopy within the study period. The mean age of the cohort was 58 years, and 50.6% were female. Polyp(s) were identified in 66.5% of patients. The SSA detection rate was 20.1%, and the adenoma detection rate was 48.0%. SSA detection was associated with longer withdrawal times. Conventional adenoma detection was associated with older age, male gender, longer withdrawal time and a positive faecal occult blood test result.Conclusion: SSA are highly prevalent in an unselected series of patients attending a gastroenterology outpatient department. Identifying and removing these polyps may help prevent interval colorectal carcinoma. This result may serve as a benchmark for a high-quality colonoscopy service.