Effect of Institution-Wide Policy of Colonoscopy Withdrawal Time ≥7 Minutes on Polyp Detection
Effect of Institution-Wide Policy of Colonoscopy Withdrawal Time ≥7 Minutes on Polyp Detection
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DOI：
10.1053/j.gastro.2008.08.024
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发表时间：
2008-12-01
期刊：
影响因子：
29.4
通讯作者：
Aronson, Mark D.
中科院分区：
文献类型：
--
作者：
Sawhney, Mandeep S.;Cury, Marcelo S.;Aronson, Mark D.
背景和目标：实践指南建议内镜医师在结肠镜撤出期间至少花费7分钟检查结肠粘膜，以优化息肉产量。本研究的目的是确定是否与结肠息肉检测的增加结肠镜撤出时间7分钟的机构范围内的政策的实施。方法：我们研究所的所有42名内镜医师被要求达到至少7分钟的结肠镜退出时间。记录所有非治疗性结肠镜检查对7分钟停药时间的依从性。计算息肉检出率（检测到的息肉数量除以进行的结肠镜检查数量）。使用回归模型评估7分钟停药时间依从性与息肉检测之间的相关性。结果：在研究期间，进行了23，910次结肠镜检查。患者平均年龄为56.8岁，其中54%为女性。结肠癌筛查或监测是42.5%结肠镜检查的适应症。在研究开始时，息肉检出率为0.48。非治疗性手术7分钟停药时间的依从性从该计划开始时的65%增加到几乎100%。然而，在同一时期内，所有息肉（斜率，0.0006; P = 0.45）或1-5 mm（斜率，0.001; P = 0.26），6-9 mm（斜率，0.002; P = 0.43）或>= 10 mm（斜率，0.006; P = 0.13）的息肉检出率没有增加。当仅分析用于筛查或监测的结肠镜检查时，未检测到相关性。结论：全机构范围内的结肠镜检查退出时间>= 7分钟的政策对结肠息肉的检测没有影响。
Background & Aims: Practice guidelines recommend that endoscopists spend at least 7 minutes examining the colonic mucosa during colonoscopy withdrawal to optimize polyp yield. The aim of this study was to determine if the implementation of an institution-wide policy of colonoscopy withdrawal time 7 minutes was associated with an increase in colon polyp detection. Methods: All 42 endoscopists at our institute were asked to attain a colonoscopy withdrawal time of at least 7 minutes. Compliance with 7-minute withdrawal time was recorded for all nontherapeutic colonoscopies. Polyp detection ratio (number of polyps detected divided by number of colonoscopies performed) was computed. Regression models were used to assess the association between compliance with 7-minute withdrawal time and polyp detection. Results: During the study period, 23,910 colonoscopies were performed. The average age of patients was 56.8 years, and 54% were female. Colon cancer screening or surveillance was the indication for 42.5% of colonoscopies. At the beginning of the study, the polyp detection ratio was 0.48. Compliance with 7-minute withdrawal time for nontherapeutic procedures increased from 65% at the beginning of the initiative to almost 100%. However, no increase in polyp detection ratio was noted over the same period for all polyps (slope, 0.0006; P =.45) or for polyps 1-5 mm (slope, 0.001; P = .26), 6-9 mm (slope, 0.002; P = .43), or >= 10 mm (slope, 0.006; P = .13). No association was detected when only colonoscopies performed for screening or surveillance were analyzed. Conclusions: An institution-wide policy of colonoscopy withdrawal time >= 7 minutes had no effect on colon polyp detection.