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首页> 外文期刊>Endoscopy International Open >Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
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Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy

机译：开发和验证一种用于在先前不完全结肠镜检查中使用标准内窥镜完成结肠镜检查的算法的方法

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Background and study aims Incomplete colonoscopy may occur as a result of colon angulation (adhesions or diverticulosis), endoscope looping, or both. Specialty endoscopes/devices have been shown to successfully complete prior incomplete colonoscopies, but may not be widely available. Radiographic or other image-based evaluations have been shown to be effective but may miss small or flat lesions, and colonoscopy is often still indicated if a large lesion is identified. The purpose of this study was to develop and validate an algorithm to determine the optimum endoscope to ensure completion of the examination in patients with prior incomplete colonoscopy. Patients and methods This was a prospective cohort study of 175 patients with prior incomplete colonoscopy who were referred to a single endoscopist at a single academic medical center over a 3-year period from 2012 through 2015. Colonoscopy outcomes from the initial 50 patients were used to develop an algorithm to determine the optimal standard endoscope and technique to achieve cecal intubation. The algorithm was validated on the subsequent 125 patients. Results The overall repeat colonoscopy success rate using a standard endoscope was 94?%. The initial standard endoscope specified by the algorithm was used and completed the colonoscopy in 90?% of patients. Conclusions This study identifies an effective strategy for completing colonoscopy in patients with prior incomplete examination, using widely available standard endoscopes and an algorithm based on patient characteristics and reasons for prior incomplete colonoscopy.
机译：背景和研究目的结肠角度（粘连或憩室病），内窥镜打圈或两者兼有可能导致结肠镜检查不完全。已显示专用内窥镜/设备可成功完成先前的不完整结肠镜检查，但可能无法广泛使用。放射学或其他基于图像的评估已被证明是有效的，但可能会遗漏小的或扁平的病灶，如果发现大的病灶，通常仍需进行结肠镜检查。这项研究的目的是开发和验证确定最佳内窥镜的算法，以确保对先前不完全结肠镜检查的患者完成检查。患者和方法这是一项前瞻性队列研究，研究对象是2012年至2015年的3年中，在单个学术医学中心就诊的175名先前不完全结肠镜检查的患者被转诊给单一内镜医师。开发确定最佳标准内窥镜的算法和实现盲肠插管的技术。该算法在随后的125位患者中得到验证。结果使用标准内窥镜进行的总重复结肠镜检查成功率为94％。使用算法指定的初始标准内窥镜，并在90％的患者中完成了结肠镜检查。结论本研究使用广泛可用的标准内窥镜和一种基于患者特征和先前不完全结肠镜检查原因的算法，为完成先前不完整检查的患者确定了完成结肠镜检查的有效策略。

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