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首页> 外文期刊>Digestive Diseases and Sciences >Does level of sedation impact detection of advanced neoplasia?
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Does level of sedation impact detection of advanced neoplasia?

机译：镇静水平是否会影响晚期瘤形成的检测？

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BACKGROUND AND AIMS: Two of the foremost issues in screening colonoscopy involve delivering quality and maximizing adenoma detection rates (ADR). Little is known about the impact of deep sedation on ADR. This study aims to compare the detection of advanced lesions during screening colonoscopy performed with moderate conscious sedation (MCS) versus deep sedation (DS). METHODS: A retrospective cohort study was performed using the Clinical Outcomes Research Initiative database. Average risk screening colonoscopies performed January 2000 to December 2005 were examined for practice setting, patient demographics, and findings, including detection of a polyp >9 mm and suspected malignant lesions. RESULTS: A total of 104,868 colonoscopies were examined, 97% of which were performed with MCS. Univariate analysis demonstrated that more polyps of any size were detected with MCS (38 vs. 34%, p < 0.0001) and more advanced lesions were found with DS compared with MCS (7 vs. 6%, p = 0.01). When exclusively examining sites that performed DS > 10% for all procedures, a more significant increase in advanced lesion detection when using DS was observed (7.5 vs. 5.7%, p = 0.003). When adjusted for age, gender, race/ethnicity, site, prep quality, and ASA group, DS was 25% more likely to detect an advanced lesion. CONCLUSIONS: Our data suggest that use of DS may be associated with a higher rate of advanced lesion detection. However, this retrospective design has limitations that necessitate follow-up with prospective studies. These follow-up studies would be essential to support any change in the standard practices of sedation.
机译：背景与目的：结肠镜筛查中最重要的两个问题涉及质量的提供和腺瘤检出率的最大化。关于深度镇静对ADR的影响知之甚少。这项研究的目的是比较以中等意识镇静（MCS）和深度镇静（DS）进行的结肠镜筛查中晚期病变的检测。方法：使用临床结果研究倡议数据库进行回顾性队列研究。对2000年1月至2005年12月进行的平均风险筛查结肠镜检查进行了检查，以了解其实际情况，患者的人口统计学特征和发现，包括检出大于9毫米的息肉和疑似恶性病变。结果：共检查了104,868例结肠镜检查，其中97％是通过MCS进行的。单因素分析表明，与MCS相比，MCS检测出更多大小的息肉（38％vs. 34％，p <0.0001），DS病变更严重（7％vs. 6％，p = 0.01）。当专门检查所有程序中执行DS> 10％的部位时，观察到使用DS时晚期病变检测的显着增加（7.5对5.7％，p = 0.003）。调整年龄，性别，种族/民族，部位，制备质量和ASA组后，DS检测到晚期病变的可能性要高25％。结论：我们的数据表明，DS的使用可能与更高的病灶发现率相关。但是，这种回顾性设计存在局限性，因此有必要进行前瞻性研究。这些随访研究对于支持镇静标准方法的任何改变都是必不可少的。

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