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首页> 外文期刊>Gastrointestinal Endoscopy >Impact of fair bowel preparation quality on adenoma and serrated polyp detection: Data from the New Hampshire Colonoscopy Registry by using a standardized preparation-quality rating
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Impact of fair bowel preparation quality on adenoma and serrated polyp detection: Data from the New Hampshire Colonoscopy Registry by using a standardized preparation-quality rating

机译：肠准备质量对腺瘤和锯齿状息肉检测的影响：新罕布什尔州结肠镜检查登记处的数据，使用标准化的准备质量等级

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Background The effect of colon preparation quality on adenoma detection rates (ADRs) is unclear, partly because of lack of uniform colon preparation ratings in prior studies. The New Hampshire Colonoscopy Registry collects detailed data from colonoscopies statewide, by using a uniform preparation quality scale after the endoscopist has cleaned the mucosa. Objective To compare the overall and proximal ADR and serrated polyp detection rates (SDR) in colonoscopies with differing levels of colon preparation quality. Design Cross-sectional. Setting New Hampshire statewide registry. Patients Patients undergoing colonoscopy. Interventions We examined colon preparation quality for 13,022 colonoscopies, graded by using specific descriptions provided to endoscopists. ADR and SDR are the number of colonoscopies with at least 1 adenoma or serrated polyp (excluding those in the rectum and/or sigmoid colon) detected divided by the total number of colonoscopies, for the preparation categories: optimal (excellent and/or good), fair, and poor. Main Outcome Measurements Overall/proximal ADR/SDR. Results The overall detection rates in examinations with fair colon preparation quality (SDR 8.9%; 95% confidence interval [CI], 7.4-10.7, ADR 27.1%; 95% CI, 24.6-30.0) were similar to rates observed in colonoscopies with optimal preparation quality (SDR 8.8%; 95% CI, 8.3-9.4, ADR 26.3%; 95% CI, 25.6-27.2). This finding also was observed for rates in the proximal colon. A logistic regression model (including withdrawal time) found that proximal ADR was statistically lower in the poor preparation category (odds ratio 0.45; 95% CI, 0.24-0.84; P <.01) than in adequately prepared colons. Limitations Homogeneous population. Conclusion In our sample, there was no significant difference in overall or proximal ADR or SDR between colonoscopies with fair versus optimal colon preparation quality. Poor colon preparation quality may reduce the proximal ADR.
机译：背景技术结肠准备质量对腺瘤检出率（ADR）的影响尚不清楚，部分原因是先前研究缺乏统一的结肠准备评分。新罕布什尔州结肠镜检查注册处在内窥镜医师清洁粘膜后，使用统一的准备质量量表从全州结肠镜检查中收集详细数据。目的比较不同结肠准备质量水平的结肠镜检查的总和近端ADR和锯齿状息肉检出率（SDR）。设计截面。设置新罕布什尔州范围内的注册表。患者接受结肠镜检查的患者。干预措施我们检查了13022例结肠镜检查的结肠准备质量，并根据提供给内镜医师的具体说明进行了分级。对于制剂类别，ADR和SDR是检测到的具有至少1个腺瘤或锯齿状息肉（不包括直肠和/或乙状结肠结肠息肉）的结肠镜检查数目除以结肠镜检查的总数：最佳（最佳和/或良好） ，公平和贫穷。主要指标总体/近端ADR / SDR。结果结肠准备质量良好的检查中的总体检出率（特别提款权8.9％; 95％置信区间[CI]，7.4-10.7，ADR 27.1％; 95％CI，24.6-30.0）与结肠镜检查中最佳检出率相似制剂质量（SDR 8.8％; 95％CI，8.3-9.4，ADR 26.3％; 95％CI，25.6-27.2）。在近端结肠中也观察到了这一发现。 Logistic回归模型（包括停药时间）发现，在准备水平较差的类别中，近端ADR在统计学上低于在适当准备的结肠中（优势比为0.45; 95％CI为0.24-0.84; P <.01）。局限性同质人口。结论在我们的样本中，结肠镜检查的结肠准备质量与最佳质量相比，总体或近端ADR或SDR没有显着差异。结肠准备质量差可能会降低近端ADR。

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