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首页> 外文期刊>Surgical Endoscopy >Adenoma detection at colonoscopy by polypectomy in withdrawal only versus both insertion and withdrawal: a randomized controlled trial
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Adenoma detection at colonoscopy by polypectomy in withdrawal only versus both insertion and withdrawal: a randomized controlled trial

机译：仅在撤回与插入和撤回之间通过息肉切除术在结肠镜检查中发现腺瘤：一项随机对照试验

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Colonic configuration during insertion phase (IP) and withdrawal phase (WP) is different and some polyps seen during IP are difficult to find during WP and vice versa. To determine if polypectomy performed during both IP and WP of colonoscopy (study arm) increases adenoma detection rate (ADR) compared to WP only (control arm). In this prospective randomized controlled trial, adults undergoing out-patient colonoscopy were enrolled. The primary outcome was mean number of adenomas detected per patient. Secondary outcomes were ADR, defined as the proportion of colonoscopies with at least one adenoma, polyp detection rates (PDR), number of patients classified as high-risk group (presence of a parts per thousand yen3 adenomas of any size, any adenoma a parts per thousand yen1 cm in size, or adenoma with villous component, or high grade dysplasia), procedural times, patients discomfort, and ease of procedure. Among 772 patients enrolled, 610 were included (329 in study arm and 281 in control arm). In both arms, mean number of adenomas detected per patient were similar, 0.78 +/- A 1.4 vs. 0.74 +/- A 1.5, P = 0.75. Also, ADR (39.2 vs. 38.1 %, P = 0.77) and PDR (57.1 and 54.1 %, P = 0.45) were similar. Mean insertion time was significantly higher in study arm (10.2 +/- A 5.8 vs. 9.3 +/- A 5.6 min, p = 0.046). Proportion of patients identified as high-risk group were significantly higher in study arm (18.8 vs. 11.7 %, P = 0.016). Conclusions: Polypectomy performed during both IP and WP compared to the WP only, did not improve ADR or mean number of adenomas detected per patient. Trial registration: Clinicaltrials.gov, #NCT01025960.
机译：在插入阶段（IP）和退出阶段（WP）期间的结肠构造不同，在IP期间看到的一些息肉很难在WP期间找到，反之亦然。为了确定在结肠镜检查（研究组）的IP和WP期间均进行息肉切除术是否比仅WP（对照组）增加了腺瘤检出率（ADR）。在这项前瞻性随机对照试验中，纳入了接受门诊结肠镜检查的成年人。主要结局是每位患者检测到的平均腺瘤数量。次要结局为ADR，定义为具有至少一个腺瘤的结肠镜检查比例，息肉检出率（PDR），归类为高风险组的患者数量（每千日元中存在一部分腺瘤3大小的腺瘤，一部分腺瘤每千日元1厘米大小，或绒毛状腺瘤，或高度不典型增生），手术时间长，患者不适，操作简便。在772名患者中，包括610名患者（研究组329例，对照组281例）。在两个手臂中，每位患者检测到的平均腺瘤数量相似，分别为0.78 +/- A 1.4和0.74 +/- A 1.5，P = 0.75。同样，ADR（39.2％对38.1％，P = 0.77）和PDR（57.1和54.1％，P = 0.45）相似。在研究组中，平均插入时间显着增加（10.2 +/- A 5.8与9.3 +/- A 5.6 min，p = 0.046）。在研究组中，被确定为高危组的患者比例显着更高（18.8比11.7％，P = 0.016）。结论：与仅进行WP相比，IP和WP期间进行的息肉切除术并未改善ADR或每位患者检测到的平均腺瘤数量。试用注册：Clinicaltrials.gov，＃NCT01025960。

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