Miss rate for colorectal neoplastic polyps:: a prospective multicenter study of back-to-back video colonoscopies

被引:407
作者
Heresbach, D. [1 ]
Barrioz, T. [2 ]
Lapalus, M. G. [3 ]
Coumaros, D. [4 ]
Bauret, P. [5 ]
Potier, P. [6 ]
Sautereau, D. [7 ]
Boustiere, C. [8 ]
Grimaud, J. C. [9 ]
Barthelemy, C. [10 ]
See, J. [11 ]
Serraj, I. [3 ]
Halluin, P. N. D. [1 ]
Branger, B. [12 ]
Ponchan, T. [3 ]
机构
[1] Hosp Pontchaillou, Dept Gastroenterol, Rennes, France
[2] Hosp Miletrie, Dept Gastroenterol, Poitiers, France
[3] Hosp Edouard Herriot, Dept Gastroenterol, Lyon, France
[4] Civil Hosp, Dept Gastroenterol, Strasbourg, France
[5] Hosp St Eloi, Dept Gastroenterol, Montpellier, France
[6] Hosp Source, Dept Gastroenterol, Orleans, France
[7] Hosp Dupuytren, Dept Gastroenterol, Limoges, France
[8] St Joseph Hosp, Dept Gastroenterol, Marseille, France
[9] Hosp Nord St Antoine, Dept Gastroenterol, Marseille, France
[10] Hosp Nord, Dept Gastroenterol, St Priest En Jarez, France
[11] Hosp Tenon, Dept Gastroenterol, Paris, France
[12] Hosp Pontchaillou, Dept Publ Hlth, Biostat Unit, Rennes, France
关键词
D O I
10.1055/s-2007-995618
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and study aim: Polyp miss rates during colonoscopy have been calculated in a few tandem or back-to-back colonoscopy studies. Our objective was to assess the adenoma miss rate while limiting technique or operator expertise biases, i.e. by performing a large multicenter study, with same-day back-to-back video colonoscopy, done by two different operators in randomized order and blinded to the other examination. Patients and methods: 294 patients at 11 centers were included. Among the 286 analyzable tandem colonoscopies, miss rates were calculated in both a lesion- and patient-based analysis. Each of these rates was determined for polyps overall, for adenomas, and then for lesions larger than 5 mm, and for advanced adenomas. Univariate and logistic regression analysis were performed to define independent variables associated with missed polyps or adenomas. Results: The miss rates for polyps, adenomas, polyps ! 5 mm, adenomas >= 5 mm, and advanced adenomas were, respectively, 28 %, 20 %,12 %, 9 % and 11 %. None of the masses with a carcinomatous (n = 3) or carcinoid component (n =1) was missed. The specific lesion miss rates for patients with polyps and adenomas were respectively 36% and 26% but the corresponding rates were 23% and 9.4% when calculated for all 286 patients. The diameter (1-mm increments) and number of polyps (>= 3) were independently associated with a lower polyp miss rate, whereas sessile or flat shape and left location were significantly associated with a higher miss rate. Adequacy of cleansing, presence of diverticula, and duration of withdrawal for the first procedure were not associated with adenoma miss rate. Conclusions: We confirm a significant miss rate for polyps or adenoma during colonoscopy. Detection of flat polyps is an issue that must be focused on to improve the quality of colonoscopy.
引用
收藏
页码:284 / 290
页数:7
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