Sedated Colonoscopy may not be Beneficial for Polyp/Adenoma Detection.

IF 2.5 4区 医学 Q3 ONCOLOGY
Jie Han, Rongrong Cao, Dongshuai Su, Yingchao Li, Cong Gao, Ke Wang, Fei Gao, Xingshun Qi
{"title":"Sedated Colonoscopy may not be Beneficial for Polyp/Adenoma Detection.","authors":"Jie Han, Rongrong Cao, Dongshuai Su, Yingchao Li, Cong Gao, Ke Wang, Fei Gao, Xingshun Qi","doi":"10.1177/10732748241272482","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sedated colonoscopy has been increasingly selected. However, the effect of sedated colonoscopy on polyp/adenoma detection rate (PDR/ADR) remains controversial among studies.</p><p><strong>Methods: </strong>In this retrospective study, the medical records of 11 504 consecutive patients who underwent colonoscopy at our department from July 1, 2021 to December 31, 2022 were collected. Patients were divided into sedated and unsedated groups according to the use of intravenous sedation during colonoscopy. Overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR were calculated. By adjusting for age, gender, body mass index, inpatient, screening/surveillance, cecal intubation time, colonoscopy withdrawal time ≥6 min, and an endoscopist's experience ≥5 years, multivariate logistic regression analyses were performed to evaluate the association of sedated colonoscopy with overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR, where the absence of PDR/ADR was used as reference. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>Overall, 2275 patients were included, of whom 293 and 1982 underwent sedated and unsedated colonoscopy, respectively. Multivariate logistic regression analyses showed that sedated colonoscopy was independently associated with lower overall PDR/ADR (OR = 0.640, 95% CI = 0.460-0.889, <i>P</i> = 0.008), right-side colon PDR/ADR (OR = 0.591, 95% CI = 0.417-0.837, <i>P</i> = 0.003), single PDR/ADR (OR = 0.659, 95% CI = 0.436-0.996, <i>P</i> = 0.048), and multiple PDR/ADR (OR = 0.586, 95% CI = 0.402-0.855, <i>P</i> = 0.005), but not transverse or left-side colon PDR/ADR.</p><p><strong>Conclusion: </strong>Sedated colonoscopy may not be beneficial in terms of overall PDR/ADR, right-side colon PDR/ADR, and number of polyps/adenomas. Thus, it should be selectively recommended. Additionally, it should be necessary to explore how to improve the quality of sedated colonoscopy.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481089/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10732748241272482","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Sedated colonoscopy has been increasingly selected. However, the effect of sedated colonoscopy on polyp/adenoma detection rate (PDR/ADR) remains controversial among studies.

Methods: In this retrospective study, the medical records of 11 504 consecutive patients who underwent colonoscopy at our department from July 1, 2021 to December 31, 2022 were collected. Patients were divided into sedated and unsedated groups according to the use of intravenous sedation during colonoscopy. Overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR were calculated. By adjusting for age, gender, body mass index, inpatient, screening/surveillance, cecal intubation time, colonoscopy withdrawal time ≥6 min, and an endoscopist's experience ≥5 years, multivariate logistic regression analyses were performed to evaluate the association of sedated colonoscopy with overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR, where the absence of PDR/ADR was used as reference. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated.

Results: Overall, 2275 patients were included, of whom 293 and 1982 underwent sedated and unsedated colonoscopy, respectively. Multivariate logistic regression analyses showed that sedated colonoscopy was independently associated with lower overall PDR/ADR (OR = 0.640, 95% CI = 0.460-0.889, P = 0.008), right-side colon PDR/ADR (OR = 0.591, 95% CI = 0.417-0.837, P = 0.003), single PDR/ADR (OR = 0.659, 95% CI = 0.436-0.996, P = 0.048), and multiple PDR/ADR (OR = 0.586, 95% CI = 0.402-0.855, P = 0.005), but not transverse or left-side colon PDR/ADR.

Conclusion: Sedated colonoscopy may not be beneficial in terms of overall PDR/ADR, right-side colon PDR/ADR, and number of polyps/adenomas. Thus, it should be selectively recommended. Additionally, it should be necessary to explore how to improve the quality of sedated colonoscopy.

镇静结肠镜检查可能无益于息肉/腺瘤检测。
背景:越来越多的人选择使用镇静结肠镜检查。然而,镇静结肠镜检查对息肉/腺瘤检出率(PDR/ADR)的影响在研究中仍存在争议:在这项回顾性研究中,收集了 2021 年 7 月 1 日至 2022 年 12 月 31 日期间在我科接受结肠镜检查的 11 504 名连续患者的病历资料。根据结肠镜检查期间使用静脉镇静剂的情况,将患者分为镇静组和非镇静组。计算总PDR/ADR,右侧、横结肠和左侧结肠PDR/ADR,单个和多个PDR/ADR。通过调整年龄、性别、体重指数、住院、筛查/监视、盲肠插管时间、结肠镜检查退出时间≥6 分钟以及内镜医师经验≥5 年等因素,进行多变量逻辑回归分析,以评估镇静结肠镜检查与总体 PDR/ADR、右侧、横侧和左侧结肠 PDR/ADR、单次和多次 PDR/ADR 的相关性,并以无 PDR/ADR 作为参考。结果显示,共纳入 2275 例患者,其中有 162 例患者有 PDR/ADR:共纳入 2275 名患者,其中分别有 293 人和 1982 人接受了镇静和非镇静结肠镜检查。多变量逻辑回归分析显示,镇静结肠镜检查与较低的总体 PDR/ADR (OR = 0.640,95% CI = 0.460-0.889,P = 0.008)、右侧结肠 PDR/ADR (OR = 0.591,95% CI = 0.417-0.837,P = 0.003)、单侧PDR/ADR(OR = 0.659,95% CI = 0.436-0.996,P = 0.048)和多侧PDR/ADR(OR = 0.586,95% CI = 0.402-0.855,P = 0.005),但横结肠或左侧结肠PDR/ADR没有:结论:就总体 PDR/ADR、右侧结肠 PDR/ADR 和息肉/腺瘤数量而言,镇静结肠镜检查可能并无益处。因此,应选择性地推荐使用。此外,有必要探讨如何提高镇静结肠镜检查的质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cancer Control
Cancer Control ONCOLOGY-
CiteScore
3.80
自引率
0.00%
发文量
148
审稿时长
>12 weeks
期刊介绍: Cancer Control is a JCR-ranked, peer-reviewed open access journal whose mission is to advance the prevention, detection, diagnosis, treatment, and palliative care of cancer by enabling researchers, doctors, policymakers, and other healthcare professionals to freely share research along the cancer control continuum. Our vision is a world where gold-standard cancer care is the norm, not the exception.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信