https://scholars.lib.ntu.edu.tw/handle/123456789/541031
標題: | Different bowel preparation schedule leads to different diagnostic yield of proximal and nonpolypoid colorectal neoplasm at screening colonoscopy in average-risk population | 作者: | HAN-MO CHIU Lin J.-T. YI-CHIA LEE JIN-TUNG LIANG CHIA-TUNG SHUN HSIU-PO WANG MING-SHIANG WU |
公開日期: | 2011 | 卷: | 54 | 期: | 12 | 起(迄)頁: | 1570-1577 | 來源出版物: | Diseases of the Colon and Rectum | 摘要: | BACKGROUND: Accumulating evidence indicates that the timing of bowel preparation is crucial, but its impact on the diagnostic yield of proximal or nonpolypoid colorectal neoplasm remains unclear. OBJECTIVE: This study aimed to investigate the impact of the timing of bowel preparation on the adenoma detection rate for nonpolypoid colorectal neoplasm at colonoscopy. DESIGN: This study is a retrospective analysis of a screening colonoscopy cohort database. SETTING: The investigation was conducted at a screening colonoscopy unit in an university hospital. PATIENTS: A consecutive series of 3079 subjects who received primary screening colonoscopy with different timing of bowel preparation was analyzed. INTERVENTION: Different timing of bowel preparation (same day vs prior day) was studied. MAIN OUTCOME MEASURES: The main outcomes measured were patient demographics, timing of bowel preparation, colon-cleansing levels, diagnostic yields of colonoscopy, including adenoma, advanced adenoma, and nonpolypoid colorectal neoplasm. RESULTS: There were a total of 1552 subjects in the morning group and 1527 in the evening group. More subjects had proximal adenoma (175, 11.3% vs 138, 9.0%, P = .04), advanced adenoma (68, 4.4% vs 46, 13.0%, P = .044), nonpolypoid colorectal neoplasm (98, 6.3% vs 67, 4.4%, P = .018), proximal nonpolypoid colorectal neoplasm (71, 4.6% vs 40, 2.6%, P = .004), and advanced nonpolypoid colorectal neoplasm (25, 1.6% vs 12, 0.8%, P = .036) detected by same-day preparation. On multivariate regression analysis, the adenoma detection rate was significantly higher in the same-day group regarding overall and proximal adenoma (OR 1.23, 95% CI: 1.00-1.50; OR 1.35, 95% CI: 1.05-1.74), advanced adenoma (OR 1.53, 95% CI: 1.04-2.28), overall, proximal, and advanced nonpolypoid colorectal neoplasm (OR 1.48, 95% CI: 1.06-2.08; OR 1.82, 95% CI: 1.20-2.75; OR 1.96, 95% CI: 1.12-3.37). The adenoma detection rate was also significantly different among endoscopists. LIMITATION: This was a single-center, nonrandomized trial. CONCLUSIONS: Improving bowel preparation quality by same-day preparation may lead to enhanced detection of overall, proximal, and advanced nonpolypoid colorectal neoplasm. ?The ASCRS 2011. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84855164888&doi=10.1097%2fDCR.0b013e318231d667&partnerID=40&md5=f81850ea0afdf6aa5f9bfdb8d84559cc https://scholars.lib.ntu.edu.tw/handle/123456789/541031 |
ISSN: | 0012-3706 | DOI: | 10.1097/DCR.0b013e318231d667 | SDG/關鍵字: | adult; article; cancer risk; colon lavage; colonoscopy; colorectal adenoma; controlled study; diagnostic value; female; human; intestine preparation; major clinical study; male; screening test; treatment outcome; adenoma; colorectal tumor; drug administration; early diagnosis; middle aged; multivariate analysis; retrospective study; risk; time; laxative; Adenoma; Adult; Cathartics; Colonoscopy; Colorectal Neoplasms; Drug Administration Schedule; Early Detection of Cancer; Female; Humans; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Retrospective Studies; Time Factors |
顯示於: | 醫學系 |
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