Reduced Adenoma Miss Rate With 9-Minute vs 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial

被引：16

作者：

Zhao, Shengbing ^{[1
,2
,3
]}

Song, Yihang ^{[1
,2
,3
]}

Wang, Shuling ^{[1
,2
,3
]}

Wang, Rong ^{[4
]}

Feng, Zhijie ^{[5
]}

Gong, Aixia ^{[6
]}

Yang, Xia ^{[7
]}

Pan, Peng ^{[1
,2
,3
]}

Yao, Dongmei ^{[5
]}

Zhang, Jingwen ^{[6
]}

Zhu, Yaqin ^{[7
]}

Li, Tao ^{[4
]}

Bi, Junhua ^{[4
]}

Ren, Xu ^{[8
]}

Tang, Xiufen ^{[8
]}

Li, Qiang ^{[8
]}

Yu, Dan ^{[8
]}

Zheng, Jinghua ^{[9
]}

Song, Bo ^{[9
]}

Wang, Ping ^{[9
]}

Chen, Weigang ^{[10
]}

Shang, Guochen ^{[10
]}

Xu, Yanqiu ^{[10
]}

Xu, Ping ^{[11
]}

Lai, Yuexing ^{[11
]}

Xu, Huanhai ^{[12
]}

Yang, Xiaomin ^{[12
]}

Sheng, Jianqiu ^{[13
,14
]}

Tao, Yurong ^{[13
,14
]}

Li, Xinghua ^{[15
]}

Zhu, Yangbei ^{[15
]}

Zhang, Xiaofeng ^{[16
]}

Shen, Hongzhang ^{[16
]}

Ma, Yingcai ^{[17
]}

Wang, Fangyu ^{[18
]}

Wu, Lin ^{[18
]}

Wang, Xianfei ^{[19
]}

Li, Zhaoshen ^{[1
,2
,3
]}

Bai, Yu ^{[1
,2
,3
]}

机构：

[1] Naval Med Univ, Mil Med Univ 2, Changhai Hosp, Dept Gastroenterol,Digest Endoscopy Ctr, Shanghai, Peoples R China

[2] Natl Clin Res Ctr Digest Dis, Shanghai, Peoples R China

[3] Natl Qual Control Ctr Digest Endoscopy, Shanghai, Peoples R China

[4] Shanxi Med Univ, Shanxi Prov Peoples Hosp, Hosp 5, Dept Gastroenterol, Taiyuan, Shanxi, Peoples R China

[5] Hebei Med Univ, Hosp 2, Dept Gastroenterol, Shijiazhuang, Hebei, Peoples R China

[6] Dalian Med Univ, Affiliated Hosp 1, Dept Gastroenterol, Dalian, Liaoning, Peoples R China

[7] 905 Hosp Peoples Liberat Army Navy, Dept Gastroenterol, Shanghai, Peoples R China

[8] Heilongjiang Prov Hosp, Harbin Inst Technol, Dept Gastroenterol, Harbin, Heilongjiang, Peoples R China

[9] Yantai Shan Hosp, Dept Gastroenterol, Yantai, Shandong, Peoples R China

[10] Shihezi Univ, Affiliated Hosp 1, Sch Med, Dept Gastroenterol, Shihezi, Xinjiang, Peoples R China

[11] Shanghai Jiao Tong Univ, Songjiang Hosp, Sch Med Preparatory Stage, Dept Gastroenterol, Shanghai, Peoples R China

[12] Wenzhou Med Univ, Affiliated Yueqing Hosp, Dept Gastroenterol, Yueqing, Zhejiang, Peoples R China

[13] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Gastroenterol, Sr Dept Gastroenterol, Beijing, Peoples R China

[14] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 7, Beijing, Peoples R China

[15] Shanghai Eighth Peoples Hosp, Dept Gastroenterol, Shanghai, Peoples R China

[16] Zhejiang Univ, Affiliated Hangzhou Peoples Hosp 1, Sch Med, Dept Gastroenterol, Hangzhou, Zhejiang, Peoples R China

[17] Qinghai Prov Peoples Hosp, Dept Gastroenterol, Xining, Qinghai, Peoples R China

[18] Nanjing Univ, Jinling Hosp, Med Sch, Dept Gastroenterol, Nanjing, Jiangsu, Peoples R China

[19] North Sichuan Med Coll, Affiliated Hosp, Digest Endoscopy Ctr, Nanchong, Sichuan, Peoples R China

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2023年 / 118卷 / 05期

基金：

中国国家自然科学基金;

关键词：

INTERVAL COLORECTAL-CANCER; SOCIETY TASK-FORCE; QUALITY; IMPACT; RECOMMENDATIONS; ASSOCIATION; UPDATE; COLON; RISK;

D O I：

10.14309/ajg.0000000000002055

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

INTRODUCTION: Although the 9-minute mean withdrawal time (m-WT) is often reported to be associated with the optimal adenoma detection rate (ADR), no randomized trials of screening colonoscopy have confirmed the impact of a 9-minute m-WT on adenoma miss rate (AMR) and ADR.METHODS: A multicenter tandem trial was conducted in 11 centers. Seven hundred thirty-three asymptomatic participants were randomized to receive segmental tandem screening colonoscopy with a 9-minute withdrawal, followed by a 6-minute withdrawal (9-minute-first group, 9MF, n = 366) or vice versa (6-minute-first group, 6MF, n = 367). The primary outcome was the lesion-level AMR.RESULTS: The intention-to-treat analysis revealed that 9MF significantly reduced the lesion-level (14.5% vs 36.6%, P < 0.001) and participant-level AMR (10.9% vs 25.9%, P < 0.001), advanced adenoma miss rate (AAMR, 5.3% vs 46.9%, P = 0.002), multiple adenomas miss rate (20.7% vs 56.5%, P = 0.01), and high-risk adenomas miss rate (14.6% vs 39.5%, P = 0.01) of 6MF without compromising detection efficiency (P = 0.79). In addition, a lower false-negative rate for adenomas (P = 0.002) and high-risk adenomas (P < 0.05), and a lower rate of shortening surveillance schedule (P < 0.001) were also found in 9MF, accompanying with an improved ADR in the 9-minute vs 6-minute m-WT (42.3% vs 33.5%, P = 0.02). The independent inverse association between m-WT and AMR remained significant even after adjusting ADR, and meanwhile, 9-minute m-WT was identified as an independent protector for AMR and AAMR.DISCUSSION: In addition to increasing ADR, 9-minute m-WT also significantly reduces the AMR and AAMR of screening colonoscopy without compromising detection efficiency.

引用

页码：802 / 811

页数：10

共 21 条

[21] Efficacy of Computed Virtual Chromoendoscopy on Colorectal Cancer Screening: A Prospective Randomized Rack-to-Back Trial of Fuji Intelligent Color Enhancement vs Conventional Colonoscopy to Compare Adenoma Miss Rates
Chung, Su Jin
Kim, Donghee
Park, Min Jung
Song, Ji Hyun
Kim, Young Sun
Kim, Joo Sung
Jung, Hyun Chae
Song, In Sung
GASTROINTESTINAL ENDOSCOPY, 2010, 71 (05) : AB247 - AB247

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