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Influence of the insertion time and number of polyps on miss rate in colonoscopy

Authors
 Jae Hak Kim  ;  Yong-Soo Kim  ;  Jae Hee Cheon  ;  Sang Kil Lee  ;  Tae Il Kim  ;  Sungmin Myoung  ;  Won Ho Kim 
Citation
 SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, Vol.46(5) : 634-639, 2011 
Journal Title
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
ISSN
 0036-5521 
Issue Date
2011
MeSH
AdenomatousPolyps/diagnosis* ; AdenomatousPolyps/pathology ; AdenomatousPolyps/surgery ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Clinical Competence ; Colonoscopy/methods* ; Colorectal Neoplasms/diagnosis* ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Sensitivity and Specificity ; Sex Factors ; TimeFactors
Keywords
Colonoscopy ; colonic polyps ; risk factor
Abstract
OBJECTIVE: Colorectal polyps can be missed even during a meticulous colonoscopy by an experienced colonoscopist. The aim of this study was to investigate patient-, procedure-, and polyp-related factors affecting the miss rate of polyps on colonoscopy.

MATERIAL AND METHODS: From March 2001 to February 2006, a total of 285 patients undergoing screening colonoscopy followed within 2 months by colonoscopy for polypectomy were enrolled. The main outcome measurements were factors associated with miss rates of polyp and the conditions for reducing missed polyps on colonoscopy.

RESULTS: From the 285 colonoscopy pairs, a total of 1326 polyps were found. Overall, 350 of the 1326 polyps were missed (26.4%). Among those, 59 polyps (4.4%) were only seen on the first colonoscopy and 291 polyps (21.9%) were found only at the second colonoscopy. Patient-related factors were male sex (Odds Ratio (OR) 2.11, 95% Confidence Interval (CI) 1.21-3.70) and older age (OR 2.51, 95% CI 1.48-4.30). Procedure-related factors were colonoscopy by clinical fellows (OR 2.20, 95% CI 1.02-4.84) and delayed insertion time (OR 4.10, 95% CI 2.14-7.86). Polyp-related factors were more than four numbers of polyps (OR 4.48, 95% CI 1.91-10.5). However, a large polyp was less frequently missed on colonoscopy (OR 0.10, 95% CI 0.05-0.19).

CONCLUSIONS: In usual clinical practice, colon polyps were frequently missed on colonoscopy. Comprehensive analysis of patient should be required to reduce the miss rates.
Full Text
http://informahealthcare.com/doi/abs/10.3109/00365521.2011.558111
DOI
10.3109/00365521.2011.558111
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Soo(김용수)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Jae Hak(김재학)
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94155
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