Analysis Of Factors Influencing The Detection Rate And Missed Detection Rate Of Colorectal Polyps

[Objective]To study the detection rate and miss rate of colorectal polyps in colonoscopy and the related risk factors affecting the detection rate and miss rate,thereby improving the detection rate of colorectal polyps in endoscopy and reducing the rate of missed polyps.Reduce the incidence and mortality of colorectal cancer.[Methods]This study was a prospective study of 911 patients who underwent colonoscopy at the Digestive Endoscopy Center of Weihai City Hospital from August 2016 to December 2018 and included statistical analysis.The number of patients who underwent colonoscopy for colorectal polyps but did not undergo endoscopic treatment was counted.The detection rate of colorectal polyps was calculated,and the first colonoscopy was performed to find endoscopic treatment of colorectal polyps.The number of patients was counted,and the rate of partial polyps was counted.The gender,age,body mass index,intestinal cleanliness,endoscopic procedure,withdrawal time,and whether the endoscopist was consciously looking for polyps,polyps,and size were included in the study.Single factor chi2 test or T test was used to analyze the relationship,between the detection rate of colorectal polyps and the miss rate of partial polyps and the above factors.Multivariate logistic regression analysis was used to exclude the mutual interference between the factors,and to analyze the independent risk factors affecting the detection rate of polyps and the miss rate of partial polyps.[Results]1.911 patients were included in the study.Among them,polyps are detected in 351 cases during the first colonoscopy.The polyp detection rate was 43.5%.The first colonoscopy found polyps,and a total of 71 patients underwent endoscopic treatment.54 patients were found to have missed polyps during the first colonoscopy,and the miss rate of partial polyps were 76%.2.The detection rates of polyps in male and female patients were 36.5%and 51.4%,respectively(χ2=20.527,P<0.001).As the patient’s age increased,the polyp detection rate increased(χ2=9.262,P<0.001);single operation,The detection rates of polyps for double operation were 54.9%and 38.8%,respectively(x2=19.934,P<0.001).The detection rates of polyps at<6 minutes and ≥6 minutes were 20.5%and 57.2%,respectively(χ2=116.722,P<0.001).3.As the patient’s age increased,the rate of polyp miss detection increased(χ2=2.087,P=0.041);the rate of partial polyps missed by intestinal preparation scores 0-3,4-6,7-9 was 86.7%.61.5%,41.2%(χ2=7.004,P=0.030);partial polyp miss detection rates of<6 minutes,≥6 minutes were 84.6%,48.9%(x2=8.925,P=0.003);At the first colonoscopy,the rate of partial polyps detected when the number of polyps was<3 was 47.6%,and the rate of partial polyps when the number of polyps was ≥3 was 82.8%(χ2=8.988,P=0.003).4.Multivariate logistic analysis showed:female(OR:2.07;95%CI:1.52-2.82,P<0.001),age(OR:1.05;95%CI:1.04-1.07,P<0.001),obesity(OR:2.98;95%CI:1.24-7.17,P=0.015),retrospective time ≥ 6 minutes(OR:4.84;95%CI:3.48-6.78,P<0.001)are independent risk factors affecting the detection rate of polyps.Among them,double operation(OR:0.64;95%CI:0.46-0.89,P=0.008),double operation is a protective factor affecting the detection rate of polyps.The detection rate of double operation is lower than single operation,so single operation An independent risk factor for affecting the rate of polyp detection.The time of withdrawal is ≥6 minutes(OR:0.15;95%CI:0.03-0.67,P=0.013),the number of polyps is ≥3(OR:11.94;95%CI:2.14-66.64,P=0.005),the time of withdrawal ≥6 minutes is a protective factor affecting the rate of partial polyps missed detection.The rate of partial polyps missed when the time of withdrawal is ≥6 minutes is lower than the time of withdrawal of the lens<6 minutes,so the time of withdrawal is<6 minutes,the initial colonoscopy polyps The number ≥3 are independent risk factors affecting the rate of partial polyps missed.[Conclusion]1.There is a correlation between gender,age,mode of operation and time of returning to the polyp.The body mass index,intestinal preparation,and endoscopic doctors were unconsciously looking for a significant correlation between the polyp and polyp detection rates.The detection rate of polyps in female patients is higher than that in males;the detection rate of polyps increases with the age of patients;the detection rate of polyps in single-operated colonoscopy is higher than that in double operation;the detection rate of polyps when the time of withdrawal is ≥6 minutes Higher than<6 minutes.2.There was a correlation between age,intestinal preparation,time to return to the mirror,number of polyps and partial polyps missed detection rate.Gender,body mass index,mode of operation,endoscopic doctors have no intention to find polyps,polyps size and some polyps missed detection rate has no significant correlation.As the patient’s age increases,the rate of partial polyps is increased.With the improvement of intestinal cleanliness,the rate of partial polyps is decreased.The rate of partial polyps missed when the time is<6 minutes is higher than ≥6 minutes.The first colonoscopy found that the rate of partial polyps in patients with polyps ≥3 was higher than the number of polyps<3.3.Female,advanced age,obesity,single operation colonoscopy,retrospective time ≥6 minutes is an independent risk factor for high polyps detection rate.The time to return the mirror<6 minutes,the first colonoscopy found that the number of polyps ≥3 were independent risk factors for the high rate of partial polyps missed.