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Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies.

Abstract : BACKGROUND AND STUDY AIM: Polyp miss rates during colonoscopy have been calculated in a few tandem or back-to-back colonoscopy studies. Our objective was to assess the adenoma miss rate while limiting technique or operator expertise biases, i. e. by performing a large multicenter study, with same-day back-to-back video colonoscopy, done by two different operators in randomized order and blinded to the other examination. PATIENTS AND METHODS: 294 patients at 11 centers were included. Among the 286 analyzable tandem colonoscopies, miss rates were calculated in both a lesion- and patient-based analysis. Each of these rates was determined for polyps overall, for adenomas, and then for lesions larger than 5 mm, and for advanced adenomas. Univariate and logistic regression analysis were performed to define independent variables associated with missed polyps or adenomas. RESULTS: The miss rates for polyps, adenomas, polyps > or = 5 mm, adenomas > or = 5 mm, and advanced adenomas were, respectively, 28 %, 20 %, 12 %, 9 % and 11 %. None of the masses with a carcinomatous (n = 3) or carcinoid component (n = 1) was missed. The specific lesion miss rates for patients with polyps and adenomas were respectively 36 % and 26 % but the corresponding rates were 23 % and 9.4 % when calculated for all 286 patients. The diameter (1-mm increments) and number of polyps (> or = 3) were independently associated with a lower polyp miss rate, whereas sessile or flat shape and left location were significantly associated with a higher miss rate. Adequacy of cleansing, presence of diverticula, and duration of withdrawal for the first procedure were not associated with adenoma miss rate. CONCLUSIONS: We confirm a significant miss rate for polyps or adenoma during colonoscopy. Detection of flat polyps is an issue that must be focused on to improve the quality of colonoscopy.
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https://hal-unilim.archives-ouvertes.fr/hal-00738330
Contributeur : Françoise Merigaud <>
Soumis le : jeudi 4 octobre 2012 - 09:43:13
Dernière modification le : samedi 24 octobre 2020 - 03:41:04

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D. Heresbach, T. Barrioz, M. G. Lapalus, D. Coumaros, P. Bauret, et al.. Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies.. Endoscopy, Thieme Publishing, 2008, 40 (4), pp.284-90. ⟨10.1055/s-2007-995618⟩. ⟨hal-00738330⟩

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