Full
Outline
To investigate polyp miss rate and influencing factors during colonoscopy using the opportunity of short-interval repeat examinations in day surgery settings.
This single-center retrospective cohort study consecutively enrolled 1 005 patients undergoing polypectomy at the Endoscopy Center of Army Medical University First Affiliated Hospital(March-June 2023). All patients received initial diagnostic colonoscopy followed by therapeutic colonoscopy(repeat examination). Using repeat examination findings as reference, we calculated patient miss rate, polyp miss rate, and adenoma patient miss rate. Multivariable logistic regression analyzed operator- and patient-related factors influencing patient miss rates.
Patient miss rate, polyp miss rate, and adenoma miss rate were 26.67%(95%CI: 23.95~29.52), 16.45%(95%CI:15.26~17.70), and 15.52%(95%CI:13.34~17.91), respectively. Multivariable analysis identified independent risk factors— operator-related: initial procedure by junior endoscopists(OR=2.07, 95%CI: 1.42~3.03, P<0.001) and afternoon procedures(13:30-16:00; OR=1.68, 95%CI: 1.01~2.81, P=0.047); Patient-related: inadequate bowel preparation(OR=4.16, 95%CI: 2.28~7.61, P<0.001) and flat-type lesions(OR=4.33, 95%CI: 2.49~7.52, P<0.001). Reduced miss rates occurred with polyps 0.3~0.5 cm(OR=0.30, 95% CI: 0.21~0.41, P<0.001) and 0.6~0.9 cm(OR=0.10, 95%CI: 0.04~0.22, P<0.001). Inadequate preparation during therapeutic examination decreased polyp detection(OR=0.23, 95%CI: 0.10~0.53, P<0.001).
Colonoscopy exhibits significant polyp miss rates influenced by operator and patient factors. Standardized repeat examinations in day surgery settings effectively detect missed lesions, supporting long-term quality control.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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