Assessing polyp miss rates and their determinants through same-day tandem colonoscopy in ambulatory care settings
10.16016/j.2097-0927.202509098
- VernacularTitle:利用日间治疗二次检查评估结肠镜息肉漏诊率及其影响因素
- Author:
Meng WU
1
;
Jing CHEN
;
Zhi GAO
;
Lei CHEN
Author Information
1. 陆军军医大学(第三军医大学)第一附属医院消化内科
- Keywords:
colonoscopy;
polyp miss rate;
colonoscopy quality control;
adenoma;
daycare surgery
- From:
Journal of Army Medical University
2025;47(23):2943-2952
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate polyp miss rate and influencing factors during colonoscopy using the opportunity of short-interval repeat examinations in day surgery settings.Methods 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.Results 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).Conclusion 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.
