结肠镜检查的退出时间,过去,现在和未来,叙述回顾。

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2023-01-01 DOI:10.21037/tgh-23-8
Hossein Haghbin, Nuruddinkhodja Zakirkhodjaev, Muhammad Aziz
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引用次数: 2

摘要

背景和目的:结肠镜检查是一种经过时间验证的、安全的、金标准的结直肠癌筛查方法。为了实现其目标,定义了结肠镜检查的质量标记,包括停药时间(WT)。WT定义为在没有任何额外干预的情况下,从到达盲肠或回肠末端到结肠镜检查过程结束所花费的时间。这篇综述旨在为野生植物的功效和未来发展方向提供证据。方法:我们对评价WT的文章进行了全面的文献检索。检索仅限于来自所有同行评议期刊的英文文章。关键内容和发现:Barclay等人的开创性研究,根据2006年美国胃肠病学学会(ACG)工作组的建议,将最小WT设定为6分钟作为结肠镜检查的推荐时间。此后,许多观察性研究证实了6分钟的疗效。最近,多个大型多中心试验表明,WT为9分钟可获得更好的结果。最近,新的人工智能(AI)模型在改善WT和其他结果方面显示出希望,并被证明是胃肠病学家的一个令人兴奋的工具。其中一些工具鼓励内窥镜医师检查盲点并清理残留的粪便。这已被证明可以改善WT和ADR。我们建议对这些模型进行改进,以考虑当前和先前内镜中腺瘤检测等风险因素,以指导内镜医师在每个节段上花费时间。结论:总之,新的证据表明,WT为9分钟优于6分钟。未来的趋势是一种个性化的基于人工智能的方法,结合实时和基线数据,并指导内镜医生在每次结肠镜检查过程中在结肠的每个部分花费多少时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Withdrawal time in colonoscopy, past, present, and future, a narrative review.

Background and objective: Colonoscopy is a time proven, safe, and gold standard screening method for colorectal cancer (CRC). In order to achieve its objectives, quality markers have been defined for colonoscopy, including withdrawal time (WT). WT is defined as the time spent from reaching the cecum or terminal ileum till the end of procedure in colonoscopies without any additional interventions. This review aims to provide evidence on WT efficacy and future directions.

Methods: We conducted a comprehensive literature search of articles evaluating WT. Search was limited to English language articles from all peer-reviewed journals.

Key content and findings: The seminal study by Barclay et al., led to setting of a minimum WT of 6 minutes as the recommended amount for colonoscopy, per 2006 American College of Gastroenterology (ACG) taskforce. Since then, many observational studies have confirmed the efficacy of 6 minutes. Recently, multiple large multicenter trials suggest WT of 9 minutes as the alternative for better outcomes. Recently, novel Artificial Intelligence (AI) models have shown promise in improving WT and other outcomes and proved an exciting tool in the armamentarium of gastroenterologists. Some of these tools encourage the endoscopists to check the blind spots and clean the residual stool. This has shown to improve both WT and ADR. We recommend an improvement of these models to consider risk factors like adenoma detection in current and prior scopes to guide endoscopists spend time in each segment.

Conclusions: In conclusion, new evidence demonstrates that WT of 9 minutes is better than 6 minutes. Future trends point toward an individualized AI-based approach combining real time and baseline data and guiding the endoscopist on how much time to spend in every segment of the colon in every colonoscopy procedure.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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