Multiple, zonal and multi-zone adenoma detection rates according to quality of cleansing during colonoscopy

摘要

Background: The safety and diagnostic accuracy of colonoscopy depend on the quality of colon cleansing. The adenoma\uddetection rate is usually used as a quality measurement score.\udObjective: We aimed to introduce and evaluate three new parameters to determine polyps and adenomas segmental\udlocalization and their distribution in association with different bowel preparation levels during colonoscopy. We introduce\udthe multiple adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy),\udthe zonal adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different\udcolon areas (rectum, sigmoid, descending, transverse, ascending and cecum colon)), and multi-zone adenoma detection\udrate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different colon areas with at\udleast a segment between them with or without lesions (i.e. rectum and descending colon with or without lesions in the\udsigmoid)).\udMethods: We prospectively enrolled outpatients who underwent colonoscopy from January 2013 to October 2014. The bowel\udpreparation quality, according to the Aronchick modified scale, number and location of lesions, Paris classification and\udhistology, were recorded. The multiple adenoma/polyp detection rate, zonal adenoma/polyp detection rate, and multi-zone\udadenoma/polyp detection rate were determined.\udResults: In total, 519 consecutive patients (266/253 M/F; mean age 55.3 12.8 years) were enrolled. The adenoma and polyp\uddetection rates were 21% and 35%, respectively. Multiple adenomas were detected in 28 patients. Adenoma and polyp\uddetection rate and new parameters were statistically significantly higher in the optimal as compared with the adequate\udbowel preparation.\udConclusions: An optimal level of bowel preparation was strongly associated not only with a higher adenoma detection rate,\udbut also with a higher chance of detecting multiple clinically relevant lesions in adjacent or discrete segments of the colon.