在三级医院3年内重复结肠镜检查的诊断后果:单中心观察性研究
Srivishnu Ravichandran1,2, Andrea Slusarczyk2, Pasan Gunatilaka1,2
1Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Internal medicine journal
|December 13, 2025
概括
澳大利亚的重复结肠镜检查显示,晚期腺瘤和结肠直肠癌的诊断产量很低. 遵守国家卫生和医学研究委员会 (NHMRC) 监测结肠镜指南是不充分的,需要更严格的转诊审查.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 澳大利亚日益增长的结肠镜检查率使卫生系统资源受到压力.
- 显著比例的结肠镜检查是在三年内重复的程序.
- 这凸显了需要评估这些重复程序的效率和必要性.
研究的目的:
- 评估在前一次手术后三年内进行的重复结肠镜的诊断产量.
- 评估国家卫生和医学研究委员会 (NHMRC) 监测结肠镜指南的遵守情况.
- 识别影响诊断产量和遵循指南的因素.
主要方法:
- 在西澳大利亚一家三级医院2021年进行的结肠镜的回顾分析.
- 数据提取包括患者人口统计学,适应症,发现和程序学专业.
- 分析的重点是三年内重复结肠镜检查,并遵守NHMRC的指导方针.
主要成果:
- 在5838次结肠镜检查中,有16.3%在三年内重复检查.
- 遵守NHMRC的指导方针对聚的监测是56.2%.
- 在8.8%的重复结肠镜检查中发现了高风险的常规腺瘤;在0.32%的重复结肠镜检查中发现了高级状状病变 (SSLs);没有发现癌症.
结论:
- 遵循NHMRC监测结肠镜指导方针在多叶切除术后是不够的,许多手术超过了推的间隔.
- 在三年内重复结肠镜检查中,晚期腺瘤,SSL或结肠直肠癌的诊断产量在所有指示中都很低.
- 建议加强对三年内重复结肠镜转诊的审查,以优化资源配置和患者护理.
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