Correlation Analysis Between Colonoscopy Withdrawal Time Combined With Colonoscopy Insertion Time And Detection Rate Of Colorectal Polyps

BackgroundColorectalcancer(CRC)is a very common malignant tumor of digestive system all over the world,with the third incidence rate(10%)in the world.In China,the incidence rate of CRC ranks second and the mortality rate ranks fifth.The research shows that the progressive sequence of "polyp-cancer" is one of the ways of the occurrence and development of CRC,and adenomatous polyp is especially closely related to the development of CRC.At present,the main way to find colorectal polyps is colonoscopy.Polypdetectionrate(PDR)and Adenomadetectionrate(ADR)are effective indicators to evaluate the quality of colonoscopy.However,colonoscopy is a multi-factor process.At present,many international clinical standards are summarized to regulate colonoscopy.One of the most important standards is that the withdrawal time of colonoscopy is no less than 6 minutes.However,this process is rarely mentioned in the entry stage.As the initial observation in colonoscopy,the stage of entry stage is irreplaceable in colonoscopy,because its operation methods(such as rotation angle)are different from those of colonoscopy.ObjectiveTo analyze the relationship between the length of colonoscopy insertion time and the detection rate of colorectal polyps/adenomatous polyps when the colonoscopy withdrawal time is qualified.MethodsThe patients who were hospitalized in Huaihe Hospital of Henan University from January 1,2021 to January 31,2022 and successfully completed painless colonoscopy were taken as the research objects.The general data(age,sex,height,weight)of the patients and the imaging data during colonoscopy were collected.At the same time,whether polyps were found during the examination,the pathological nature and the location of polyps were counted.Analyze whether the time of entering the mirror is a risk factor to predict the PDR/ADR of patients,and analyze the influence of different time ranges of entering the mirror on the PDR/ADR of patients.Then,make a chi-square analysis comparison with the traditional patients with qualified single withdrawal time,compare whether there is any difference in PDR/ADR between the two groups,and find out the time range of entering the mirror when the PDR/ADR is the highest.SPSS26.0software was used for statistical analysis.The measurement data were expressed as mean standard deviation(s),and the counting data were expressed as rate or percentage(%).Chi-square analysis was used for comparison between groups,and the difference was statistically significant when P < 0.05.Logistic regression was carried out on whether polyps and adenomas were detected or not,with the statistical significance of single factor index analysis as independent variables.Results1.A total of 400 patients were collected,including 208 male patients(52.00%)and 192 female patients(48.00%),aged from 18 to 86 years old,with an average age of 54.50 ±13.48 years.Through univariate and multivariate analysis,it was found that compared with female patients,age < 50 years old,entry time > 10 minutes,BMI < 28kg/m2 patients,male,age ≥ 50 years old,entry time ≤ 10 minutes,BMI≥ 28 kg/m2 patients had higher PDR/ADR.2.The comparison of PDR and ADR between patients with lens withdrawal time of 6-10 minutes and lens entry time of less than or equal to 10 minutes(experimental group)and patients with single lens withdrawal time of 6-10 minutes(control group)showed that the PDR and ADR of patients in experimental group(60.89%)and ADR(49.60%)were higher than those in control group(51.33%).Then,the patients with less than or equal to 10 minutes of exposure time were divided into groups at 1 minute intervals,and the PDR and ADR of each group were compared.The comparison results showed that there was no statistical significance(P values were 0.086 and 0.107 respectively).Then,the groups were divided at2-minute intervals,and the PDR and ADR of each group were compared.The comparison results showed that there was statistical significance between the groups(P values were 0.034 and 0.037,respectively).Further multiple comparative analysis showed that the PDR/ADR of the patients was the highest when the lens-in time was 7-10 minutes.3.Comparing the detection rate of colon polyps in different endoscopic time ranges,the results show that the PDR of colon polyps in the best endoscopic time range is higher than that in other endoscopic time ranges,and the difference is statistically significant(P < 0.05).Conclusion1.Male,age ≥50 years old,insertion time ≤10 minutes,BMI≥28kg/m2 are independent risk factors for predicting PDR/ADR.2.Endoscopists should pay more attention to the entry stage.On the basis of 6-10 minutes withdrawal time,PDR/ADR can be further improved when the insertion time is 7-10 minutes.3.PDR of each segment of colon is higher in the best insertion time than in other time ranges.