Analysis Of The Related Factors Of The Missed Diagnosis Of Colorectal Polyps

Objective:Through the statistics of all the patients who underwent electron colonoscopy in our hospital,we selected patients who had two colonoscopies in 120days and found polyps.Misdiagnosis and record test results,two polyps,statistical intestinal cleanliness,misdiagnosis and polyp size,number,location and pathologic types and polyp endoscopic features,analyze the related factors lead to misdiagnosis and colorectal polyps.To provide the basis for future clinical examination and treatment,avoid or reduce the influence of these misdiagnosis factors,reduce the rate of missed diagnosis,and reduce the patient’s physical pain and financial burden.Results:1.In 120 days twice a colonoscopy and find polyps in patients with a total of157 people,including 109 male patients（69.4%）,48 female patients（30.6%）,about 26-78-year-old age range,mean age about 56.2±11.2years old.About 1.2%of patients have a family history.In the first colonoscopy,346 polyps were found,89 were treated with endoscopic polyps,and 354 polyps were found in the second examination.There were 52 missed patients.The number of missed polyps was 97,the base polyp was 443,the diagnosis rate of polyp was 21.9%,and the diagnosis rate was 35.7%.2.The diagnosis rate of colorectal polyp and the size of polyp(X²⁼0.232,P<0.05)、the shape of colorectal polyp(X²⁼0.178,P<0.05),number of basic polyps(X²⁼0.207,P<0.05)and intestinal cleanliness(X²⁼0.303,P<0.05)have a correlation.The number of polyps less than 5mm in diameter was 187,and the missed diagnosis rate was 25.7%.The diagnosis rate of polyps with diameter of 5mm to 10mm was 18.8%.The diagnosis rate of polyps with diameter greater than 10mm was 11.3%.The diagnosis rate of polyps with diameter greater than 10mm was 11.3%.The rate of（Ip）missed diagnosis is 9.5%.The rate of（Isp）missed diagnosis was 17.4%.Untethered polyp（Is type）missed diagnosis rate of 29.4%.Superficial uplift（IIa）missed diagnosis rate was 16.7%.The number of basal polyps was 1² and the missed diagnosis rate was 12.3%.The number of basal polyps was 3⁴ and the rate of missed diagnosis was 26.7%.The number of basal polyps 5 was 33.3%.The missed diagnosis rate of patients in the level I group was 25%.The missed diagnosis rate of patients in the clean grade II group was 40.4%.Clean grade III group,the patient missed diagnosis rate is 61.5%.3.The diagnosis rate of polyp between the position of polyp(X²⁼0.107,P>0.05)、pathological types(X²⁼0.101,P>0.05)was no correlation.The leakage rate of polyps in the rectum was 22.1%.The missed diagnosis rate of sigmoid colon polyp was 22.4%.The number of polyps in the descending colon was 28.1%.The leakage rate of polyps in the transverse colon was 18.7%.The leakage of polyps in the ascending colon was18.1%.The missed diagnosis rate located in the back blind polyp was 14.3%.The diagnosis rate of inflammatory polyp was 16.7%.The rate of the increase of polyp was17.5%.The diagnosis rate of adenomatous polyp was 26.3%.The undetected polyp and serrated adenoma of the hamartoma were not found.Conclusion:1.A certain percentage of colorectal polyp was missed during the colonoscopy.2.The diagnosis rate of colorectal polyp is related to polyp size,polyp morphology,number of basal polyps and intestinal cleanliness.However,the location and pathological type of polyp were not correlated,and it was not a risk factor for polyp missed diagnosis.The smaller the polyp,the more basic polyp,the higher the intestinal cleanliness,the higher the rate of missed diagnosis,and the highest rate of missed diagnosis.3.In this study,the diagnosis rate of polyp was not related to the location of polyps and pathological types.Discrepancies with other studies may be related to small sample size and other factors.