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진단결장내시경술과 내시경 폴립절제술 비교에 의한 대장용종의 간과율
송주한 외 중앙대학교 의과대학 의과학연구소 2008 中央醫大誌 Vol.33 No.1,2
Colonoscopy is an effective method for discovery of adenomas and for colon cancer screening and prevention. However, it has been difficult to assess its accuracy. We retrospectively estimated the colonoscopic miss-rate of colorectal polyp and adenoma. We studied the data from patients who had colonoscopic polypectomy within 60 days after the initial examination. From 78 patients, a total of 235 polyps were found, 37 (15.7%) of polyps and 27 (14.2%) of adenomas were missed. As the size of polyps and adenomas decreased, the miss-rate increased significantly. Pathologic findings of missed polyps revealed adenoma (73.0%), hyperplasia (24.3%), inflammation (2.7%). Adenomas with high grade dysplasia were detected in 10.8% of missed polyps. The most frequent location was cecum and transverse colon. There was no difference of missing rate according to the shape of polyp, colonopist and number of polyps detected on the initial examination. There is a significant colonoscopic missing rate for colorectal polyps in routine clinical practice, especially in patients with small colorectal polyps and at the site of the cecum and transverse colon.
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