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Reduced Adenoma Miss Rate with 9-Minute vs. 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial: Nine-minute WT reduces the AMR of screening colonoscopy

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Pubmed体系：
作者：
Zhao Shengbing[1] * ; Song Yihang[1] * ; Wang Shuling[1] * ; Wang Rong[2] * ; Feng Zhijie[3] * ; Gong Aixia[4] * ; Yang Xia[5] * ; Pan Peng[1] ; Yao Dongmei[3] ; Zhang Jingwen[4] ; Zhu Yaqin[5] ; Li Tao[2] ; Bi Junhua[2] ; Ren Xu[6] ; Tang Xiufen[6] ; Li Qiang[6] ; Yu Dan[6] ; Zheng Jinghua[7] ; Song Bo[7] ; Wang Ping[7] ; Chen Weigang[8] ; Shang Guochen[8] ; Xu Yanqiu[8] ; Xu Ping[9] ; Lai Yuexing[9] ; Xu Huanhai[10] ; Yang Xiaomin[10] ; Sheng Jianqiu[11] ; Tao Yurong[11] ; Li Xinghua[12] ; Zhu Yangbei[12] ; Zhang Xiaofeng[13] ; Shen Hongzhang[13] ; Ma Yingcai[14] ; Wang Fangyu[15] ; Wu Lin[15] ; Wang Xianfei[16] ; Li Zhaoshen[1,*1] ; Bai Yu[1,*1] ;
机构： [1]Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases, National Quality Control Center of Digestive Endoscopy, Shanghai,China. [2]Digestive Endoscopy Center,Shanxi Provincial People's Hospital,The Fifth Hospital of Shanxi Medical University, Taiyuan 030012, Shanxi, China [3]Department of Gastroenterology, The Second Hospital of Hebei Medical University,Hebei Medical University, Shijiazhuang 050004, Hebei, China [4]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University,Dalian Medical University, Dalian 116011, Liaoning, China [5]Department of Gastroenterology, No. 905 Hospital of People's Liberation Army Navy,Shanghai 200050, China [6]Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin 150036, Heilongjiang, China [7]Department of Gastroenterology, Yantai Shan Hospital, Yantai 264008, Shandong, China [8]Department of Gastroenterology, First Affiliated Hospital, School of Medicine,Shihezi University, Shihezi 832099, Xinjiang, China [9]Department of Gastroenterology, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai Jiaotong University, Shanghai 201699, China [10]Department of Gastroenterology, Yueqing People's Hospital, Wenzhou Medical University, Wenzhou 325699, Zhejiang [11]Department of Gastroenterology, Senior Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital [12]The Seventh Medical Center of Chinese PLA General Hospital, Beijing100010, China [12]Department of Gastroenterology, Shanghai Eighth People's Hospital, Shanghai 200235,China [13]Department of Gastroenterology, Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang, China [14]Department of Gastroenterology, Qinghai Provincial People’s Hospital, Xining 810007,Qinghai, China [15]Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, No.305 Zhongshan East Road, Nanjing 210002, Jiangsu, China [16]Digestive Endoscopy Center, Affiliated Hospital of North Sichuan Medical College,Nanchong, Sichuan 637000, China.
出处：
DOI： 10.14309/ajg.0000000000002055
ISSN：

摘要：
Although the 9-minute mean withdrawal time (m-WT) is often reported to be associated with the optimal adenoma detection rate (ADR), no randomized trials of screening colonoscopy have confirmed the impact of 9-minute m-WT on adenoma miss rate (AMR) and ADR.A multicenter tandem trial was conducted in 11 centers. 733 asymptomatic participants were randomized to receive segmental tandem screening colonoscopy with 9-minute withdrawal followed by 6-minute withdrawal (9-minute-first group, 9MF, n=366) or vice versa (6-minute-first group, 6MF, n=367). The primary outcome was the lesion-level AMR.The intention-to-treat analysis revealed that, 9MF significantly reduced the lesion-level (14.5% vs. 36.6%, P<0.001) and participant-level AMR (10.9% vs. 25.9%, P<0.001), advanced adenoma miss rate (AAMR, 5.3% vs. 46.9%, P=0.002), multiple adenomas miss rate (20.7% vs. 56.5%, P=0.01) and high-risk adenomas miss rate (HRAs, 14.6% vs. 39.5%, P=0.01) of 6MF without compromising detection efficiency (P=0.79). Additionally, a lower false-negative rate for adenomas (P=0.002) and HRAs (P<0.05), as well as a lower rate of shortening surveillance schedule (P<0.001) were also demonstrated in 9MF, accompanying with an improved ADR in the 9-minute versus 6-minute m-WT (42.3% vs. 33.5%, P=0.02). The independent inverse association between m-WT and AMR remained significant even after adjusting ADR, and meanwhile 9-minute m-WT was identified as an independent protector for AMR and AAMR.In addition to increasing ADR, 9-minute m-WT also significantly reduces the AMR and AAMR of screening colonoscopy without compromising detection efficiency.Copyright © 2022 by The American College of Gastroenterology.

基金：
This work was supported by the National Science and Technology Plan Project of the Ministry of Science and Technology of China (grant no. 2015BAI13B08). Dr. Bai Yu is supported by the National Natural Science Foundation of China (No.82170567, 81873546), the "Shu Guang" project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation (No. 19SG30, China) and 234 Discipline Climbing Plan of Changhai Hospital, Naval Medical University (No. 2019YXK004, China).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
最新[2025]版：
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
第一作者：
第一作者机构： [1]Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases, National Quality Control Center of Digestive Endoscopy, Shanghai,China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases, National Quality Control Center of Digestive Endoscopy, Shanghai,China. [*1]Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University,National Clinical Research Center for Digestive Diseases,National Quality Control Center of Digestive Endoscopy, Shanghai, China.
推荐引用方式(GB/T 7714)：
Zhao Shengbing,Song Yihang,Wang Shuling,et al.Reduced Adenoma Miss Rate with 9-Minute vs. 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial: Nine-minute WT reduces the AMR of screening colonoscopy[J].The American Journal Of Gastroenterology.2022,doi:10.14309/ajg.0000000000002055.
APA：
Zhao Shengbing,Song Yihang,Wang Shuling,Wang Rong,Feng Zhijie...&Bai Yu.(2022).Reduced Adenoma Miss Rate with 9-Minute vs. 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial: Nine-minute WT reduces the AMR of screening colonoscopy.The American Journal Of Gastroenterology,,
MLA：
Zhao Shengbing,et al."Reduced Adenoma Miss Rate with 9-Minute vs. 6-Minute Withdrawal Times for Screening Colonoscopy: A Multicenter Randomized Tandem Trial: Nine-minute WT reduces the AMR of screening colonoscopy".The American Journal Of Gastroenterology .(2022)

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