목적: 대장내시경 회수시간은 대장내시경검사에서 폴립 발견의 중요한 질관리 지표 중 하나이다. 이번 연구에서는 대장내시경검사에서 시술자간의 폴립 발견율의 차이가 있는지를 알아보고, 이에 영향을 미치는 인자를 찾아보고자 하였다. 대상 및 방법: 한양대학교 구리병원의 전임의 2년차 7명이 시행한 대장내시경 1,515건 중 장 절제술의 기왕력이 있거나, 염증성 장질환 환자 등을 제외한 1,299건을 후향적으로 분석하였다. 대상 환자의 폴립 발견율, 대장내시경 삽입시간, 회수시간, 장 정결도, 폴립 크기, 폴립 위치 등을 조사하였다. 결과: 대장내시경을 시행한 시술자별로 분류하였을 때, 시술자간 폴립 발견율은 15∼35%로 큰 차이가 있었다. 각 군 마다 성별, 나이, 장 정결도, 폴립의 위치에 있어서 의미있는 차이는 없었다. 평균 대장내시경 삽입시간은 7.6∼12.3분으로 개인별로 차이가 있었으나, 대장내시경 삽입시간과 폴립 발견율은 관계가 없었다. 대장내시경 회수시간은 개인마다 평균 3.6±2.8분에서 7.1±2.5분까지로 차이가 있었으며, 대장내시경 회수시간과 폴립 발견율에서 의미있는 상관관계가 있었다(p＜0.001). 또한, 대장내시경 회수시간이 긴 경우에 5 mm 이하의 작은 폴립의 발견율이 높았다. 평균 대장내시경 회수시간을 6분을 기준으로 분석하였을 때 회수시간이 6분 이상인 경우 6분 미만에 비해 폴립 발견율이 의미있게 높았다(30.7% vs 18.4%, p＜ 0.001). 결론: 대장내시경검사에서 시술자간 폴립 발견율의 차이가 있었고, 대장내시경 회수시간과 폴립 발견율에는 양의 상관관계가 있었다. 대장내시경 검사에서 폴립 발견율을 높이기 위해서는 충분한 대장내시경 회수시간이 필요할 것이다.

Background/Aims: The colonoscopic withdrawal time has been proposed as a quality indicator for colonoscopy, and this is based on the recent evidence that the Colon withdrawal time is associated with adenoma detection rate. In this study, we examined the difference of the polyp detection rates between practicing endoscopists, and we analysed certain factors that might lead to such differences, and particularly the colonoscopic withdrawal time. Methods: We retrospectively evaluated the colonoscopic procedures that were performed by 7 second-year GI fellows at Hanyang University Guri Hospital. A total of 1,515 colonoscopies were assessed for the polyp detection rate, the insertion time, the withdrawal time, bowel preparation, the size of the detected polyps and the location of polyps. Results: The median withdrawal time for the case with no polyps removed was 3.6 to 7.1 minutes. There was a strong positive correlation between the colonoscopic withdrawal times and the polyp detection rates (p＜0.001). Furthermore, a longer withdrawal time resulted in discovering a higher percentage of small polyps. On comparing groups, the group of colonoscopists with a withdrawal time longer than 6 minutes had a higher rate of detecting polyps (30.7% vs 18.4%, p＜0.001). Conclusions: There is wide range of polyp detection rates among practicing colonoscopists and there is strong positive correlation between the colonoscopic withdrawal times and the rate of detecting polyps. A long enough withdrawal time, perhaps 7 minutes, is needed to raise the rate of detecting polyps during colonoscopy.

Background/Aims: The colonoscopic withdrawal time has been proposed as a quality indicator for colonoscopy, and this is based on the recent evidence that the Colon withdrawal time is associated with adenoma detection rate. In this study, we examined the difference of the polyp detection rates between practicing endoscopists, and we analysed certain factors that might lead to such differences, and particularly the colonoscopic withdrawal time. Methods: We retrospectively evaluated the colonoscopic procedures that were performed by 7 second-year GI fellows at Hanyang University Guri Hospital. A total of 1,515 colonoscopies were assessed for the polyp detection rate, the insertion time, the withdrawal time, bowel preparation, the size of the detected polyps and the location of polyps. Results: The median withdrawal time for the case with no polyps removed was 3.6 to 7.1 minutes. There was a strong positive correlation between the colonoscopic withdrawal times and the polyp detection rates (p＜0.001). Furthermore, a longer withdrawal time resulted in discovering a higher percentage of small polyps. On comparing groups, the group of colonoscopists with a withdrawal time longer than 6 minutes had a higher rate of detecting polyps (30.7% vs 18.4%, p＜0.001). Conclusions: There is wide range of polyp detection rates among practicing colonoscopists and there is strong positive correlation between the colonoscopic withdrawal times and the rate of detecting polyps. A long enough withdrawal time, perhaps 7 minutes, is needed to raise the rate of detecting polyps during colonoscopy.

Colonoscopy, Withdrawal time, Polyp detection