Bevezetés: Magyarországon 2019-ben indult az 50–70 éves populáció körében a kétlépcsős vastagbélszűrő program, melynek célja a colorectalis carcinoma kialakulásának megelőzése. Célkitűzés: Kutatásunk célja volt a Szegedi Tudományegyetemen és a Bács-Kiskun Vármegyei Oktatókórházban a szűrőprogram keretein belül végzett kolonoszkópiák minőségi mutatóinak és kimeneteli indikátorainak, valamint a betegbiztonságnak a vizsgálata a magyar szakmai ajánlás tükrében. Módszerek: Intervencióval nem járó, obszervációs kohorszvizsgálatunkban az adatgyűjtés során felhasználtuk a Nemzeti Népegészségügyi és Gyógyszerészeti Központ által működtetett regiszter prospektív adatait, melyeket retrospektíven kiegészítettünk az egészségügyi nyilvántartási rendszer segítségével. Eredmények: Összesen 1739 szűrő kolonoszkópiára (átlagéletkor 62,36 ± 5,86 év, férfiarány 56,81%) került sor 97,07%-os coecumintubációs arány mellett. A béltisztaság az esetek 90,28%-ában megfelelő volt, ezen belül az esetek 63,31%-ában kiváló. Az eszközvisszahúzási időről 1397 komplett kolonoszkópia esetén volt adat, mely 96,35%-ban meghaladta az irányelv által javasolt 6 percet, átlagos hossza 9,51 ± 5,76 perc volt. Szedációt a páciensek 40,37%-a igényelt, melynek során 92,02%-ban midazolámot alkalmaztak. A kolonoszkópiák 62,51%-ában találtak neoplasztikus és 27,03%-ában csak nem neoplasztikus laesiót. Összesen 2879 polipot találtak 1064 páciensnél (polipfelismerési arány 61,18%), melyek közül a legrelevánsabbnak a mérete az esetek 39,38%-ában meghaladta az 1 cm-t, és 72,97%-a a bal colonfélben helyezkedett el. A páciensek 98,97%-a az index- és komplettáló kolonoszkópiák során polipmentessé vált. Adenoma 871 esetben igazolódott, ez 50,09%-os adenomafelismerési arányt jelent. Colorectalis carcinomát 80 páciensnél (4,60%) fedeztek fel. Szövődmény 10 főnél (0,58%) lépett fel, beavatkozással összefüggő halálozás nem következett be. Tisztázó gasztroszkópia a negatív eredményű kolonoszkópiák 24,08%-ában történt, ezek során 1 főnél nyelőcső-laphámcarcinoma igazolódott. Az utánkövetési időszakban 114 páciensnél (6,56%) történt ismételt kolonoszkópia, melynek során intervallum colorectalis carcinomát 1 esetben (0,06%) találtak. Következtetés: A kutatás során vizsgált két centrumban végzett szűrő kolonoszkópiák megfeleltek a magyar irányelvben meghatározott minőségi és kimeneteli mutatóknak, valamint betegbiztonsági szempontoknak. Ugyanakkor a regiszterbe történő adatbevitel és a negatív kolonoszkópiákat követő tisztázó gasztroszkópiák aránya korrekcióra szorul. Orv Hetil. 2024; 165(6): 221–231.
Introduction: The Hungarian population-based colorectal screening program was initiated in 2019 for asymptomatic individuals aged between 50 and 70, aiming to prevent the development of colorectal cancer. Objective: The study aimed to examine the quality indicators, outcome indicators, and safety of colonoscopies conducted at the University of Szeged and the Bács-Kiskun County Teaching Hospital within the context of the screening program, aligning with Hungarian professional guidelines. Methods: In this non-intervention, observational cohort study, we utilized prospectively collected data from the National Public Health Center register, supplemented retrospectively with data from the hospital information system. Results: A total of 1,739 screening colonoscopies (mean age 62.36 ± 5.86 years, male rate 56.81%) were performed with a cecum intubation rate of 97.07%. Bowel cleansing was adequate in 90.28% of cases, including excellent in 63.31% of cases. The withdrawal time was reported for 1397 complete colonoscopies, which exceeded the guideline recommended 6 minutes in 96.35% of cases, the mean duration was 9.51 ± 5.76 minutes. Sedation was required for 40.37% of patients, of which 92.02% received midazolam. Colonoscopies found neoplastic lesions in 62.51% of cases, and in 27.03% of patients only non-neoplastic lesions were seen. A total of 2,879 polyps were found in 1,064 patients (polyp detection rate 61.18%), of which the size of the most relevant polyp exceeded 1 cm in 39.38% of the cases and 72.97% of them were located in the left colon. Index and complementary colonoscopy made 98.97% of patients polyp-free. Adenoma was confirmed in 871 patients, resulting in an adenoma detection rate of 50.09%. Colorectal carcinoma was detected in 80 patients (4.60%). Complications were seen in 10 patients (0.58%) and no intervention-related deaths occurred. Clarifying gastroscopy was performed in 24.08% of the negative colonoscopies, which confirmed esophageal squamous cell carcinoma in 1 patient. In the follow-up period, 114 patients (6.56%) underwent repeated colonoscopy, with interval colorectal carcinoma in 1 patient (0.06%). Conclusion: The screening colonoscopies performed in the two centers included in the study met the quality and outcome indicators as well as patient safety criteria defined by the Hungarian guidelines. However, improvements are needed in data entry in the registry and the rate of clarifying gastroscopies following negative colonoscopies. Orv Hetil. 2024; 165(6): 221–231.
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