The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
ObjectiveTo systematically evaluate the effectiveness and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 studies were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95% CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95% CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95% CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95% CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤ 5mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased; The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The computer-aided detection system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.