Τίτλος:
Lower adenoma miss rate with FUSE vsconventional colonoscopy with proximal retroflexion: A randomized back-to-back trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and study aims Full-spectrum colonoscopy (FSC) promises to increase adenoma detection by providing a wider field of view. The aim of this study was to compare adenoma miss rates of FSC with those of conventional colonoscopy complemented by right-colon re-examination using scope retroflexion (CC/R). Patients and methods At two tertiary endoscopy facilities, patients who were scheduled for colonoscopy for the assessment of symptoms or for colorectal cancer screening/surveillance were randomized (1:1) to undergo same-day, back-to-back colonoscopies (FSC or CC/R first), performed by one of five endoscopists who had documented adenoma detection rates >35%. Per-protocol data were analyzed. Results We randomized 220 patients. There were five FSC technical failures (three air pump and two left screen); therefore, 107 and 108 cases were analyzed in the FSC and CC/R index procedure arms, respectively. Withdrawal times were similar for FSC and CC/R (7.7 minutes vs. 7.6 minutes). Overall, we detected 3 cancers and 153 adenomas (FSC=92; CC/R=61); 81 were detected in the proximal colon, 3 of which were detected by retroflexed examination. By per-lesion analysis, FSC showed a significantly lower adenoma miss rate compared with CC/R overall (10.9% [95% confidence interval (CI) 3.8 to 18.1] vs. 33.7% [95%CI 23.4 to 44.1]) and in the proximal colon (13.9% [95%CI 2.6 to 25.2] vs. 42.2% [95%CI 27.8 to 56.7]). The advanced adenoma miss rate was lower with FSC overall (4.3% [95%CI-4.0 to 12.7] vs. 25.9% [95%CI 9.4 to 42.5]). There were no adverse events. Conclusions FSC outperformed conventional colonoscopy with right-colon scope retroflexion in the detection of missed adenomas, both overall and in the proximal colon, even when performed by experienced endoscopists. Trial registered at ClinicalTrials.gov (NCT02117674). © 2017 Published by Elsevier B.V.
Συγγραφείς:
Papanikolaou, I.S.
Apostolopoulos, P.
Tziatzios, G.
Vlachou, E.
Sioulas, A.D.
Polymeros, D.
Karameris, A.
Panayiotides, I.
Alexandrakis, G.
Dimitriadis, G.D.
Triantafyllou, K.
Περιοδικό:
Gastrointestinal Endoscopy
Εκδότης:
Georg Thieme Verlag
Λέξεις-κλειδιά:
adult; Article; ascending colon; colon adenoma; colon polyp; colonoscope; colonoscopy; colorectal cancer; controlled study; crossover procedure; false negative result; female; full spectrum colonoscopy; human; major clinical study; male; middle aged; polypectomy; priority journal; prospective study; randomized controlled trial; sensitivity analysis; adenoma; aged; clinical trial; colon tumor; colonoscopy; comparative study; diagnostic imaging; early cancer diagnosis; health survey; multicenter study; procedures; time factor; transverse colon, Adenoma; Aged; Colon, Ascending; Colon, Transverse; Colonic Neoplasms; Colonoscopy; Cross-Over Studies; Early Detection of Cancer; False Negative Reactions; Female; Humans; Male; Middle Aged; Population Surveillance; Prospective Studies; Time Factors
DOI:
10.1055/s-0042-124415
