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Sherif Naguib M, Khairy A, Shehab H, Abosheaishaa H, Meguid Kassem A. The impact of EndoCuff-assisted colonoscopy on the polyp detection rate: A cross-over randomized back-to-back study. Arab J Gastroenterol 2024; 25:102-108. [PMID: 38418285 DOI: 10.1016/j.ajg.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/29/2023] [Accepted: 11/28/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND STUDY AIMS Colorectal cancer (CRC) is one of the most common cancers worldwide, and most CRCs develop from polyps with malignant potential. We aimed to study the difference in polyp detection rate between EndoCuff-assisted colonoscopies (EAC) and standard colonoscopy (SC). PATIENTS AND METHODS This study was conducted at Cairo University Hospitals on patients referred for screening or diagnostic colonoscopy from July 2018 to August 2020. All included patients underwent back-to-back standard colonoscopy (SC) and ENDOCUFF VISION-assisted colonoscopies (EAC). RESULTS 214 patients were included in this study. In comparison between EAC and SC, EAC increased the polyp detection rate (69 (32.24 %) vs. 57(26.64 %) (p < 0.05), EAC increased the detection of diminutive polyps ≤ 5 mm (104 vs. 81) (p < 0.05), and small polyps 6-9 mm (12 vs. 10) while there was no difference in large polyps ≥ 10 mm. EAC increased the adenoma detection rate (ADR) (37 (17.2 %) vs. 32(14.9 %) (p < 0.05). The findings detected by EAC shortened the interval of surveillance determined by SC findings. EndoCuff caused six mucosal erosions (2.8 %) in patients. CONCLUSION EAC increases the number of detected colonic polyps, primarily small polyps on the left and right sides of the colon.
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Affiliation(s)
- Mohammed Sherif Naguib
- Gastrointestinal Endoscopy and Liver Unit, Faculty of Medicine Cairo University, Cairo, Egypt
| | - Ahmed Khairy
- Gastrointestinal Endoscopy and Liver Unit, Faculty of Medicine Cairo University, Cairo, Egypt; Gastroenterology Division, Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Hany Shehab
- Gastrointestinal Endoscopy and Liver Unit, Faculty of Medicine Cairo University, Cairo, Egypt; Gastroenterology Division, Endemic Medicine Department, Cairo University, Cairo, Egypt
| | - Hazem Abosheaishaa
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, NYC Health + Hospitals Queens, NY, USA.
| | - Abdel Meguid Kassem
- Gastrointestinal Endoscopy and Liver Unit, Faculty of Medicine Cairo University, Cairo, Egypt; Gastroenterology Division, Endemic Medicine Department, Cairo University, Cairo, Egypt
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Li Y, Meng F, Cao R, Gao C, Su D, Wang K, Han J, Qi X. Excellent Bowel Preparation Quality Is Not Superior to Good Bowel Preparation Quality for Improving Adenoma/Polyp Detection Rate. Clin Med Insights Oncol 2024; 18:11795549241229190. [PMID: 38332773 PMCID: PMC10851725 DOI: 10.1177/11795549241229190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Background Adequate bowel preparation quality is essential for high-quality colonoscopy according to the current guidelines. However, the excellent effect of bowel preparation on adenoma/polyp detection rate (ADR/PDR) remained controversial. Methods During the period from December 2020 to August 2022, a total of 1566 consecutive patients underwent colonoscopy by an endoscopist. Their medical records were reviewed. According to the Boston bowel preparation scale, patients were divided into excellent, good, and poor bowel preparation quality groups. ADR/PDR, diminutive ADR/PDR, small ADR/PDR, intermediate ADR/PDR, large ADR/PDR, and number of adenomas/polyps were compared among them. Logistic regression analyses were performed to identify the factors that were significantly associated with ADR/PDR. Results Overall, 1232 patients were included, of whom 463, 636, and 133 were assigned to the excellent, good, and poor groups, respectively. The good group had a significantly higher ADR/PDR (63% vs 55%, P = .015) and a larger number of adenomas/polyps (2.5 ± 3.2 vs 2.0 ± 2.8, P = .030) than the poor group. Both ADR/PDR (63% vs 55%, P = .097) and number of adenomas/polyps (2.2 ± 2.8 vs 2.0 ± 2.8, P = .219) were not significantly different between excellent and poor groups. The excellent (9% vs 4%, P = .045) and good (9% vs 4%, P = .040) groups had a significantly higher intermediate ADR/PDR than the poor group. Logistic regression analyses showed that either good (odds ratio [OR] = 1.786, 95% CI = 1.046-3.047, P = .034) or excellent (OR = 2.179, 95% CI = 1.241-3.826, P = .007) bowel preparation quality was independently associated with a higher ADR/PDR compared with poor bowel preparation quality. Excellent (OR = 1.202, 95% CI = 0.848-1.704, P = .302) bowel preparation quality was not independently associated with a higher ADR/PDR compared with good bowel preparation quality. Conclusions The pursuit of excellence in bowel preparation does not show an association with increased ADR/PDR and number of adenomas/polyps compared with a good level. In addition, our study further contributes to the existing evidence that poor bowel preparation compromises ADR/PDR and number of adenomas/polyps.
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Affiliation(s)
- Yingchao Li
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Fanjun Meng
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Rongrong Cao
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Cong Gao
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Dongshuai Su
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Ke Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Jie Han
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
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Wang CL, Zhao ZY, Wu JY, Yan FH, Yuan J, Xing JJ, Wang H, Yu ED. Efficacy of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy: A prospective, randomized, pilot trial. Medicine (Baltimore) 2023; 102:e34806. [PMID: 37653767 PMCID: PMC10470795 DOI: 10.1097/md.0000000000034806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Although colonoscopic retroflexion has been proved effective in reducing missed adenomas, there is still a lack of comprehensive and in-depth research focused on the ascending colon. We aimed to conduct a randomized controlled trial and tandem colonoscopy to investigate whether cecal retroflexion observed during colonoscopy can reduce missed adenomas in the ascending colon. METHODS Men and women required to be between 45 and 80 years of age were screened for enrollment in the trial. Patients were randomly assigned according to a 1:1 ratio to either the trial group or control group. Patients in the trial group underwent 2 forward examination and a cecal retroflexion observed in the ascending colon, while patients in the control group underwent only 2 forward examinations in the ascending colon. The primary outcome was adenoma miss rate. The secondary outcomes contained adenoma detection rate, polyp miss rate, polyp detection rate, insertion time and withdrawal time. Differences between groups in the primary outcome and in the other categorical indicators were tested using chi-squared test and Fisher exact test. For the comparison of continuous outcomes, the Student t test was applied. RESULTS A total of 60 subjects were eligible for the study between April to June 2020, of which 55 were randomized and eligible for analysis (26 to the control group and 29 to the trial group). The characteristics of patients were no significant differences statistically between the trial group and the control group. Similarly, the characteristics of the colonoscopy procedures included cecal insertion distance, the length of cecum and ascending colon, insertion time, withdrawal time, quality of bowel preparation, numerical rating scale for pain, polyps detected, and adenomas detected, and there were no significant differences statistically between the 2 groups (P = .864, P = .754, P = .700, P = .974, P = .585, P = .835, P = .373, P = .489). The characteristics of the polyps were also no significant differences statistically between the 2 groups. CONCLUSION This pilot trial failed to show benefit of cecal retroflexion observed on adenoma missing of ascending colon during colonoscopy; however, further conclusions require a prospective study with a higher level of evidence. (NCT03355443).
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Affiliation(s)
- Cheng-Long Wang
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
- Department of Gastroenterology and GI Endoscopy Center, Xiamen University Affiliated Chenggong Hospital (Chinese PLA 73rd Army Corps Hospital), Xiamen, Fujian, China
| | - Zi-Ye Zhao
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - Jia-Yi Wu
- Department of Civil Engineering and Architecture, Jinhua Open University, Jinhua, Zhejiang, China
| | - Fei-Hu Yan
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - Jie Yuan
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - Jun-Jie Xing
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - Hao Wang
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
| | - En-Da Yu
- Department of Colorectal Surgery and GI Endoscopy Center, Naval Medical University First Affiliated Hospital (Changhai Hospital), Shanghai, China
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Kawanishi K, Maekita T, Ikeda Y, Furotani M, Tsuboi S, Kanno T, Niwa T, Nagaoka T, Tabata Y, Hatamaru K, Iguchi M, Kitano M. Oral indigo carmine for the detection of colon adenoma. Scand J Gastroenterol 2021; 56:351-355. [PMID: 33378628 DOI: 10.1080/00365521.2020.1867897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Colonoscopy is currently considered the optimal method to detect colorectal neoplasia; however, some adenomas remain undetected. While indigo carmine staining with a dye-spray catheter has demonstrated promising results for reducing the miss rate, we investigated the oral indigo carmine method. The aim of this study was to determine whether oral indigo carmine intake before standard colonoscopy increases the adenoma (and adenocarcinoma) detection rate (ADR) or the mean number of adenomas per patient (MAP). MATERIALS AND METHODS The oral indigo carmine method was performed from April 2018 to July 2020 in two hospitals. Data were collected in a prospective manner and compared to the conventional group whose data were collected retrospectively and consecutively from January 2016 to March 2018. All data were anonymized. RESULTS Among the 704 patients included, colonoscopies were completely performed in 693 patients (347 in the indigo group). The ADR did not significantly differ between the groups: 42.3% vs. 40.3% (indigo vs. conventional group; odds ratio: 1.13; 95% confidence interval: 0.9-1.33, p = .33). The MAP was significantly greater in the indigo group (1.15) than that in the conventional group (0.82; p = .009). The cecal intubation rate and time to cecal intubation did not differ between the indigo and conventional group (98.6% vs. 98.3%, p = .83, and 6.2 min vs. 5.9 min, p = .39, respectively). CONCLUSION The routine use of oral indigo carmine does not lead to a higher ADR despite the higher MAP.
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Affiliation(s)
- Koki Kawanishi
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Takao Maekita
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Yoshifumi Ikeda
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Masahiko Furotani
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Sayaka Tsuboi
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Takayuki Kanno
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Toru Niwa
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Tsunehiro Nagaoka
- Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan
| | - Yoshinari Tabata
- Department of General Surgery, Wakayama Seikyo Hospital, Wakayama City, Wakayama, Japan
| | - Keiichi Hatamaru
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
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Floer M, Tschaikowski L, Schepke M, Kempinski R, Neubauer K, Poniewierka E, Kunsch S, Ameis D, Heinzow HS, Auer A, Schmidt HH, Ellenrieder V, Meister T. Standard versus Endocuff versus cap-assisted colonoscopy for adenoma detection: A randomised controlled clinical trial. United European Gastroenterol J 2021; 9:443-450. [PMID: 33349200 PMCID: PMC8259258 DOI: 10.1177/2050640620982952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022] Open
Abstract
Background and aims Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three‐armed randomised controlled clinical trial aimed at comparing a head‐to‐head setting standard colonoscopy (SC) with Endocuff‐assisted colonoscopy (EC) and cap‐assisted colonoscopy (CAC) for improvement of ADR. Methods Patients from Poland and Germany with independent indication for colonoscopy were randomised into three arms of this trial: EC, CAC and SC. Exclusion criteria were age <18 years, active Crohn's disease or ulcerative colitis, known stenosis and post‐colonic resection status. Results A total of 585 patients (195 SC, 189 EC and 186 CAC) were enrolled in this study. Indications were not different between the groups (colorectal cancer screening 51%, diagnostic colonoscopy in 31% and post‐polypectomy follow‐up in 18%; p = 0.94). Withdrawal time was a mean of 7 min in all groups (p = 0.658), and bowel preparation did not differ between the groups. The time to reach the caecum was significantly reduced when using the cap (a mean of 6 min for CAC vs. 7 min for SC; p = 0.0001). There was no significant difference in the primary outcome of the ADR between the groups (EC 32%, CAC 30%, SC 30%; p = 0.815). EC proved to be superior (EC vs. SC) in the sigmoid colon and transverse colon for polyp detection. Conclusion The use of EC increased the total number of polyps seen during colonoscopy. In contrast to recent studies, no significant improvement of the ADR was detected.
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Affiliation(s)
- Martin Floer
- Department of Medicine 1, Klinikum Ibbenbueren, Teaching Hospital University of Muenster, Münster, Germany.,Department of Medicine 2, Helios Albert-Schweitzer-Klinik Northeim, Teaching Hospital University Goettingen, Northeim, Germany
| | - Laura Tschaikowski
- Department of Medicine 2, Helios Albert-Schweitzer-Klinik Northeim, Teaching Hospital University Goettingen, Northeim, Germany
| | - Michael Schepke
- Department of Gastroenterology, Helios Klinikum Siegburg, Siegburg, Germany
| | - Radoslaw Kempinski
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Neubauer
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Elzbieta Poniewierka
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Steffen Kunsch
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Centre Goettingen, Goettingen, Germany
| | - Detlev Ameis
- Department of Gastroenterology, Helios Hospital Helmstedt, Helmstedt, Germany
| | | | - Agneta Auer
- Department of Medicine 1, Klinikum Ibbenbueren, Teaching Hospital University of Muenster, Münster, Germany.,Department of Medicine 2, Helios Albert-Schweitzer-Klinik Northeim, Teaching Hospital University Goettingen, Northeim, Germany
| | - Hartmut H Schmidt
- Department of Medicine B, University Hospital Muenster, Muenster, Germany
| | - Volker Ellenrieder
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Centre Goettingen, Goettingen, Germany
| | - Tobias Meister
- Department of Medicine 1, Klinikum Ibbenbueren, Teaching Hospital University of Muenster, Münster, Germany.,Department of Medicine 2, Helios Albert-Schweitzer-Klinik Northeim, Teaching Hospital University Goettingen, Northeim, Germany
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Cavicchi M, Tharsis G, Burtin P, Cattan P, Venezia F, Tordjman G, Gillet A, Samama J, Nahon-Uzan K, Karsenti D. Difference in Physician- and Patient-Dependent Factors Contributing to Adenoma Detection Rate and Serrated Polyp Detection Rate. Dig Dis Sci 2019; 64:3579-3588. [PMID: 31471862 DOI: 10.1007/s10620-019-05808-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adenoma detection rate (ADR) is correlated with the risk of interval colorectal cancer and is considered as a quality benchmark for colonoscopy. Serrated polyp detection rate (SPDR) might be a more stringent indicator of quality in polyp detection. AIMS To evaluate in a 2-year monocentric observational study patient-dependent and endoscopist-dependent factors influencing ADR and SPDR in daily practice. METHODS We determined ADR and SPDR. We collected patient-dependent factors and endoscopist-dependent factors. Links between these data and detection rates were assessed by uni- and multivariate analysis. RESULTS A total of 11682 colonoscopies were performed (female: 54.3%; male: 45.7%; median age 58) by 30 endoscopists (female: 9; male: 21). ADR and SPDR were 29.2% and 8%, respectively. In multivariate analysis, ADR was associated with patient-dependent factors: age (OR 1.044, CI 95% 1.040-1.048), male gender (OR 1.7, CI 95% 1.56-1.85), personal history of polyp/cancer (OR 1.53, CI 95% 1.3-1.9), and positive fecal immunochemical test (OR 2.47, CI 95% 2.0-3.1). In multivariate analysis, SPDR was associated with withdrawal time (OR 1.25, CI 95% 1.17-1.32), low volume activity (OR 1.3, CI 95% 1.1-1.52), and personal history of polyp/cancer (OR 1.61, CI 95% 1.15-2.25). CONCLUSION In this large series of routine colonoscopies, we found that ADR was mainly driven by patient-dependent conditions, i.e., age, male gender, colonoscopy indication for positive FIT, and a personal history of polyp or cancer. In contrast, SPDR was mainly related to endoscopist-dependent factor, i.e., withdrawal time and low volume activity.
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Affiliation(s)
- Maryan Cavicchi
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France.
| | - Gaëlle Tharsis
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Pascal Burtin
- Gastroenterology Unit, Gustave Roussy, 114, Rue Edouard-Vaillant, 94805, Villejuif Cedex, France
| | - Philippe Cattan
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Franck Venezia
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Gilles Tordjman
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Agnès Gillet
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Joëlle Samama
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - Karine Nahon-Uzan
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
| | - David Karsenti
- Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France
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Jian HX, Feng BC, Zhang Y, Qu JY, Li YY, Zuo XL. EndoCuff-assisted colonoscopy could improve adenoma detection rate: A meta-analysis of randomized controlled trials. J Dig Dis 2019; 20:578-588. [PMID: 31429214 DOI: 10.1111/1751-2980.12814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 08/08/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This meta-analysis aimed to evaluate whether EndoCuff-assisted colonoscopy (EAC) could improve adenoma detection rate (ADR) compared with standard colonoscopy (SC). METHODS PubMed, EMBASE, Scopus, Cochrane Library, and Google Scholar databases were searched for articles published up to March 2019. All pure randomized controlled trials comparing ADR between EAC and SC groups were included. Dichotomous data were pooled to obtain the odds ratio with a 95% confidence interval (CI), whereas continuous data were pooled using a mean difference with 95% CI. Review Manager Version 5.3 was used for data analysis. RESULTS Thirteen randomized controlled trials consisting of 9038 patients (EAC: 4574; SC: 4464) were included. The EAC group showed significant superiority over the SC group in ADR (odds ratio 1.37, 95% CI 1.15-1.62). However, there were no differences between the EAC and SC groups in adverse events, cecal intubation rate, and cecal intubation time. CONCLUSIONS EAC could significantly improve ADR without increasing adverse events, especially for operators with low ADRs. In addition, no significant difference was observed in cecal intubation time and cecal intubation rate between EAC and SC.
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Affiliation(s)
- Hai Xu Jian
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Bing Cheng Feng
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Yan Zhang
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Jun Yan Qu
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Yue Yue Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Xiu Li Zuo
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
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8
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León Moreno JF. ADR evaluation of screening colonoscopies during 2016 - 2017 in a private health clinic in Peru. Endosc Int Open 2018; 6:E1304-E1309. [PMID: 30410949 PMCID: PMC6221814 DOI: 10.1055/a-0672-1045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/14/2018] [Indexed: 11/03/2022] Open
Abstract
Background and study aims High-quality colonoscopy is fundamental for preventing colorectal cancer (CRC). The adenoma detection rate (ADR) is a key colonoscopy quality measure. The aim of this study was to establish the screening colonoscopy ADR of a tertiary referral center in Peru, identify the relationship between the ADR and patient age, sex and the colonoscopist, and determine the endoscopic and histopathological characteristics of the lesions found. Patients and methods A retrospective observational longitudinal study was undertaken between January 2016 and June 2017. Results Eight colonoscopists performed screening colonoscopies on 620 patients scoring ≥ 6 points on the Boston Bowel Preparation Scale (BBPS); cecal intubation was complete in 595 patients (cecal intubation rate [CIR] 95.9 %). The overall ADR was 29.7 % (females 25.4 %, males 33.1 %, P = 0.040, 95 %Cl). The ADR colonoscopist range was 25.0 % to 34.4 %. The highest ADR (41.2 %, P = 0.013, 95 %Cl) was for patients aged 65 to 75 years. Adenoma colon locations were: left 49 %, transverse 21.6 % and right 29.4 %. Adenoma dysplasia grades: low 98 %, high 2 %. Sixty-three percent of the lesions were 5 mm to 10 mm. Resections performed: 78.5 % cold biopsy forceps (CBF), 3.4 % cold snare polypectomy (CSP) and 18.1 % endoscopic mucosal resection (EMR). Conclusions The ADR established was in line with the joint American College of Gastroenterology (ACG)/American Society for Gastrointestinal Endoscopy (ASGE) recommendations and related to patient age and gender but not to the colonoscopist. Colonoscopists should ensure rigorous application of the colonoscopy quality actions. ADR should be evaluated frequently.
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Affiliation(s)
- Julio F. León Moreno
- Instituto de Enfermedades Digestivas, Department of Gastroenterology, Clínica Internacional, Lima, Perú
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9
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Kato M, Kubosawa Y, Hiarai Y, Abe K, Hirata T, Takada Y, Wada M, Takatori Y, Kinoshita S, Takabayashi K, Kikuchi M, Ohishi T, Uraoka T. Usefulness of Mean Corpuscular Volume for Detection of Advanced Colorectal Cancer in Patients Older than 85 Years. Digestion 2018; 97:177-182. [PMID: 29320764 DOI: 10.1159/000485378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/14/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS The aim of this study was to elucidate clinical indicators for the detection of advanced colorectal cancer (ACRC). METHODS This was a retrospective study conducted at a tertiary hospital. This study included 333 patients older than 85 years who underwent colonoscopy from April 2006 to May 2010. The detection rate of ACRC was assessed. Then, we analyzed the association between the detection of ACRC and various background factors including mean corpuscular volume (MCV). We also analyzed the cumulative overall survival of patients with detected ACRC. RESULTS ACRC was found in 37 patients, resulting in a detection rate of 15%. Multivariate logistic regression analysis revealed that a decreased MCV was an independent predictor for the detection of ACRC (OR 0.88, 95% CI 0.84-0.94), whereas symptoms such as abdominal pain, hematochezia, or anemia were not independent predictors. MCV was an independent predictor irrespective of the location of the tumor. The cumulative survival rates at 3 and 5 years after diagnosis were 78 and 58%, respectively, during a median observational period of 30.3 months. CONCLUSION This study demonstrated the usefulness of MCV as an indicator of the necessity of colonoscopy for older patients.
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Affiliation(s)
- Motohiko Kato
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yoko Kubosawa
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yuichiro Hiarai
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Keiichiro Abe
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Tetsu Hirata
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yoshiaki Takada
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Michiko Wada
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yusaku Takatori
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Satoshi Kinoshita
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kaoru Takabayashi
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Masahiro Kikuchi
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takashi Ohishi
- Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Toshio Uraoka
- Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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10
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Castaneda D, Popov VB, Verheyen E, Wander P, Gross SA. New technologies improve adenoma detection rate, adenoma miss rate, and polyp detection rate: a systematic review and meta-analysis. Gastrointest Endosc 2018; 88:209-222.e11. [PMID: 29614263 DOI: 10.1016/j.gie.2018.03.022] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 03/25/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The need to increase the adenoma detection rate (ADR) for colorectal cancer screening has ushered in devices that mechanically or optically improve conventional colonoscopy. Recently, new technology devices (NTDs) have become available. We aimed to compare the ADR, polyp detection rate (PDR), and adenoma miss rate (AMR) between NTDs and conventional colonoscopy and between mechanical and optical NTDs. METHODS MEDLINE and Embase databases were searched from inception through September 2017 for articles or abstracts reporting ADR, PDR, and AMR with NTDs. Randomized controlled trials and case-control studies with >10 subjects were included. Primary outcomes included ADR, PDR, and AMR odds ratio (OR) between conventional colonoscopy and NTDs. Secondary outcomes included cecal intubation rates, adverse events, cecal intubation time, and total colonoscopy time. RESULTS From 141 citations, 45 studies with 20,887 subjects were eligible for ≥1 analyses. Overall, the ORs for ADR (1.35; 95% confidence interval [CI] 1.24-1.47; P < .01) and PDR (1.51; 95% CI, 1.37-1.67; P < .01) were higher with NTDs. Higher ADR (OR, 1.52 vs 1.25; P = .035) and PDR (OR, 1.63 vs 1.10; P ≤ .01) were observed with mechanical NTDs. The overall AMR with NTDs was lower compared with conventional colonoscopy (OR, .19; 95% CI, .14-.26; P < .01). Mechanical NTDs had lower AMRs compared with optical NTDs (OR, .10 vs .33; P < .01). No differences in cecal intubation rates, cecal intubation time, or total colonoscopy time were found. CONCLUSIONS Newer endoscopic technologies are an effective option to improve ADR and PDR and decrease AMR, particularly with mechanical NTDs. No differences in operability and safety were found.
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Affiliation(s)
- Daniel Castaneda
- Department of Medicine, Mount Sinai St. Luke's-West Hospitals, Icahn School of Medicine, New York, New York, USA
| | - Violeta B Popov
- Division of Gastroenterology, New York VA Harbor Healthcare, NYU School of Medicine, New York, New York, USA
| | - Elijah Verheyen
- Department of Medicine, Mount Sinai St. Luke's-West Hospitals, Icahn School of Medicine, New York, New York, USA
| | - Praneet Wander
- Department of Gastroenterology, Northshore Long Island Jewish Hospital, New York, New York, USA
| | - Seth A Gross
- Clinical Care and Quality, Division of Gastroenterology, NYU Langone Health, NYU School of Medicine, New York, New York, USA
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11
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Facciorusso A, Del Prete V, Buccino V, Valle ND, Nacchiero MC, Muscatiello N. Full-spectrum versus standard colonoscopy for improving polyp detection rate: A systematic review and meta-analysis. J Gastroenterol Hepatol 2018; 33:340-346. [PMID: 28675478 DOI: 10.1111/jgh.13859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/13/2017] [Accepted: 06/28/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIM Full-spectrum endoscopy represents a new endoscopic platform allowing a panoramic 330 degree view of the colon, but evidence of its superiority over standard colonoscopy is still lacking. Our study is the first meta-analysis comparing the efficacy of full-spectrum endoscopy with standard colonoscopy. METHODS Through a systematic literature review until May 2017, we identified eight randomized-controlled trials. Primary outcomes were polyp detection rate and adenoma detection rate, while cecal intubation time and total colonoscopy time were secondary outcomes. Direct meta-analysis was performed using a random effects model. RESULTS No difference in terms of polyp detection rate and adenoma detection rate was found (risk ratio: 1.00, 95% confidence interval 0.89-1.12, P = 0.96, and 1.05, 0.94-1.17, P = 0.40, respectively). Adenoma miss rate resulted significantly in favor of full-spectrum endoscopy (risk ratio: 0.35, 0.25-0.48, P < 0.01), although the difference was not significant for greater (>5 mm) and pedunculated lesions (risk ratio: 0.38, 0.09-1.60, P = 0.19, and risk ratio: 0.15, 0.01-3.00, P = 0.21, respectively). Cecal intubation time was not different between the two techniques (mean standardized difference: 0.22 min, -1.18 to 1.62, P = 0.76), while total colonoscopy time was significantly shorter when adopting full-spectrum endoscopy (mean difference: -2.60, -4.60 to -0.61, P = 0.01). Sensitivity analysis confirmed all the findings. CONCLUSIONS Full-spectrum endoscopy appears as a promising and reliable technology able to significantly decrease the number of adenomas missed and procedural times, while its superiority over standard colonoscopy in terms of adenoma detection rate results is still unclear.
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Affiliation(s)
- Antonio Facciorusso
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Valentina Del Prete
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Buccino
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Nicola Della Valle
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | | | - Nicola Muscatiello
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
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12
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Skay A, Van Dam J. Advanced endoscopic imaging: Polyps and dysplasia detection. SEMINARS IN COLON AND RECTAL SURGERY 2017. [DOI: 10.1053/j.scrs.2016.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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