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Ferreira AO, Reves JB, Nascimento C, Frias-Gomes C, Costa-Santos MP, Ramos LR, Palmela C, Gloria L, Cravo M, Dinis-Ribeiro M, Canena J. Narrow Band Imaging versus White Light for the Detection of Sessile Serrated Colorectal Lesions: A Randomized Clinical Trial. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2023; 30:368-374. [PMID: 37868631 PMCID: PMC10586213 DOI: 10.1159/000526606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/14/2022] [Indexed: 10/24/2023]
Abstract
Background Colorectal cancer (CRC) is a leading cause of cancer. The detection of pre-malignant lesions by colonoscopy is associated with reduced CRC incidence and mortality. Narrow band imaging has shown promising but conflicting results for the detection of serrated lesions. Methods We performed a randomized clinical trial to compare the mean detection of serrated lesions and hyperplastic polyps ≥10 mm with NBI or high-definition white light (HD-WL) withdrawal. We also compared all sessile serrated lesions (SSLs), adenoma, and polyp prevalence and rates. Results Overall, 782 patients were randomized (WL group 392 patients; NBI group 390 patients). The average number of serrated lesions and hyperplastic polyps ≥10 mm detected per colonoscopy (primary endpoint) was similar between the HD-WL and NBI group (0.118 vs. 0.156, p = 0.44). Likewise, the adenoma detection rate (55.2% vs. 53.2%, p = 0.58) and SSL detection rate (6.8% vs. 7.5%, p = 0.502) were not different between the two study groups. Withdrawal time was higher in the NBI group (10.88 vs. 9.47 min, p = 0.004), with a statistically nonsignificant higher total procedure time (20.97 vs. 19.30 min, p = 0.052). Conclusions The routine utilization of narrow band imaging does not improve the detection of serrated class lesions or any pre-malignant lesion and increases the withdrawal time.
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Affiliation(s)
- Alexandre Oliveira Ferreira
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Joana Branco Reves
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | | | | | - Maria Pia Costa-Santos
- Department of Gastroenterology, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - Lídia Roque Ramos
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Carolina Palmela
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Luísa Gloria
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Marília Cravo
- Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal
- Department of Gastroenterology, Hospital da Luz Lisboa, Lisboa, Portugal
| | - Mário Dinis-Ribeiro
- Department of Gastroenterology, Instituto Português de Oncologia, Porto, Portugal
- Cintesis, Center for Health Technology and Services Research, Porto, Portugal
| | - Jorge Canena
- Cintesis, Center for Health Technology and Services Research, Porto, Portugal
- Department of Gastroenterology, Nova Medical School/Faculty of Medical Sciences, Lisboa, Portugal
- University Center of Gastroenterology, Hospital Cuf Tejo, Lisbon, Portugal
- Department of Gastroenterology, Professor Doutor Fernando Fonseca Hospital, Amadora, Portugal
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Díaz-Tasende J. Colonoscopy - When quality matters. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2022; 114:314-316. [PMID: 35638771 DOI: 10.17235/reed.2022.8942/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Colonoscopy technical quality is a primary determinant of clinical outcome. Unfortunately, there is enough evidence available for significant variability in endoscopists' performance. An assessment of the factors determining these differences will be crucial for designing measures to ensure effectiveness and safety in these procedures.
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