Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2018-03-09 , DOI: 10.1016/j.gie.2018.02.043 Douglas K. Rex , Alessandro Repici , Seth A. Gross , Cesare Hassan , Prasanna L. Ponugoti , Jonathan R. Garcia , Heather M. Broadley , Jack C. Thygesen , Andrew W. Sullivan , William W. Tippins , Samuel A. Main , George J. Eckert , Krishna C. Vemulapalli
Background and Aims
Devices used to improve polyp detection during colonoscopy have seldom been compared with each other.
Methods
We performed a 3-center prospective randomized trial comparing high-definition (HD) forward-viewing colonoscopy alone to HD with Endocuff to HD with EndoRings to the full spectrum endoscopy (FUSE) system. Patients were age ≥50 years and had routine indications and intact colons. The study colonoscopists were all proven high-level detectors. The primary endpoint was adenomas per colonoscopy (APC).
Results
Among 1188 patients who completed the study, APC with Endocuff (APC mean ± standard deviation: 1.82 ± 2.58), EndoRings (1.55 ± 2.42), and standard HD colonoscopy (1.53 ± 2.33) were all higher than FUSE (1.30 ± 1.96; P < .001 for APC). The APC for Endocuff was higher than standard HD colonoscopy (P = .014). Mean cecal insertion times with FUSE (468 ± 311 seconds) and EndoRings (403 ± 263 seconds) were both longer than with Endocuff (354 ± 216 seconds; P = .006 and .018, respectively).
Conclusions
For high-level detectors at colonoscopy, forward-viewing HD instruments dominate the FUSE system, indicating that for these examiners image resolution trumps angle of view. Further, Endocuff is a dominant strategy over EndoRings and no mucosal exposure device on a forward-viewing HD colonoscope. (Clinical trial registration number: NCT02345889.)
中文翻译:
高清晰度结肠镜检查与Endocuff对比EndoRings对比全光谱内窥镜在结肠镜检查中检测腺瘤:一项多中心随机试验
背景和目标
很少将用于在结肠镜检查中改善息肉检测的装置进行相互比较。
方法
我们进行了一项三中心前瞻性随机试验,比较了单独使用高清(HD)前视结肠镜检查与使用Endocuff进行高清检查与使用EndoRings进行HD进行全光谱内窥镜检查(FUSE)系统的比较。患者年龄≥50岁,具有常规指征和完整的结肠。研究的结肠镜医师都是经过验证的高级探测器。主要终点是结肠镜检查/结肠镜检查(APC)。
结果
在完成这项研究的1188例患者中,带内窥镜检查的APC(APC平均值±标准差:1.82±2.58),EndoRings(1.55±2.42)和标准HD结肠镜检查(1.53±2.33)均高于FUSE(1.30±1.96;P <.001(对于APC)。内窥镜检查的APC高于标准的高清结肠镜检查(P = .014)。FUSE(468±311秒)和EndoRings(403±263秒)的平均盲肠插入时间均比Endocuff的平均盲肠插入时间(354±216秒; 分别为P = .006和.018 )。
结论
对于结肠镜检查中的高级检测器,前视高清仪器在FUSE系统中占主导地位,这表明这些检查者的图像分辨率胜于视角。此外,在前视高清结肠镜上,Endocuff是EndoRings的主要策略,并且没有粘膜暴露装置。(临床试验注册号:NCT02345889。)