Abstract:
BACKGROUND:Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. OBJECTIVE:To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. DESIGN:Prospective, multicenter. SETTING:Six endoscopy units (3 in the United States and 3 in Israel). PATIENTS:In vitro colon model with simulated colon polyps (n = 21 metallic beads). INTERVENTIONS:Detection of simulated colon polyps on colonoscope withdrawal. MAIN OUTCOME MEASUREMENTS:Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy. RESULTS:On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0%) right colon, 2.4 ± 0.87 (48.0%) transverse colon, and 5.7 ± 1.5 (51.8%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7% polyp detection rate (P < .001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0%) right colon, 4.0 ± 0.87 (80.0%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3%) left colon (all comparisons, P < .001). Importantly, the ultrawide-viewing mode detected significantly more "hidden" simulated polyps (81.9% vs 31.9%, P < .0001). LIMITATIONS:Nonrandomized design, use of a colon model, and "simulated" colon polyps. CONCLUSIONS:Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Gralnek IM,Carr-Locke DL,Segol O,Halpern Z,Siersema PD,Sloyer A,Fenster J,Lewis BS,Santo E,Suissa A,Segev Mdoi
10.1016/j.gie.2012.12.011subject
Has Abstractpub_date
2013-03-01 00:00:00pages
472-9issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(12)03064-7journal_volume
77pub_type
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journal_title:Gastrointestinal endoscopy
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