Abstract:
BACKGROUND AND AIMS:Colorectal polyps are often detected during the insertion phase of colonoscopy but are commonly removed during the withdrawal phase. We aimed to investigate the clinical advantages of instant removal of colorectal polyps during the insertion phase to determine the appropriate strategy for polyps detected on insertion. METHODS:This prospective, multicenter, randomized trial targeted patients with at least 1 left-sided polyp <10 mm in size detected unintentionally on endoscope insertion from April 2018 to March 2019. Patients were allocated to the following 2 groups: study group, consisting of patients who had polyp removal instantly on insertion, and control group, comprising patients who had the endoscope inserted to the cecum first and polyps removed subsequently on withdrawal. Carbon dioxide gas insufflation and cold polypectomy were applied to minimize the influences of polypectomy on endoscope insertion. Twenty advanced endoscopists from 7 community-based institutions participated in this trial. RESULTS:Of 1451 patients enrolled, 220 patients were eligible for full assessment. Mean total procedure time was significantly shorter in the study group (18.9 vs 22.3 minutes, P < .001). Mean pure cecal intubation time and number of polyps per patient were similar between the 2 groups. In the control group, among 107 polyps found during insertion, 48 (45.8%) required reinspection and 7 (6.5%) were completely missed, with an average reinspection time of approximately 3 minutes. CONCLUSIONS:Polypectomy during the insertion phase in the colon and rectum significantly shortens the total procedure time and eliminates all missed polyps without experiencing any disadvantages.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Teramoto A,Aoyama N,Ebisutani C,Matsumoto T,Machida H,Yoshida S,Uchima N,Utsumi T,Tochio T,Hirata D,Iwatate M,Hattori S,Fujita M,Sano W,Sano Ydoi
10.1016/j.gie.2019.12.019subject
Has Abstractpub_date
2020-04-01 00:00:00pages
917-924issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(19)32561-1journal_volume
91pub_type
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
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pub_type: 临床试验,杂志文章
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02532-x
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
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