Efficacy of Full-Spectrum Endoscopy to Visualize the Major Duodenal Papilla in Patients with Familial Adenomatous Polyposis.

Abstract:

BACKGROUND AND AIMS:Duodenal cancer is one of the extracolonic malignancies with known mortality in familial adenomatous polyposis (FAP) patients. Visualization of the major duodenal papilla (MDP) with a standard esophagogastroduodenoscopy (EGD) is currently insufficient because of the limited field of view. Full-spectrum endoscopy (FUSE), utilizing double imagers located on the front and side of the endoscopic tip, provides a wider field of view up to 245 degrees. The aim of this study was to evaluate the efficacy of FUSE in visualizing MDP in patients with FAP. METHODS:This study was a single-center retrospective study including 49 FAP patients undergoing surveillance at our institution. EGD was performed by qualified endoscopists using FUSE, and visibility of the MDP was evaluated. All examinations were video-recorded, and the clips for individual patient were edited to forward view images alone (conventional group) and 2-view images of the duodenum (forward and side-view [FUSE group]). Three other qualified external endoscopists independently reviewed the videos and compared the visibility of MDP between the conventional and the FUSE groups. Primary endpoint was the rate of Type 1 visibility (whole area of the papilla) in off-site video reviews. We also assessed MDP visibility on-site as secondary endpoint. RESULTS:The rate of type 1 MDP visibility was significantly higher in the FUSE group than conventional group in both on-site (32.6/100%, p < 0.001) and off-site reviews (8.2, 16.3, 14.3/100, 98, and 100%, p < 0.001). CONCLUSIONS:FUSE is recommended in screening and surveillance EGD to better visualize MDP in FAP patients.

journal_name

Digestion

journal_title

Digestion

authors

Ichijima R,Abe S,Kobayashi S,Minagawa T,Tagawa T,Nakajima T,Yamada M,Takamaru H,Sekiguchi M,Sakamoto T,Oda I,Matsuda T,Saito Y,Gotoda T

doi

10.1159/000501476

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

563-570

issue

5

eissn

0012-2823

issn

1421-9867

pii

000501476

journal_volume

101

pub_type

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