High-definition colonoscopy increases adenoma detection rate.

Autor: Jrebi NY; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA. nejrebi@hsc.wvu.edu.; Department of Surgery, West Virginia University-Ruby Memorial Hospital, 1 Medical Center Drive, PO BOX 9238, Morgantown, WV, 26506, USA. nejrebi@hsc.wvu.edu., Hefty M; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA., Jalouta T; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA., Ogilvie J; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA., Davis AT; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA., Asgeirsson T; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA., Luchtefeld M; Ferguson Clinic, Grand Rapids Medical Education Partners Research Department, Michigan State University, Grand Rapids, MI, USA.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2017 Jan; Vol. 31 (1), pp. 78-84. Date of Electronic Publication: 2016 Jun 10.
DOI: 10.1007/s00464-016-4986-7
Abstrakt: Background: The adenoma detection rate (ADR) is a quality indicator for colonoscopy. High-definition (HD) imaging has been reported to increase polyp detection rates.
Objective: The primary objective of this study was to compare polyp detection rate (PDR) and adenoma detection rate (ADR) before and after the implementation of HD colonoscopy.
Methods: A retrospective chart review was performed on patients aged 48-55 years old, who underwent first-time screening colonoscopy. The first group underwent standard-definition (SD) colonoscopy in the first 6 months of 2011. The second group underwent screening with HD colonoscopy during the first 6 months of 2012. We compared age, gender, PDR, ADR, and average sizes of adenomatous polyps between gastroenterologist and colorectal surgeon and among physicians themselves. Statistical analysis was performed with Fischer's exact test and Pearson Chi-square.
Results: A total of 1268 patients were involved in the study (634 in each group). PDR (35.6 vs. 48.2 %, p < 0.001) and ADR (22.2 vs. 30.4 %, p = 0.02) were higher in the HD group. The average size of an adenomatous polyp was the same in the two groups (0.58 vs. 0.57, p = 0.69). However, this difference was not seen among colorectal surgeons PDR (35.7 vs. 37 %, p = 0.789), ADR (22.9 vs. 24.5 % p = 0.513), but clearly seen among gastroenterologist, PDR (35.6 vs. 53.1 % p < 0.001) and ADR (21.9 vs. 32.9 % p < 0.001). When polyps were categorized into size groups, there was no difference in ADR between the two timeframes (<5 mm in size (41.5 vs. 35.4 %), 5-10 mm (49.3 vs. 60.1 %) and >10 mm (9.2 vs. 4.5 %), p = 0.07). Polyps were most commonly seen in the sigmoid colon (26.1 vs. 24.7 %). There was no difference in the rate of synchronous polyp detection between modalities (25.6 vs. 29 %, p = 0.51). Withdrawal time was the same in both procedure (9.2 vs. 8.5 min, p = 0.10).
Conclusion: Screening colonoscopy with high-definition technology significantly improved both PDR and ADR. In addition, high-definition colonoscopy may be particularly useful and advantageous among less experienced endoscopists in various community settings. However, there needs to be application to specific patient populations in future studies to assess for any statistical differences between standard- and high-definition modalities to determine clinical utility.
Databáze: MEDLINE
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