Impact of a ring-fitted cap on insertion time and adenoma detection: a randomized controlled trial.

Autor: Rex DK; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Kessler WR; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Sagi SV; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Rogers NA; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Fischer M; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Bohm ME; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Wo JM; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Dewitt JM; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., McHenry L; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Lahr RE; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Searight MP; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., MacPhail M; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Sullivan AW; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., McWhinney CD; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA., Vemulapalli KC; Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2020 Jan; Vol. 91 (1), pp. 115-120. Date of Electronic Publication: 2019 Jul 09.
DOI: 10.1016/j.gie.2019.06.042
Abstrakt: Background and Aims: Devices for flattening colon folds can improve polyp detection at colonoscopy. However, there are few data on the endoscopic ring-fitted cap (EndoRings; EndoAid, Caesarea, Israel). We sought to compare adenoma detection with EndoRings with that of standard high-definition colonoscopy.
Methods: This was a single-center, randomized controlled trial of 562 patients (284 randomized to EndoRings and 278 to standard colonoscopy) at 2 outpatient endoscopy units in the Indiana University Hospital system. Adenoma detection was the primary outcome measured as adenoma detection rate (ADR) and adenomas per colonoscopy (APC). We also compared sessile serrated polyp detection rate, insertion times, withdrawal times, and ease of passage through the sigmoid colon.
Results: EndoRings was superior to standard colonoscopy in terms of APC (1.46 vs 1.06, P = .025), but there were no statistically significant differences in ADR or sessile serrated polyp detection rate. Mean withdrawal time (in patients with no polyps) was shorter and insertion time (all patients) was longer in the EndoRings arm by 1.8 minutes and 0.75 minutes, respectively. One provider had significantly higher detection with Endo-Rings and contributed substantially to the overall results.
Conclusions: EndoRings can increase adenoma detection without a significant increase in procedure time, but the effect varies between operators. The use of EndoRings slows colonoscope insertion. (Clinical trial registration number: NCT03418662.).
(Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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