Impact of endoscopy system, high definition, and virtual chromoendoscopy in daily routine colonoscopy: a randomized trial.

BACKGROUND

To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested, including high definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed to investigate their use for the detection of polyps in patients referred for colonoscopy in a large tertiary hospital.

METHODS

Demographic, endoscopic, and histological data from 1855 consecutive patients undergoing colonoscopy were collected prospectively. Patients were randomly assigned to three endoscopy systems (Fujinon, Olympus, or Pentax) in combination with four modalities: conventional white-light colonoscopy (n = 505), high definition white-light colonoscopy (n = 582), virtual chromoendoscopy (n = 285) and high definition virtual chromoendoscopy (n = 483).

RESULTS

The mean adenoma detection rate (ADR) was 34.9 %, and the adenoma per colonoscopy rate (APCR) was 2.1. No significant differences were noted between the three endoscopy systems. Moreover, no differences in ADR or APCR were observed between the four imaging modalities. High definition white-light colonoscopy resulted in a significantly higher detection of sessile serrated adenomas (8.2 % vs. 3.8 %;

CONCLUSIONS

No significant differences in ADR or APCR between different endoscopy systems, high definition, and/or virtual chromoendoscopy could be observed in routine colonoscopies in the general population. High definition endoscopy was associated with a significantly higher detection rate of serrated adenomas and adenocarcinomas.

Informations de copyright

© Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

Dr. Bessissow has received research support from Pentax and speaker fees from Ferring and Pendopharm. Dr. Cuyle has received nonfinancial support (travel expenses) from Norgine. Dr. Ferrante has received consultancy fees from Ferring and speaker fees from Dr. Falk Pharma and Ferring. Dr. Van Assche has received speaker fees from Ferring. Dr. Vermeire has received consultancy fees from Ferring and speaker fees from Dr. Falk Pharma and Ferring. Dr. Bisschops has received speaker fees, consultancy fees, and/or research support from Boston Scientific, CDx Diagnostics, Cook Medical, Fujifilm, Olympus, Medtronic, and Pentax.Dr. Roelandt is supported by Clinical Mandate from Belgian Foundation against Cancer (Stichting tegen Kanker). Drs. Ferrante, Van Assche, and Vermeire are senior clinical investigators of the Research Foundation – Flanders (FWO). Dr. Bisschops is supported by a grant from the Research Foundation – Flanders (FWO).