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


Journal

Digestion
ISSN: 1421-9867
Titre abrégé: Digestion
Pays: Switzerland
ID NLM: 0150472

Informations de publication

Date de publication:
2020
Historique:
received: 28 02 2019
accepted: 13 06 2019
pubmed: 17 7 2019
medline: 29 6 2021
entrez: 17 7 2019
Statut: ppublish

Résumé

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. 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. 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). FUSE is recommended in screening and surveillance EGD to better visualize MDP in FAP patients.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
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 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 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 CONCLUSIONS
FUSE is recommended in screening and surveillance EGD to better visualize MDP in FAP patients.

Identifiants

pubmed: 31311010
pii: 000501476
doi: 10.1159/000501476
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

563-570

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Ryoji Ichijima (R)

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Seiichiro Abe (S)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan, seabe@ncc.go.jp.

Shunsuke Kobayashi (S)

Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan.

Takeyoshi Minagawa (T)

Department of Gastroenterology, Tonan Hospital, Sapporo, Japan.

Teppei Tagawa (T)

Tagawa Clinic, Yokohama, Japan.

Takeshi Nakajima (T)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Clinical Genetic Oncology, Cancer Institute Hospital, Tokyo, Japan.

Masayoshi Yamada (M)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Hiroyuki Takamaru (H)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Masau Sekiguchi (M)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.

Taku Sakamoto (T)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Ichiro Oda (I)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Takahisa Matsuda (T)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.

Yutaka Saito (Y)

Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.

Takuji Gotoda (T)

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.

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Classifications MeSH