Cap-Assisted Chromoendoscopy Using a Mounted Cap Versus Standard Colonoscopy for Adenoma Detection.
- Title
- Cap-Assisted Chromoendoscopy Using a Mounted Cap Versus Standard Colonoscopy for Adenoma Detection.
- Author
- 은창수
- Keywords
- WHITE-LIGHT COLONOSCOPY; COLORECTAL-CANCER; NEGATIVE COLONOSCOPY; DETECTION RATES; COLON ADENOMAS; RISK; PREDICTORS; NEOPLASIA; LESIONS; POLYPS
- Issue Date
- 2020-03
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Citation
- AMERICAN JOURNAL OF GASTROENTEROLOGY, v. 115, no. 3, page. 465-472
- Abstract
- OBJECTIVES: Some neoplastic lesions remain undetected on colonoscopy. To date, no studies have investigated whether combining cap-assisted colonoscopy with chromoendoscopy increases the adenoma detection rate (ADR). This study aimed to compare cap-assisted chromoendoscopy (CAP/CHROMO) with standard colonoscopy (SC) with respect to their efficacy in detecting adenomas. METHODS: This prospective, multicenter, randomized controlled trial included asymptomatic subjects aged 45-75 years who underwent colonoscopy for the first time at 14 university hospitals. Subjects were randomized to either the CAP/CHROMO group (with 0.09% indigo carmine spraying using a cap-mounted catheter at the tip of the colonoscope) or the SC group. All polyps were resected, but only histologically confirmed neoplastic lesions were considered for analysis. The primary outcome was ADR, defined as the proportion of subjects with at least 1 adenoma. RESULTS: A total of 1,905 subjects were randomized to the CAP/CHROMO (n = 948) or SC (n = 957) group at 14 centers. Subjects' demographic characteristics were similar between both groups. The CAP/CHROMO group had significantly higher ADR than the SC group (54.4% vs 44.9%,P< 0.001). Significantly, more subjects with at least 1 proximal colon adenoma were identified by CAP/CHROMO (38.6%) than by SC (31.2%) (P= 0.001). The proximal serrated polyp detection rate by CAP/CHROMO was significantly higher in the female subgroup vs SC. However, advanced ADR was not different between the CAP/CHROMO and SC groups (9.3% vs 7.6%,P= 0.180). DISCUSSION: CAP/CHROMO markedly improved the ADR and enhanced the detection of proximal adenoma. CAP/CHROMO is feasible for routine application and will allow for a more effective surveillance program.
- URI
- https://journals.lww.com/ajg/Fulltext/2020/03000/Cap_Assisted_Chromoendoscopy_Using_a_Mounted_Cap.21.aspxhttps://repository.hanyang.ac.kr/handle/20.500.11754/161956
- ISSN
- 0002-9270; 1572-0241
- DOI
- 10.14309/ajg.0000000000000510
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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