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Impact of Colonoscopy Insertion Techniques on Adenoma Detection
S. Cadoni, P. Falt, S. Sanna, M. Argiolas, V. Fanari, P. Gallittu, M. Liggi, D. Mura, ML. Porcedda, V. Smajstrla, M. Erriu, FW. Leung,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
Medline Complete (EBSCOhost) od 2009-07-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest) od 1997-01-01 do Před 1 rokem
Health & Medicine (ProQuest) od 1997-01-01 do Před 1 rokem
Family Health Database (ProQuest) od 1997-01-01 do Před 1 rokem
Odkazy
PubMed
26846118
DOI
10.1007/s10620-016-4053-1
Knihovny.cz E-zdroje
- MeSH
- adenom diagnóza patologie MeSH
- časná detekce nádoru MeSH
- colon ascendens patologie MeSH
- kolonoskopie metody MeSH
- kolorektální nádory diagnóza patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Low adenoma detection rate (ADR) predicts development of interval cancers, found mainly in the right (cecum-ascending) colon, where poor bowel preparation is an associated factor. Single-site studies reported increased detection of adenomas in the proximal colon segments by water exchange (WE). Data about colon cleansing revealed that WE had the greatest impact in the right colon. AIMS: To test the hypothesis that WE had the greatest impact on ADR in colon segments with the most favorable bowel cleanliness scores, namely the right colon. METHODS: We pooled right colon and overall ADR data of three similarly designed colonoscopy trials that compared WE, water immersion (WI) and insufflation of air or carbon dioxide (AICD) in a mixed gender European population. RESULTS: In this study, 1200 (704 males) subjects and were included. 288 were screening cases. Demographic and procedural data were comparable. Water exchange achieved significantly higher right colon <10 mm ADR (11.9 %, vs WI 6.9 %, p = 0.016; vs AICD 7.2 %, p = 0.025). Water exchange achieved the lowest proportions of poor bowel preparation and the highest right colon and overall Boston bowel preparation scale scores (p range 0.003, <0.0005). In patients with right colon excellent bowel cleanliness, water exchange was the only method significantly associated with right colon adenoma detection. One of the limitations is unblinded colonoscopists. CONCLUSIONS: In a mixed gender European population, water exchange is confirmed to be a superior insertion technique showing a significant increase in <10 mm right colon adenoma detection, achieving the cleanest colon and lowest proportions of poor bowel preparation requiring repeat procedures. CLINICALTRIALS. GOV NO: NCT01781650, 01954862, 01780818.
Department of Surgical Sciences University of Cagliari 09121 Cagliari Italy
Digestive Diseases Center Vìtkovice Hospital Zálužanského 1192 15 703 84 Ostrava Czech Republic
Digestive Endoscopy Unit N S di Bonaria Hospital 09037 San Gavino Monreale VS Italy
Digestive Endoscopy Unit St Barbara Hospital Via S Leonardo 1 09016 Iglesias CI Italy
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