Insertion water exchange increases right colon adenoma and hyperplastic polyp detection rates during withdrawal
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie
PubMed
27017108
DOI
10.1016/j.dld.2016.03.004
PII: S1590-8658(15)30284-X
Knihovny.cz E-zdroje
- Klíčová slova
- Adenoma detection rate, Colon cleanliness, Interval colon cancer, Right colon hyperplastic polyps,
- MeSH
- adenom diagnóza MeSH
- časná detekce nádoru MeSH
- cékum patologie MeSH
- colon ascendens patologie MeSH
- hyperplazie MeSH
- kolonoskopie metody MeSH
- kolorektální nádory diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- plošný screening metody MeSH
- polypy tlustého střeva diagnóza patologie MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- voda MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- Geografické názvy
- Česká republika MeSH
- Itálie MeSH
- Spojené státy americké MeSH
- Názvy látek
- voda MeSH
BACKGROUND: Single site studies in male Veterans in the U.S. reported increased detection of presumptive cancer precursors (adenomas, hyperplastic polyps) in the proximal colon (cecum-splenic flexure) by water exchange. AIMS: Assess the reproducibility of the observation. METHODS: Analysis of secondary outcomes collected prospectively in 3 similarly designed randomized controlled trials using water exchange, water immersion and insufflation (air or carbon dioxide). MAIN OUTCOME: detection rates of adenomas and hyperplastic polyps in proximal, transverse and right colon (cecum-ascending). RESULTS: 704 males (173 screening) were evaluated. In the proximal colon, WE showed increased detection of small adenomas (p=0.009) and adenomas plus hyperplastic polyps (p=0.015) (vs insufflation); increased detection of adenomas plus hyperplastic polyps of any size (p=0.045) and of small size (p=0.04) (vs water immersion). In the right colon water exchange increased detection of small adenomas (19% vs 12.1%, p=0.04) (vs insufflation); small adenomas (19% vs 12%, p=0.038), adenomas plus hyperplastic polyps of any size (25% vs 16.7%, p=0.028) and of small size (23.7% vs 14.6%, p=0.012) (vs water immersion). Water exchange significantly improved bowel cleanliness. Sedation had no impact on lesion detection. CONCLUSIONS: Water exchange is a superior insertion technique for detection of adenomas and hyperplastic polyps primarily in the right colon, especially those of small size.
Department of Surgical Sciences University of Cagliari Cagliari CA Italy
Digestive Diseases Center Vìtkovice Hospital Ostrava Czech Republic
Digestive Endoscopy Unit N S di Bonaria Hospital San Gavino Monreale VS Italy
Digestive Endoscopy Unit St Barbara Hospital Iglesias CI Italy
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