Insertion water exchange increases right colon adenoma and hyperplastic polyp detection rates during withdrawal
Language English Country Netherlands Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial
PubMed
27017108
DOI
10.1016/j.dld.2016.03.004
PII: S1590-8658(15)30284-X
Knihovny.cz E-resources
- Keywords
- Adenoma detection rate, Colon cleanliness, Interval colon cancer, Right colon hyperplastic polyps,
- MeSH
- Adenoma diagnosis MeSH
- Early Detection of Cancer MeSH
- Cecum pathology MeSH
- Colon, Ascending pathology MeSH
- Hyperplasia MeSH
- Colonoscopy methods MeSH
- Colorectal Neoplasms diagnosis MeSH
- Middle Aged MeSH
- Humans MeSH
- Logistic Models MeSH
- Mass Screening methods MeSH
- Colonic Polyps diagnosis pathology MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Water MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Czech Republic MeSH
- Italy MeSH
- United States MeSH
- Names of Substances
- Water 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
References provided by Crossref.org
