Artur Pasternak, MD, PHD, Miroslaw Szura, MD, PhD, Solecki Rafal, MD, PhD, Pawel Bogacki, MD. Jagiellonian University Medical College
Colonoscopy is crucial to detect and localize pathological lesions within the colon. Its quality is defined by a number of parameters such as cecal intubation rate (CIR), withdrawal time, adenoma detection rate (ADR) and polyp detection rate (PDR). The newly introduced Full-spectrum endoscope (FUSE®, EndoChoice®) provides a 330° field of view thereby potentially allowing the endoscopists to see more anatomy of the colon compared to standard forward viewing endoscopes. Introduction of FUSE is intended to increase detection of pathological lesions, especially those situated behind the haustral folds of the bowel. This diagnostic modality should affect the rise of ADR, especially in the right hemicolon.
The aim of the study was to explore the efficacy of FUSE for the detection of pathologic lesions in different colonic regions in patients undergoing complete colonoscopy.
Material and methods. The study enrolled 408 patients aged 18-80 years who were eligible for colonoscopic examination performed for different indications. Patients with prior abdominal surgery, colorectal resections or inflammatory bowel disease were excluded from the study. Patients were randomized to either standard frontal view (SFV) (Olympus Evis Exera III 190) or the novel full-spectrum colonoscopy (FUSE colonoscope CDVL slim c38). The analysis was performed in three broad regions of the colon: right colon (including cecum and ascending colon), transverse colon (including hepatic and splenic flexures), and left colon (including descending colon, sigmoid colon, and rectum) in regard to the Boston Bowel Preparation Scale. The study was approved by the local bioethics committee and was registered on ClinicalTrial.gov (NCT02929381).
Results. There were 209 patients examined with SFV and 199 with FUSE. The mean age of patients was 64.3 years (SD ± 10,33). Both groups were comparable in terms of sex, age and BMI, and the preparation of individual colon regions. PDR was higher in all colonic regions examined with FUSE (p <0.001). Moreover, FUSE yielded higher diverticula detection rate (DDR) in the right and middle colon (p <0.001). ADR and advanced ADR (aADR) in respective regions of the colon were similar between the groups, however, total number of adenomas detected with FUSE was higher in the right and middle regions of the colon as compared with SFV (p <0.05).
Conclusions. Full-spectrum colonoscopy allows for effective recognition of pathological lesions in the right and middle region of the colon. Although it does not statistically affect ADR, the absolute number of adenomas detected is higher as compared to classical endoscopy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87806
Program Number: S078
Presentation Session: Flexible Endoscopy Session
Presentation Type: Podium