Miroslaw Szura, MD, PhD1, Artur Pasternak, MD, PhD1, Rafal Solecki, MD1, Tomasz Gach, MD2. 1Jagiellonian University Medical College, 2St John Grande Hospital, Krakow, Poland
Background: Colonoscopy is the most commonly performed endoscopic examination worldwide and is considered the gold standard for colorectal cancer screening. The quality of examination and endoscopic treatment is affected by a number of factors that are verified by recognized parameters such as cecal intubation rate and time (CIR, CIT), withdrawal time, adenoma detection rate (ADR) and polyp detection rate (PDR). Advanced endoscopic imaging improves accurate recognition of the nature and variety of pathologic lesions, while the endoscope tips, third eye retroscope and wide-angle endoscopy allow detection of lesions located on the proximal side of the intestinal folds.
The aim of the study was to assess the suitability of wide-angle colonoscopy for the detection of colorectal lesions and to analyze the functionality of a special endoscope series regarding CIR, CIT and withdrawal time.
Material and methods: The study enrolled 421 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 wide-angle FUSE colonoscopy (FUSE colonoscope CDVL slim c38). The study was approved by the local bioethics committee and was registered on ClinicalTrial.gov (NCT02929381).
Results: There were 214 patients examined with SFV and 207 with FUSE. The mean age of patients was 64.1 years (SD ± 10.23). Both groups were comparable in gender, age and BMI. The median cecal intubation time was 234 sec with SFV vs. 311 with FUSE (p <0.001). There were no statistical differences in CIR and withdrawal time. FUSE had a higher incidence of diverticula detection rate (DDR) in the proximal part of the intestine (p <0.05). PDR with SFV was 34.8% and 40.1% with FUSE (p <0.001), however, ADR and advanced ADR (aADR) in both groups were similar (26.4% vs 27.1% and 14, 2% vs. 13.9%).
Conclusions: Colonoscopy with FUSE endoscopes lasts longer and allows for the detection of more polyps and diverticula without affecting ADR and aADR. Our study did not revealed the superiority of wide-angle colonoscopy in prevention of colorectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87826
Program Number: P385
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster