Full-spectrum versus standard colonoscopy for improving polyp detection rate: A systematic review and meta-analysis

2018 ◽  
Vol 33 (2) ◽  
pp. 340-346 ◽  
Author(s):  
Antonio Facciorusso ◽  
Valentina Del Prete ◽  
Vincenzo Buccino ◽  
Nicola Della Valle ◽  
Maurizio Cosimo Nacchiero ◽  
...  
2021 ◽  
Vol 09 (01) ◽  
pp. E41-E50
Author(s):  
Muhammad Aziz ◽  
Hossein Haghbin ◽  
Manesh Kumar Gangwani ◽  
Sachit Sharma ◽  
Yusuf Nawras ◽  
...  

Abstract Background and study aims Recently, the newer Endocuff Vision (ECV) has been evaluated for improving colonoscopy outcome metrics such as adenoma detection rate (ADR) and polyp detection rate (PDR). Due to lack of direct comparative studies between ECV and original Endocuff (ECU), we performed a systematic review and network meta-analysis to evaluate these outcomes. Methods The following databases were searched: PubMed, Embase, Cochrane, and Web of Sciences to include randomized controlled trials (RCTs) comparing ECV or ECU colonoscopy to high-definition (HD) colonoscopy. Direct as well as network meta-analyses comparing ADR and PDR were performed using a random effects model. Relative-risk (RR) with 95 % confidence interval (CI) was calculated. Results A total of 12 RCTs with 8638 patients were included in the final analysis. On direct meta-analysis, ECV did not demonstrate statistically improved ADR compared to HD colonoscopy (RR: 1.12, 95 % CI 0.99–1.27). A clinically and statistically improved PDR was noted for ECV compared to HD (RR: 1.15, 95 % CI 1.03–1.28) and ECU compared to HD (RR: 1.26, 95 % CI 1.09–1.46) as well as improved ADR (RR: 1.22, 95 % CI 1.05–1.43) was observed for ECU colonoscopy when compared to HD colonoscopy. These results were also consistent on network meta-analysis. Lower overall complication rates (RR: 0.14, 95 % CI 0.02–0.84) and particularly lacerations/erosions (RR: 0.11, 95 % CI 0.02–0.70) were noted with ECV compared to ECU colonoscopy. Conclusions Although safe, the newer ECV did not significantly improve ADR compared to ECU and HD colonoscopy. Further device modification is needed to increase the overall ADR and PDR.


2020 ◽  
Vol 08 (06) ◽  
pp. E701-E707
Author(s):  
Muhammad Aziz ◽  
Simcha Weissman ◽  
Rawish Fatima ◽  
Zubair Khan ◽  
Babu P. Mohan ◽  
...  

Abstract Background and study aims Choice of sedation (propofol vs opioid/benzodiazepine) has been studied in the literature and has shown variable outcomes. The majority of recent studies have evaluated propofol sedation (PS) versus opioids, benzodiazepines, or a combination of both. We performed a systematic review and meta-analysis of studies comparing PS to other sedation methods to assess the impact on colonoscopy outcomes. Methods Multiple databases were searched and studies of interest were extracted. Primary outcome of the study was adenoma detection rate (ADR) and secondary outcomes included polyp detection rate (PDR), advanced adenoma detection rate (AADR), and cecal intubation rate (CIR). Results A total of 11 studies met the inclusion criteria with a total of 177,016 patients (148,753 and 28,263 in the opioids/benzodiazepine group and PS group, respectively). Overall, ADR (RR: 1.07, 95 % CI 0.99–1.15), PDR (RR: 1.01, 95 % CI 0.93–1.10), and AADR (RR: 1.17, 95 % CI 0.92–1.48) did not improve with the use of PS. The CIR was slightly higher for propofol sedation group (RR 1.02, 95 % CI 1.00–1.03). Conclusion Based on our analysis, PS and opioid/benzodiazepine sedation seem to have comparable ADR. Our results do not favor use of a particular sedation method and the choice of sedation should be individualized based on patient preference, risk factors and resource availability.


2020 ◽  
Vol 91 (6) ◽  
pp. AB565
Author(s):  
Muhammad Aziz ◽  
Simcha Weissman ◽  
Rawish Fatima ◽  
Zubair Khan ◽  
Babu P. Mohan ◽  
...  

2017 ◽  
pp. 36-46
Author(s):  
V. V. Veselov ◽  
A. M. Nechipai ◽  
E. A. Poltoryhina ◽  
A. V. Vasilchenko

Colonoscopy with a forward-viewing camera leaves regions that are not visualized in detail. Thus development of video-enoscopy systems with wide angle of view is needed. Full-spectrum colonoscopes providing image of Ultra HD 4K quality are now available in Russia. MATERIALS AND METHODS. Seventy patents were assessed with a full-spectrum colonoscope. In 51 (72,8°%) of them the procedure was performed also for physician's training purposes. Fifteen (21,4%) patients underwent simultaneous full-spectrum and forward-viewing colonoscopies, while in 4 (5,7%) full-spectrum endoscope was used to visualize lesions that were non-assessable with traditional equipment. RESULTS. Applying Jull-spectrum colonoscopy for diagnosis resulted in detecting 170 polyps in 51 patients (polyp detection rate was 47,1%). Simultaneous use of full-spectrum colonoscope after forward-viewing equipment led to 9 additional polyps detection in one patient and 23 additional polyps in another one. In 7 patents full-spectrum colonoscopy allowed detection of polyps that were not found via forward-viewing equipment. CONCLUSION. During full-spectrum colonoscopy inner colonic surface can be visualized with an angle of view of 330° which is twice more than video-capturing area ofa standard forward-viewing endoscope. The equipment allows to significantly increase adenoma detection rate.


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