Universität zu Köln

Buerger, Martin, Weber, Marko, Petersen, Iver, Stallmach, Andreas and Schmidt, Carsten (2022). Adenoma detection rate using narrow-band imaging is inferior to high-definition white light colonoscopy in screening and surveillance colonoscopies in daily clinical care A randomized controlled trial. Medicine (Baltimore), 101 (32). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-5964

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Abstract

Background: Despite recent advances in endoscopic technology adenoma miss rate still is up to 20% contributing to interval cancers. Improved imaging modalities have been introduced to increase adenoma detection rate (ADR). Recently, narrow-band imaging (NBI) (Exera II series, Olympus Corporation) was not significantly better than high-definition white light colonoscopy (HD-WLC). An improved second generation of NBI (190-NBI) is characterized by better illumination of the bowel lumen and may be associated with a higher ADR. Methods: We performed a prospective randomized study on patients referred to the Jena University Hospital for screening or surveillance colonoscopy between January 2015 and April 2017. Participating endoscopists were divided into 2 subgroups depending on their individual experience. Colonoscopy was performed by use of HD-WLC or 190-NBI upon withdrawal. Results: Five hundred fifty-three patients participated in the study. Eighty patients were excluded (insufficient bowel cleansing [n = 34], anticoagulation precluding polypectomy [n=15], partial colonic resection [n=9], other reasons [n = 22]). Mean age was 66.9 years (standard deviation 10.3 years), and 253 patients were male (53.5%). Bowel preparation and withdrawal time were not different. ADR among all subgroups was 39.4% using HD-WLC, but only 29.1% were using 190-NBI (P = .02). Number of polyps per patient was lower using 190-NBI than with HD-WLC (0.58 vs 0.86; P = .02). Subgroup analysis revealed that 190-NBI was inferior to HD-WLC only in unexperienced endoscopists. Conclusion: In our stud,y ADR was lower by use of 190-NBI. These differences persisted only in unexperienced investigators. 190-NBI seems to be more challenging regarding ADR, requiring more intensive training prior to implementing this technology in daily clinical care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Buerger, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Marko UNSPECIFIED UNSPECIFIED UNSPECIFIED Petersen, Iver UNSPECIFIED UNSPECIFIED UNSPECIFIED Stallmach, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-680208
DOI:	10.1097/MD.0000000000029858
Journal or Publication Title:	Medicine (Baltimore)
Volume:	101
Number:	32
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-5964
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GASTROINTESTINAL ENDOSCOPY; COLORECTAL-CANCER; EUROPEAN-SOCIETY; SERRATED LESIONS; POLYPS; METAANALYSIS; MULTICENTER; GUIDELINES; NEOPLASIA; QUALITY Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68020