Brooker Jim C, Saunders Brian P, Shah Syed G, Thapar Catherine J, Thomas Huw J W, Atkin Wendy S, Cardwell Christopher R, Williams Christopher B
Wolfson Unit for Endoscopy and Imperial Cancer Research Fund, St Mark's Hospital, Northwick Park, London, United Kingdom.
Gastrointest Endosc. 2002 Sep;56(3):333-8. doi: 10.1016/s0016-5107(02)70034-5.
Small adenomas may be missed during colonoscopy, but chromoscopy has been reported to enhance detection. The aim of this randomized-controlled trial was to determine the effect of total colonic dye spray on adenoma detection during routine colonoscopy.
Consecutive outpatients undergoing routine colonoscopy were randomized to a dye-spray group (0.1% indigo carmine used to coat the entire colon during withdrawal from the cecum) or control group (no dye).
Two hundred fifty-nine patients were randomized, 124 to the dye-spray and 135 to the control group; demographics, indication for colonoscopy, and quality of the preparation were similar between the groups. Extubation from the cecum took a median of 9:05 minutes (range: 2:48-24:44 min) in the dye-spray group versus 4:52 minutes (range: 1:42-15:21 min) in the control group (p < 0.0001). The proportion of patients with at least 1 adenoma and the total number of adenomas were not different between groups. However, in the dye-spray group significantly more diminutive adenomas (<5 mm) were detected proximal to the sigmoid colon (p = 0.026) and more patients were identified with 3 or more adenomas (p = 0.002). More non-neoplastic polyps were detected throughout the colon in the dye-spray group (p = 0.003). There were no complications.
Dye-spray increases the detection of small adenomas in the proximal colon and patients with multiple adenomas, but long-term outcomes should be studied to determine the clinical value of these findings.
结肠镜检查期间可能会漏诊小腺瘤，但据报道，染色法可提高其检出率。本随机对照试验的目的是确定在常规结肠镜检查期间全结肠染料喷洒对腺瘤检出的影响。
将连续接受常规结肠镜检查的门诊患者随机分为染料喷洒组（在从盲肠退镜时使用0.1%靛胭脂覆盖整个结肠）或对照组（不使用染料）。
259例患者被随机分组，124例进入染料喷洒组，135例进入对照组；两组患者的人口统计学特征、结肠镜检查指征及肠道准备质量相似。染料喷洒组从盲肠退镜的中位时间为9:05分钟（范围：2:48 - 24:44分钟），而对照组为4:52分钟（范围：1:42 - 15:21分钟）（p < 0.0001）。两组中至少有1个腺瘤的患者比例及腺瘤总数无差异。然而，在染料喷洒组中，在乙状结肠近端检测到的微小腺瘤（<5 mm）明显更多（p = 0.026），且更多患者被发现有3个或更多腺瘤（p = 该文档中此处有误，根据前文推测应为0.002）。染料喷洒组在整个结肠中检测到更多的非肿瘤性息肉（p = 0.003）。未发生并发症。
染料喷洒可增加近端结肠小腺瘤及多发腺瘤患者的检出率，但应研究长期结果以确定这些发现的临床价值。
