University Medical Center Utrecht, Utrecht, The Netherlands.
Gastrointest Endosc. 2011 Mar;73(3):480-9. doi: 10.1016/j.gie.2010.09.004. Epub 2010 Nov 10.
Although colonoscopy is currently the optimal method for detecting colorectal polyps, some are missed. The Third Eye Retroscope provides an additional retrograde view that may detect polyps behind folds.
To determine whether the addition of the Third Eye Retroscope to colonoscopy improves the adenoma detection rate.
Prospective, multicenter, randomized, controlled trial.
Nine European and U.S. centers.
Of 448 enrolled subjects, 395 had data for 2 procedures.
Subjects underwent same-day tandem examinations with standard colonoscopy (SC) and Third Eye colonoscopy (TEC). Subjects were randomized to SC followed by TEC or TEC followed by SC.
Detection rates for all polyps and adenomas with each method.
In the per-protocol population, 173 subjects underwent SC and then TEC, and TEC yielded 78 additional polyps (48.8%), including 49 adenomas (45.8%). In 176 subjects undergoing TEC and then SC, SC yielded 31 additional polyps (19.0%), including 26 adenomas (22.6%). Net additional detection rates with TEC were 29.8% for polyps and 23.2% for adenomas. The relative risk of missing with SC compared with TEC was 2.56 for polyps (P < .001) and 1.92 for adenomas (P = .029). Mean withdrawal times for SC and TEC were 7.58 and 9.52 minutes, respectively (P < .001). The median difference in withdrawal times was 1 minute (P < .001). The mean total procedure times for SC and TEC were 16.97 and 20.87 minutes, respectively (P < .001).
Despite randomization and a large cohort, there was disparity in polyp prevalence between the 2 groups of subjects.
The Third Eye Retroscope increases adenoma detection rate by visualizing areas behind folds. (
NCT01044732.).
虽然结肠镜检查目前是检测结直肠息肉的最佳方法，但仍有一些息肉会被遗漏。第三只眼内镜提供了一个额外的逆行视角，可以检测到褶皱后面的息肉。
确定在结肠镜检查中加入第三只眼内镜是否能提高腺瘤的检出率。
前瞻性、多中心、随机、对照试验。
欧洲和美国的 9 个中心。
448 名入组患者中，395 名患者有 2 次检查的数据。
患者同日进行标准结肠镜检查（SC）和第三只眼结肠镜检查（TEC）的串联检查。患者随机分为 SC 后行 TEC 或 TEC 后行 SC。
两种方法检测所有息肉和腺瘤的检出率。
在符合方案人群中，173 名患者先接受 SC，然后接受 TEC，TEC 检出 78 个额外息肉（48.8%），其中 49 个腺瘤（45.8%）。在 176 名先接受 TEC 然后接受 SC 的患者中，SC 检出 31 个额外息肉（19.0%），其中 26 个腺瘤（22.6%）。TEC 的净额外检出率为息肉 29.8%，腺瘤 23.2%。与 TEC 相比，SC 漏诊的相对风险为息肉 2.56（P<0.001），腺瘤 1.92（P=0.029）。SC 和 TEC 的平均退镜时间分别为 7.58 分钟和 9.52 分钟（P<0.001）。退镜时间的中位数差异为 1 分钟（P<0.001）。SC 和 TEC 的总手术时间分别为 16.97 分钟和 20.87 分钟（P<0.001）。
尽管进行了随机分组和大样本量研究，但两组患者的息肉患病率仍存在差异。
第三只眼内镜通过观察褶皱后面的区域增加了腺瘤的检出率。（临床试验注册号：NCT01044732。）
