Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy.
J Gastroenterol Hepatol. 2018 Feb;33(2):340-346. doi: 10.1111/jgh.13859.
Full-spectrum endoscopy represents a new endoscopic platform allowing a panoramic 330 degree view of the colon, but evidence of its superiority over standard colonoscopy is still lacking. Our study is the first meta-analysis comparing the efficacy of full-spectrum endoscopy with standard colonoscopy.
Through a systematic literature review until May 2017, we identified eight randomized-controlled trials. Primary outcomes were polyp detection rate and adenoma detection rate, while cecal intubation time and total colonoscopy time were secondary outcomes. Direct meta-analysis was performed using a random effects model.
No difference in terms of polyp detection rate and adenoma detection rate was found (risk ratio: 1.00, 95% confidence interval 0.89-1.12, P = 0.96, and 1.05, 0.94-1.17, P = 0.40, respectively). Adenoma miss rate resulted significantly in favor of full-spectrum endoscopy (risk ratio: 0.35, 0.25-0.48, P < 0.01), although the difference was not significant for greater (>5 mm) and pedunculated lesions (risk ratio: 0.38, 0.09-1.60, P = 0.19, and risk ratio: 0.15, 0.01-3.00, P = 0.21, respectively). Cecal intubation time was not different between the two techniques (mean standardized difference: 0.22 min, -1.18 to 1.62, P = 0.76), while total colonoscopy time was significantly shorter when adopting full-spectrum endoscopy (mean difference: -2.60, -4.60 to -0.61, P = 0.01). Sensitivity analysis confirmed all the findings.
Full-spectrum endoscopy appears as a promising and reliable technology able to significantly decrease the number of adenomas missed and procedural times, while its superiority over standard colonoscopy in terms of adenoma detection rate results is still unclear.
全谱内镜代表了一种新的内镜平台，可实现结肠 330 度全景观察，但仍缺乏其优于标准结肠镜的证据。本研究是第一项比较全谱内镜与标准结肠镜疗效的荟萃分析。
通过系统文献回顾，直到 2017 年 5 月，我们确定了八项随机对照试验。主要结局是息肉检出率和腺瘤检出率，而盲肠插管时间和全结肠镜检查时间是次要结局。采用随机效应模型进行直接荟萃分析。
在息肉检出率和腺瘤检出率方面无差异（风险比：1.00，95%置信区间 0.89-1.12，P=0.96 和 1.05，0.94-1.17，P=0.40）。全谱内镜对腺瘤检出率的差异有统计学意义（风险比：0.35，0.25-0.48，P<0.01），但对>5mm 和有蒂病变的差异无统计学意义（风险比：0.38，0.09-1.60，P=0.19 和风险比：0.15，0.01-3.00，P=0.21）。两种技术的盲肠插管时间无差异（平均标准化差异：0.22min，-1.18 至 1.62，P=0.76），而全谱内镜的全结肠镜检查时间明显缩短（平均差异：-2.60，-4.60 至-0.61，P=0.01）。敏感性分析证实了所有发现。
全谱内镜是一种有前途且可靠的技术，能显著减少漏诊的腺瘤数量和操作时间，但其在腺瘤检出率方面优于标准结肠镜的结果仍不清楚。
