Roepstorff Søren, Hadi Sabah Anwar, Rasmussen Morten
a Digestive Disease Center , Bispebjerg Hospital, University of Copenhagen , Copenhagen , Denmark.
Scand J Gastroenterol. 2017 Nov;52(11):1298-1303. doi: 10.1080/00365521.2017.1363278. Epub 2017 Aug 11.
To investigate the diagnostic performance of Full Spectrum Endoscopy (FUSE) compared to a conventional standard forward-viewing endoscope (SFV). The primary outcome was adenoma detection rate (ADR) and mean adenoma detection. Secondary outcome was feasibility of FUSE opposed to SFV.
Consecutive patients participating in the Danish colorectal cancer (CRC) screening programme were prospectively included in the study (n = 205). Demographic and health-related characteristics were obtained. Following procedural parameters were recorded: completion rate, caecal intubation time, fentanyl and midazolam sedation, CRC detection, ADR, diverticulosis, bowel preparation, patient discomfort and endoscopist difficulty rating. Participants underwent FUSE colonoscopy on days when the FUSE system was available, while the remaining participants had SFV. All colonoscopies were performed by two trained endoscopists.
A total of 109 patients were included in the FUSE group and 106 in the SFV group. Groups were comparable in baseline characteristics. Completion rate was 83.5% and 93.4% in the FUSE and SFV groups (p = .040). Caecal intubation time was 11.4 ± 6.7 min versus 9.1 ± 6.2 min in the FUSE and SFV groups (p = .040). ADR was 67.0% and 59.6% (p = .097), while the mean adenoma detection was 1.79 and 1.38 (p = .022) in the FUSE and SFV groups. Endoscopists reported increased difficulty rating with FUSE compared to SFV (p > .001).
FUSE colonoscopy provides a higher mean adenoma detection and there is tendency toward higher ADR compared to SFV in a high-risk population. Nonetheless, FUSE colonoscopy has a lower completion rate, longer caecal intubation time and a higher difficulty rating from an endoscopist point of view.
研究全谱内镜检查（FUSE）与传统标准前视内镜（SFV）相比的诊断性能。主要结局是腺瘤检出率（ADR）和平均腺瘤检出数。次要结局是FUSE与SFV相比的可行性。
前瞻性纳入参与丹麦结直肠癌（CRC）筛查项目的连续患者（n = 205）。获取人口统计学和健康相关特征。记录以下操作参数：完成率、盲肠插管时间、芬太尼和咪达唑仑镇静、CRC检出情况、ADR、憩室病、肠道准备、患者不适和内镜医师困难程度评分。当FUSE系统可用时，参与者接受FUSE结肠镜检查，其余参与者接受SFV检查。所有结肠镜检查均由两名经过培训的内镜医师进行。
FUSE组共纳入109例患者，SFV组共纳入106例患者。两组基线特征具有可比性。FUSE组和SFV组的完成率分别为83.5%和93.4%（p = 0.040）。FUSE组和SFV组的盲肠插管时间分别为11.4±6.7分钟和9.1±6.2分钟（p = 0.040）。ADR分别为67.0%和59.6%（p = 0.097），FUSE组和SFV组的平均腺瘤检出数分别为1.79和1.38（p = 0.022）。内镜医师报告称，与SFV相比，FUSE的困难程度评分更高（p > 0.001）。
在高危人群中，FUSE结肠镜检查的平均腺瘤检出数更高，与SFV相比有更高ADR的趋势。尽管如此，从内镜医师的角度来看，FUSE结肠镜检查的完成率较低，盲肠插管时间更长，困难程度评分更高。
