Ratone Jean-Philippe, Bories Erwan, Caillol Fabrice, Pesenti Christian, Godat Sébastien, Sellier Floriane, Hoibian Solene, Landon Marine, Servajean Cécilia, Cassan Chiara De, Lestelle Valentin, Casanova Jean-Patrick, Poizat Flora, Giovannini Marc
Endoscopy Unit (Jean-Philippe Ratone, Erwan Bories, Fabrice Caillol, Christian Pesenti, Sébastien Godat, Floriane Sellier, Solene Hoibian, Marine Landon, Cécilia Servajean, Chiara De Cassan, Valentin Lestelle, Jean-Patrick Casanova, Marc Giovannini), Paoli-Calmettes Institute, Marseille, France.
Pathology Unit (Flora Poizat), Paoli-Calmettes Institute, Marseille, France.
Ann Gastroenterol. 2017;30(5):512-517. doi: 10.20524/aog.2017.0176. Epub 2017 Jul 5.
Currently, colonoscopy and polypectomy are the gold standard methods for the prevention of incident cases of colorectal cancer. The use of a new colonoscope (Fuse, EndoChoice) with a larger view of up to 330° appears to improve the adenoma detection rate (ADR). We performed a prospective observational study concerning this scope. The primary endpoint was potentially omitted adenomas (POA), i.e. adenomas seen on the side screens that will not appear on the central display during colonoscopy withdrawal without oriented movements. Secondary endpoints included our ADR, Fuse impact on ADR, time to cecal intubation and withdrawal time.
We performed a single-center prospective study in one French center. We enrolled patients over 18 years of age between January 2015 and March 2016.
We included 141 patients; 3 were excluded because their colonoscopies were incomplete. Our study included 78 men and 60 women (sex ratio 1.3). The mean age was 60.4 years. A total of 130 polyps were resected. In all, 88/130 were adenomas (68%) and 34/88 adenomas (39%) were POA. The mean time to cecum was 10 min, and the mean withdrawal time was 12 min. ADR was 35% for men and 31% for women. The estimated ADR without POA was 29% for men and 19% for women.
The Fuse system appears to be safe and efficient. POA represented 39% of all adenomas. The impact of the panoramic view on the ADR was considered substantial. The main limitations are the lack of randomization and the absence of a control group.
目前，结肠镜检查和息肉切除术是预防结直肠癌新发病例的金标准方法。使用视野可达330°的新型结肠镜（Fuse，EndoChoice）似乎可提高腺瘤检出率（ADR）。我们针对该结肠镜进行了一项前瞻性观察研究。主要终点是潜在遗漏腺瘤（POA），即在结肠镜检查退镜过程中，若不进行定向操作，在侧屏幕上可见但在中央显示屏上不会出现的腺瘤。次要终点包括我们的ADR、Fuse对ADR的影响、到达盲肠的时间和退镜时间。
我们在法国的一个中心进行了一项单中心前瞻性研究。我们纳入了2015年1月至2016年3月期间年龄在18岁以上的患者。
我们纳入了141例患者；3例因结肠镜检查不完整而被排除。我们的研究包括78名男性和60名女性（性别比1.3）。平均年龄为60.4岁。共切除130枚息肉。其中，88/130为腺瘤（68%），34/88腺瘤（39%）为POA。到达盲肠的平均时间为10分钟，平均退镜时间为12分钟。男性的ADR为35%，女性为31%。无POA时男性的估计ADR为29%，女性为19%。
Fuse系统似乎安全有效。POA占所有腺瘤的39%。全景视野对ADR的影响被认为很大。主要局限性是缺乏随机化且没有对照组。
