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使用内镜外套管可提高腺瘤检出率:一项随机试验。

Higher adenoma detection rate with the endocuff: a randomized trial.

机构信息

Gastrointestinal Endoscopy Department of the National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.

Gastrointestinal Endoscopy Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico.

出版信息

Endoscopy. 2017 Nov;49(11):1061-1068. doi: 10.1055/s-0043-117879. Epub 2017 Sep 12.

Abstract

Different techniques have been introduced to improve the endoscopist's view and enhance the detection of polyps. The endocuff is a polymer sleeve cap that is connected to the tip of the colonoscope in order to improve visualization of the mucosa during colonoscopy. The aim of the study was to compare adenoma detection rates (ADR) of endocuff-assisted colonoscopy and conventional colonoscopy.  Patients 50 years or older were randomized into two groups: an endocuff-assisted colonoscopy group and a conventional colonoscopy group without the endocuff.  A total of 337 patients were included: 174 in the endocuff group and 163 in the conventional group. The median age was 61 years (interquartile range 55 - 70 years), and 74 % were women. The ADR was higher in the endocuff group than in the conventional group (22.4 % vs. 13.5 %;  = 0.02). The mean number of adenomas was 0.30 (SD 0.25) in the endocuff group and 0.21 (SD 0.26) in the conventional group ( = 0.02). The rate of ileal intubation was lower in the endocuff group (73 % vs. 87 %;  < 0.001). No serious adverse events occurred with the use of the endocuff.  Endocuff colonoscopy achieved a greater ADR than conventional colonoscopy.Trial registered at ClinicalTrials.gov (NTC02387593).

摘要

不同的技术已被引入以改善内镜医师的视野并提高息肉的检测率。 内镜外套管是一种聚合物套管帽,连接到结肠镜的尖端,以改善结肠镜检查期间的黏膜可视化。 该研究的目的是比较内镜外套管辅助结肠镜检查和常规结肠镜检查的腺瘤检出率(ADR)。 50 岁或以上的患者被随机分为两组:内镜外套管辅助结肠镜检查组和无内镜外套管的常规结肠镜检查组。 共纳入 337 例患者:内镜外套管组 174 例,常规组 163 例。 中位年龄为 61 岁(四分位距 55-70 岁),74%为女性。 内镜外套管组的 ADR 高于常规组(22.4%比 13.5%; = 0.02)。 内镜外套管组的平均腺瘤数为 0.30(标准差 0.25),常规组为 0.21(标准差 0.26)( = 0.02)。 内镜外套管组的回肠插管率较低(73%比 87%;  < 0.001)。 使用内镜外套管未发生严重不良事件。 内镜外套管结肠镜检查的 ADR 高于常规结肠镜检查。试验在 ClinicalTrials.gov 注册(NTC02387593)。

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