Jacob Abraham, Schafer Amy, Yong Johnathan, Tonkin Darren, Rodda David, Eteuati Jimmy, Ganesh Shanthan, Hewett Peter
Colorectal Surgical Unit, The University of Adelaide, Adelaide, South Australia, Australia.
Department of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
ANZ J Surg. 2019 May;89(5):E174-E178. doi: 10.1111/ans.15067. Epub 2019 Mar 21.
Adenoma detection rate (ADR) has shown to be an independent predictor, to reduce the rate of interval colorectal cancer. Endocuff Vision is a relatively new device that has shown promise to improve the ADR. The primary objective was to conduct a randomized controlled trial to compare Endocuff Vision-assisted colonoscopy (EVAC) with standard colonoscopy (SC). The primary outcome of the study is ADR and the secondary outcomes are caecal intubation rate, terminal ileum intubation rate, scope withdrawal time, quality of bowel preparation and adverse events.
A randomized controlled trial was performed to compare EVAC versus SC. All patients who presented to the endoscopy suite at the Queen Elizabeth Hospital were assessed for eligibility. Patients were recruited from 15 June 2016 to 20 January 2017. A total of 360 patients were included; 40 were excluded. The patients were randomized using block randomization; 138 patients were recruited to SC and 182 to EVAC.
A total of 231 polyps were retrieved during the study period. Polyp detection rate (PDR) was high in both groups: 53% in the EVAC group versus 41.1% in SC. This was statistically significant with a P-value of 0.035. ADR was similarly high in both groups: 36.81% in EVAC group versus 28.99% in SC group. ADR did not reach statistical significance.
EVAC does improve the PDR. Though the ADR did not reach statistical significance, there is a trend towards improved adenoma detection and there is statistical significance in the overall PDR.
腺瘤检出率(ADR)已被证明是降低结直肠癌间期癌发生率的独立预测指标。Endocuff Vision是一种相对较新的设备,已显示出有望提高ADR。主要目的是进行一项随机对照试验,比较Endocuff Vision辅助结肠镜检查(EVAC)与标准结肠镜检查(SC)。该研究的主要结局是ADR,次要结局是盲肠插管率、回肠末端插管率、镜身退出时间、肠道准备质量和不良事件。
进行了一项随机对照试验,比较EVAC与SC。对所有到伊丽莎白女王医院内镜室就诊的患者进行资格评估。患者于2016年6月15日至2017年1月20日招募。共纳入360例患者;排除40例。患者采用区组随机化进行随机分组;138例患者被招募到SC组,182例患者被招募到EVAC组。
在研究期间共取出231枚息肉。两组的息肉检出率(PDR)都很高:EVAC组为53%,而SC组为41.1%。这具有统计学意义,P值为0.035。两组的ADR同样很高:EVAC组为36.81%,SC组为28.99%。ADR未达到统计学意义。
EVAC确实提高了PDR。虽然ADR未达到统计学意义,但腺瘤检出有改善趋势,且总体PDR具有统计学意义。