Kawanishi Koki, Maekita Takao, Ikeda Yoshifumi, Furotani Masahiko, Tsuboi Sayaka, Kanno Takayuki, Niwa Toru, Nagaoka Tsunehiro, Tabata Yoshinari, Hatamaru Keiichi, Iguchi Mikitaka, Kitano Masayuki
Department of Gastroenterology, Nate Hospital, Kinokawa City, Wakayama, Japan.
Second Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan.
Scand J Gastroenterol. 2021 Mar;56(3):351-355. doi: 10.1080/00365521.2020.1867897. Epub 2020 Dec 30.
Colonoscopy is currently considered the optimal method to detect colorectal neoplasia; however, some adenomas remain undetected. While indigo carmine staining with a dye-spray catheter has demonstrated promising results for reducing the miss rate, we investigated the oral indigo carmine method. The aim of this study was to determine whether oral indigo carmine intake before standard colonoscopy increases the adenoma (and adenocarcinoma) detection rate (ADR) or the mean number of adenomas per patient (MAP).
The oral indigo carmine method was performed from April 2018 to July 2020 in two hospitals. Data were collected in a prospective manner and compared to the conventional group whose data were collected retrospectively and consecutively from January 2016 to March 2018. All data were anonymized.
Among the 704 patients included, colonoscopies were completely performed in 693 patients (347 in the indigo group). The ADR did not significantly differ between the groups: 42.3% vs. 40.3% (indigo vs. conventional group; odds ratio: 1.13; 95% confidence interval: 0.9-1.33, = .33). The MAP was significantly greater in the indigo group (1.15) than that in the conventional group (0.82; = .009). The cecal intubation rate and time to cecal intubation did not differ between the indigo and conventional group (98.6% vs. 98.3%, = .83, and 6.2 min vs. 5.9 min, = .39, respectively).
The routine use of oral indigo carmine does not lead to a higher ADR despite the higher MAP.
结肠镜检查目前被认为是检测结直肠肿瘤的最佳方法；然而，仍有一些腺瘤未被检测到。虽然使用染料喷雾导管进行靛胭脂染色在降低漏诊率方面已显示出有前景的结果，但我们研究了口服靛胭脂方法。本研究的目的是确定在标准结肠镜检查前口服靛胭脂是否会提高腺瘤（和腺癌）检测率（ADR）或每位患者的腺瘤平均数量（MAP）。
2018年4月至2020年7月在两家医院采用口服靛胭脂方法。数据以前瞻性方式收集，并与2016年1月至2018年3月回顾性连续收集数据的传统组进行比较。所有数据均匿名。
在纳入的704例患者中，693例患者完成了结肠镜检查（靛胭脂组347例）。两组的ADR无显著差异：42.3%对40.3%（靛胭脂组对传统组；优势比：1.13；95%置信区间：0.9 - 1.33，P = 0.33）。靛胭脂组的MAP显著高于传统组（1.15对0.82；P = 0.009）。靛胭脂组和传统组的盲肠插管率和到达盲肠的时间无差异（分别为98.6%对98.3%，P = 0.83，以及6.2分钟对5.9分钟，P = 0.39）。
尽管MAP较高，但常规使用口服靛胭脂并不会导致更高的ADR。
