内镜翼辅助与透明帽辅助结肠镜检查在结直肠腺瘤检测中的比较：一项随机对照试验。

Endo-wing versus transparent hood-assisted colonoscopy for colorectal adenoma detection: A randomized controlled trial.

机构信息

Department of General Internal Medicine, Saitama Medical University, Moroyama, Japan.

Department of Gastroenterology, Saitama Medical University, Moroyama, Japan.

出版信息

J Gastroenterol Hepatol. 2022 Apr;37(4):766-772. doi: 10.1111/jgh.15805. Epub 2022 Feb 22.

DOI:10.1111/jgh.15805

PMID:35174541

Abstract

BACKGROUND AND AIM

This study aimed to compare the mean number of adenomas in patients undergoing Endo-wing-assisted colonoscopy (EAC) and transparent hood-assisted colonoscopy (TAC).

METHODS

Patients undergoing colonoscopy for positive fecal immunochemical tests, colon polyp surveillance, and evaluation of abdominal symptoms at a single institution were randomly assigned to the EAC or TAC group. The mean number of adenomas per patient, adenoma detection rate, cecal intubation time, withdrawal time, mean number of adenomas per location, and adenoma size were compared.

RESULTS

Overall, 800 patients were enrolled. The EAC and TAC groups comprised 372 and 393 patients, respectively. The groups did not significantly differ with respect to cecal intubation and withdrawal times. The mean number of adenomas per patient was significantly higher in the EAC group (1.13 vs 0.90, P = 0.04), particularly in the sigmoid colon (0.54 [201/372] vs 0.38 [149/393], P = 0.04). The adenoma detection rates were 48.1% and 45.0% in the EAC and TAC groups, respectively, albeit without significant difference between the two groups (P = 0.393). The total number of sessile-type adenomas (0.73 [270/372] vs 0.47 [183/393], P < 0.0001) and small polyps (≤ 5 mm) (0.53 [198/372] vs 0.41 [159/393], P = 0.016) was significantly higher in the EAC group.

CONCLUSION

Endo-wing-assisted colonoscopy is significantly superior to TAC in terms of the mean number of adenomas per patient.

摘要

背景与目的

本研究旨在比较使用 Endo-wing 辅助结肠镜（EAC）与透明帽辅助结肠镜（TAC）的患者的腺瘤平均数量。

方法

在一家医疗机构中，对接受阳性粪便免疫化学检测、结肠息肉监测以及腹部症状评估的患者进行结肠镜检查，将其随机分配至 EAC 或 TAC 组。比较每位患者的腺瘤平均数量、腺瘤检出率、盲肠插管时间、退镜时间、每个部位的腺瘤平均数量和腺瘤大小。

结果

共有 800 名患者入组。EAC 组和 TAC 组分别有 372 名和 393 名患者。两组患者的盲肠插管和退镜时间无显著差异。EAC 组每位患者的腺瘤平均数量显著较高（1.13 比 0.90，P=0.04），尤其是在乙状结肠（0.54 [201/372] 比 0.38 [149/393]，P=0.04）。EAC 组和 TAC 组的腺瘤检出率分别为 48.1%和 45.0%，但两组之间无显著差异（P=0.393）。EAC 组的无蒂型腺瘤总数（0.73 [270/372] 比 0.47 [183/393]，P<0.0001）和小息肉（≤5 毫米）（0.53 [198/372] 比 0.41 [159/393]，P=0.016）也显著更高。