Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China.
Department of Gastroenterology, Beijing Shijingshan Hospital, Teaching Hospital of Capital Medical University, Beijing, China.
Am J Gastroenterol. 2024 Nov 1;119(11):2224-2232. doi: 10.14309/ajg.0000000000002829. Epub 2024 Apr 25.
To evaluate the effect of Embrella, a novel-designed colonoscopic distal attachment, on adenoma detection rate (ADR) and adenoma per colonoscopy (APC), compared with standard colonoscopy in routine practice.
All consecutive participants who underwent routine colonoscopic examinations at 3 endoscopy centers in China were enrolled. Participants were randomly assigned in a 1:1 ratio to the Embrella-assisted colonoscopy (EAC) or standard colonoscopy (SC) groups. ADR, APC, inspection time, pain scores, and adverse events were recorded.
Overall, 1,179 participants were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% ( P < 0.001) and improved APC from 0.44 to 0.64 ( P = 0.002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs 8.5%, P = 0.004 for 5-9 mm and 27.0% vs 17.2%, P < 0.001 for < 5 mm), nonpedunculated adenomas (26.6% vs 18.8%, P < 0.001), and adenomas in the transverse (10.8% vs 6.1%, P = 0.004) and left colon (21.6% vs 13.7%, P < 0.001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 vs 6.68 minutes, P = 0.046), with no significant impact on participants' pain scores ( P = 0.377). Moreover, no EAC-related adverse events occurred.
EAC significantly increased ADR and APC compared with SC, particularly for adenomas <10 mm, nonpedunculated adenomas, and adenomas in the transverse and left colon.
本研究旨在评估新型结肠镜远端附件 Embrella 在常规临床实践中对腺瘤检出率（ADR）和每例结肠镜检查检出腺瘤数（APC）的影响，与标准结肠镜检查进行对比。
所有连续在我国 3 家内镜中心接受常规结肠镜检查的参与者均被纳入研究。参与者以 1:1 的比例随机分配至 Embrella 辅助结肠镜检查（EAC）组或标准结肠镜检查（SC）组。记录 ADR、APC、检查时间、疼痛评分和不良事件。
共有 1179 名参与者被随机分配至 EAC（n = 593）和 SC 组（n = 586）。EAC 使总体 ADR 从 24.6%提高至 34.2%（P < 0.001），APC 从 0.44 提高至 0.64（P = 0.002）。亚组分析表明，EAC 可显著提高 < 10mm 腺瘤（13.8%比 8.5%，P = 0.004[5-9mm]和 27.0%比 17.2%，P < 0.001[< 5mm]）、无蒂腺瘤（26.6%比 18.8%，P < 0.001）和横结肠（10.8%比 6.1%，P = 0.004）和左半结肠（21.6%比 13.7%，P < 0.001）的 ADR。亚组分析中 APC 与 ADR 一致。EAC 的平均检查时间更短（6.52 比 6.68 分钟，P = 0.046），但对参与者的疼痛评分无显著影响（P = 0.377）。此外，未发生与 EAC 相关的不良事件。
EAC 与 SC 相比，可显著提高 ADR 和 APC，尤其在 < 10mm 腺瘤、无蒂腺瘤和横结肠及左半结肠的腺瘤。
