Neuhaus Horst, Nowak Tanja, Schmidt Arthur
Department of Gastroenterology, Interdisciplinary Care Clinic, Duesseldorf, Germany.
Hamburg, Medical Affairs, Hamburg, Germany.
Endosc Int Open. 2024 Oct 28;12(10):E1230-E1236. doi: 10.1055/a-2422-9502. eCollection 2024 Oct.
Colonoscopy, the gold standard for early detection of colorectal cancer, may miss polyps especially those hidden behind folds. This prospective study compared polyp detection and performance of a novel colonoscope with extra-wide field of view (EFOV) of 230 degrees (partially retrograde) to a standard colonoscope (SC, 170 degrees) in a colon model. A 3D printed colon model was used featuring 12 polyps placed throughout different colon segments, with several located on the proximal side of haustral folds. Endoscopists were instructed to identify polyps, first inserting the SC immediately followed by the EFOV device, and to place a snare to simulate a polypectomy. A standardized survey was used to record operator impressions. Twenty-nine experienced endoscopists participated in this study. On average, 5.3 vs 9.6 polyps were detected with the standard and EFOV colonoscopes, respectively ( < 0.001). Five of 29 operators (17.2%) detected all 12 polyps with the EFOV device, whereas no operator detected all polyps with the SC. The success rate for snare placement was 100% for both endoscopes with similar times (mean of 14 vs 15 seconds for SC and EFOV, respectively). EFOV handling and optical performance were rated as equally good or better by all endoscopists. Use of a colonoscope with novel optics significantly improved polyp detection compared with a standard colonoscope in this non-randomized model-based study, with favorable performance and usability ratings for the EFOV instrument. Clinical studies are needed to confirm these encouraging preliminary results.
结肠镜检查是早期检测结直肠癌的金标准，但可能会漏诊息肉，尤其是那些隐藏在皱襞后的息肉。这项前瞻性研究在结肠模型中，将一款具有230度超广角视野（部分逆行）的新型结肠镜与标准结肠镜（170度）的息肉检测情况及性能进行了比较。使用了一个3D打印的结肠模型，其中在不同结肠段放置了12个息肉，有几个位于袋状皱襞的近端。内镜医师被要求识别息肉，先插入标准结肠镜，紧接着插入超广角视野设备，并放置圈套器模拟息肉切除术。采用标准化调查问卷记录操作者的印象。29名经验丰富的内镜医师参与了这项研究。标准结肠镜和超广角视野结肠镜平均分别检测到5.3个和9.6个息肉（<0.001）。29名操作者中有5名（17.2%）使用超广角视野设备检测到了所有12个息肉，而使用标准结肠镜没有操作者检测到所有息肉。两种内镜圈套器放置的成功率均为100%，时间相似（标准结肠镜和超广角视野结肠镜分别平均为14秒和15秒）。所有内镜医师对超广角视野设备的操作和光学性能评价同样良好或更好。在这项基于模型的非随机研究中，与标准结肠镜相比，使用具有新型光学系统的结肠镜显著提高了息肉检测率，超广角视野设备的性能和易用性评分良好。需要进行临床研究来证实这些令人鼓舞的初步结果。
