Kim Shin Hee, Kim One Zoong, Yoo In Kyung, Park Jae Yong, Yang Young Joo, Park Jin Hwa, Lee Sang Pyo, Lee Jae Gon
Digestive Disease Center and Research Institute, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Bucheon, Republic of Korea.
Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea.
J Gastroenterol Hepatol. 2025 Jul;40(7):1667-1674. doi: 10.1111/jgh.16964. Epub 2025 Apr 14.
BACKGROUND/AIMS: Repeat examination of the right colon increases adenoma detection rates (ADRs) in the right colon. This study aimed to investigate whether a second examination of the right colon using narrow-band imaging (NBI) increases ADRs in the right colon compared with repeat examinations using white light imaging (WLI).
Consecutive patients with routine indications for colonoscopy were enrolled and randomly assigned to two groups. The control arm underwent two repeat forward examinations of the right colon using WLI only (repeat-WLI group), and the intervention arm underwent the first examination of the right colon using WLI and the second examination using NBI (WLI-NBI group). Lesions detected during the first and second examinations in each group were analyzed. The primary outcome was ADR in the right colon.
A total of 476 colonoscopies were analyzed, including 240 and 236 in the repeat-WLI and WLI-NBI groups, respectively. The overall ADR in the right colon was significantly higher in the WLI-NBI group than that in the repeat-WLI group (27.1% vs. 17.9%; p = 0.022). The number of adenomas per colonoscopy in the right colon was also significantly higher in the WLI-NBI group than in the repeat-WLI group (mean number of adenomas, 0.36 vs. 0.24; p = 0.042). However, there were no significant differences in the detection rates of advanced adenomas and sessile serrated lesions between the WLI-NBI and repeat-WLI groups (advanced adenoma, 4.7% vs. 2.9%; sessile serrated lesion, 2.5% vs. 3.3%).
A second forward examination of the right colon using NBI increased ADRs in the right colon.
背景/目的：对右半结肠进行重复检查可提高右半结肠腺瘤检出率（ADR）。本研究旨在探讨与使用白光成像（WLI）进行重复检查相比，采用窄带成像（NBI）对右半结肠进行第二次检查是否能提高右半结肠的ADR。
纳入有结肠镜检查常规指征的连续患者，并随机分为两组。对照组仅使用WLI对右半结肠进行两次重复向前检查（重复WLI组），干预组先用WLI对右半结肠进行首次检查，再用NBI进行第二次检查（WLI-NBI组）。分析每组第一次和第二次检查期间发现的病变。主要结局是右半结肠的ADR。
共分析了476例结肠镜检查，重复WLI组和WLI-NBI组分别为240例和236例。WLI-NBI组右半结肠的总体ADR显著高于重复WLI组（27.1%对17.9%；p = 0.022）。WLI-NBI组右半结肠每次结肠镜检查的腺瘤数量也显著高于重复WLI组（腺瘤平均数，0.36对0.24；p = 0.042）。然而，WLI-NBI组和重复WLI组之间高级别腺瘤和无蒂锯齿状病变的检出率无显著差异（高级别腺瘤，4.7%对2.9%；无蒂锯齿状病变，2.5%对3.3%）。
采用NBI对右半结肠进行第二次向前检查可提高右半结肠的ADR。
