Rui Guo, Jingzhai Wang, L. Min, Ningning Dong, Li Zhang, Ruyun Song, Yang Zhang, Qian Zhang, Huihong Zhai, Peng Li, Shutian Zhang
{"title":"使用新型结肠镜远端附件提高腺瘤检出率:多中心随机对照试验。","authors":"Rui Guo, Jingzhai Wang, L. Min, Ningning Dong, Li Zhang, Ruyun Song, Yang Zhang, Qian Zhang, Huihong Zhai, Peng Li, Shutian Zhang","doi":"10.14309/ajg.0000000000002829","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo 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.\n\n\nMETHODS\nAll consecutive patients who underwent routine colonoscopic examinations at three 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.\n\n\nRESULTS\nOverall, 1179 patients were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% (P < .001) and improved APC from 0.44 to 0.64 (P = .002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs. 8.5%, P = .004 for 5-9 mm and 27.0% vs. 17.2%, P < .001 for < 5 mm), non-pedunculated adenomas (26.6% vs. 18.8%, P < .001), and adenomas in the transverse (10.8% vs. 6.1%, P = .004) and left colon (21.6% vs. 13.7%, P < .001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 min vs. 6.68 min, P = .046), with no significant impact on patients' pain scores (P = .377). Moreover, no EAC-related adverse events occurred.\n\n\nCONCLUSION\nEAC significantly increased ADR and APC compared with SC, particularly for adenomas < 10 mm, non-pedunculated adenomas, and adenomas in the transverse and left colon.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improved adenoma detection rate using a novel colonoscopic distal attachment: a multicenter randomized controlled trial.\",\"authors\":\"Rui Guo, Jingzhai Wang, L. Min, Ningning Dong, Li Zhang, Ruyun Song, Yang Zhang, Qian Zhang, Huihong Zhai, Peng Li, Shutian Zhang\",\"doi\":\"10.14309/ajg.0000000000002829\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nTo 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.\\n\\n\\nMETHODS\\nAll consecutive patients who underwent routine colonoscopic examinations at three 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.\\n\\n\\nRESULTS\\nOverall, 1179 patients were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% (P < .001) and improved APC from 0.44 to 0.64 (P = .002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs. 8.5%, P = .004 for 5-9 mm and 27.0% vs. 17.2%, P < .001 for < 5 mm), non-pedunculated adenomas (26.6% vs. 18.8%, P < .001), and adenomas in the transverse (10.8% vs. 6.1%, P = .004) and left colon (21.6% vs. 13.7%, P < .001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 min vs. 6.68 min, P = .046), with no significant impact on patients' pain scores (P = .377). Moreover, no EAC-related adverse events occurred.\\n\\n\\nCONCLUSION\\nEAC significantly increased ADR and APC compared with SC, particularly for adenomas < 10 mm, non-pedunculated adenomas, and adenomas in the transverse and left colon.\",\"PeriodicalId\":507623,\"journal\":{\"name\":\"The American Journal of Gastroenterology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The American Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14309/ajg.0000000000002829\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14309/ajg.0000000000002829","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Improved adenoma detection rate using a novel colonoscopic distal attachment: a multicenter randomized controlled trial.
OBJECTIVE
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.
METHODS
All consecutive patients who underwent routine colonoscopic examinations at three 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.
RESULTS
Overall, 1179 patients were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% (P < .001) and improved APC from 0.44 to 0.64 (P = .002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs. 8.5%, P = .004 for 5-9 mm and 27.0% vs. 17.2%, P < .001 for < 5 mm), non-pedunculated adenomas (26.6% vs. 18.8%, P < .001), and adenomas in the transverse (10.8% vs. 6.1%, P = .004) and left colon (21.6% vs. 13.7%, P < .001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 min vs. 6.68 min, P = .046), with no significant impact on patients' pain scores (P = .377). Moreover, no EAC-related adverse events occurred.
CONCLUSION
EAC significantly increased ADR and APC compared with SC, particularly for adenomas < 10 mm, non-pedunculated adenomas, and adenomas in the transverse and left colon.