Withdrawal Time and Use of Wide-angle Endoscope to Increase the Adenoma Detection Rate of Screening Colonoscopy
- Conditions
- Colon PolypColoRectal Cancer
- Interventions
- Procedure: Colonoscopy
- Registration Number
- NCT02985944
- Lead Sponsor
- ASST Rhodense
- Brief Summary
Colonoscopy outcome is strictly related to the adenoma detection rate (ADR). An endoscopy withdrawal time \>6min has been suggested to increase the ADR since it allows for thorough evaluation of the several hidden areas of the colon. The FUSE, full spectrum endoscopy system, has been demonstrated to reduce the rate of missed lesions due to its wide-angle view. In the present study the authors evaluate the impact of WT on ADR for High Definition Standard Endoscopes with just a single imager to the FUSE endoscope.
- Detailed Description
Introduction Colonoscopy outcome is strictly related to the adenoma detection rate. An endoscopy withdrawal time \>6min has been suggested to increase the adenoma detection rate since it allows for accurate evaluation of the several hidden areas of the colon. The FUSE endoscope has been demonstrated also to reduce the rate of missed lesions due to its wide angle view.
Aim of the study to evaluate the impact on the adenoma detection rate either of the use of a FUSE endoscope or of interventions directed at optimizing withdrawal time.
to assess the impact of different factors in influencing the withdrawal time
Methods A prospective non-randomized observational single-center study involving consecutive outpatients, aged 18-85 yr, undergoing colonoscopy with different indications. Previous abdominal colon resection, obstruction, inadequate preparation and incomplete examination were exclusion criteria.
In a 3-month period 4 expert endoscopists will performed 500 colonoscopies either with standard endoscope or with FUSE without a dedicated withdrawal time protocol. Colonoscopy withdrawal times will be measured without the endoscopists' knowledge of being monitored.
During a subsequent 3-month period the same endoscopists will perform further 500 colonoscopies with standard and FUSE scopes using dedicated inspection techniques and a minimum 6-minute withdrawal time. In this second phase withdrawal times will be again measured, but endoscopists will be aware of being monitored.
The following parameters will be recorded:
* Demographic and general characteristics
* Indications to colonoscopy
* Colonoscopy findings
* Quality of preparation: Boston scale
* Time to reach the coecum
* Withdrawal time The adenoma detection rate and the mean adenomas per patients will be calculated.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1000
- Indication for colonoscopy, age 18-85
- Previous abdominal colon resection, colon obstruction, inadequate preparation and incomplete examination
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Standard scope-long time Colonoscopy Standard colonoscopy with monitored withdrawal time FUSE scope-long time Colonoscopy Wide-angle colonoscopy with monitored withdrawal time Standard scope-short time Colonoscopy Standard colonoscopy with unmonitored withdrawal time FUSE scope-short time Colonoscopy Wide-angle colonoscopy with unmonitored withdrawal time
- Primary Outcome Measures
Name Time Method Adenoma detection rate Up to 10 days from the end of endoscopy The rate of patient with at least one adenoma detected at colonoscopy
- Secondary Outcome Measures
Name Time Method Factors affecting the withdrawal time Up to 10 days from the end of endoscopy Analysis of the factors (quality of preparation, indications for colonoscopy) likely to influence the withdrawal time
Trial Locations
- Locations (1)
ASST Rhodense
🇮🇹Garbagnate Milanese, Lombardia, Italy