Arthur Hoffman1, Linn Loth2, Johannes Wilhelm Rey3, Fareed Rahman2, Martin Goetz4, Torsten Hansen5, Achim Tresch6, Theresa Niederberger7, Peter Robert Galle8, Ralf Kiesslich3. 1. St. Mary's Hospital, Department of Medicine, Frankfurt, Germany; 1. Medical Department, Johannes Gutenberg University Mainz, Germany. Electronic address: ahoff66286@aol.com. 2. St. Mary's Hospital, Department of Medicine, Frankfurt, Germany. 3. St. Mary's Hospital, Department of Medicine, Frankfurt, Germany; 1. Medical Department, Johannes Gutenberg University Mainz, Germany. 4. 1. Medical Department, Johannes Gutenberg University Mainz, Germany; 1. Medical Department, University of Tübingen, Germany. 5. Institute of Pathology, Johannes Gutenberg University Mainz, Germany; Clinic Lippe, Institute of Pathology, Detmold, Germany. 6. Max Planck Institute, Cologne, Germany. 7. Gene Zentrum Ludwig-Maximilians-Universität München, Germany. 8. 1. Medical Department, Johannes Gutenberg University Mainz, Germany.
Abstract
BACKGROUND: High definition endoscopy is the accepted standard in colonoscopy. However, an important problem is missed polyps. AIMS: Our objective was to assess the additional adenoma detection rate between high definition colonoscopy with tone enhancement (digital chromoendoscopy) vs. white light high definition colonoscopy. METHODS: In this prospective randomized trial patients were included to undergo a tandem colonoscopy. The first exam was a white light colonoscopy with removal of all visualized polyps. The second examination was randomly assigned in a 1:1 ratio as either again white light colonoscopy (Group A) or colonoscopy with tone enhancement (Group B). Primary endpoint was the adenoma detection rate during the second withdrawal (sample size calculation - 40 per group). RESULTS: 67 lesions (Group A: n=34 vs. Group B: n=33) in 80 patients (mean age 61 years, male 64%) were identified on the first colonoscopy. The second colonoscopy detected 78 additional lesions: n=60 with tone enhancement vs. n=18 with white light endoscopy (p<0.001). Tone enhancement found more additional adenomas (A n=20 vs. B n=6, p=0.006) and identified significantly more missed adenomas per subject (0.5 vs. 0.15, p=0.006). CONCLUSIONS: High definition plus colonoscopy with tone enhancement detected more adenomas missed by white light colonoscopy.
RCT Entities:
BACKGROUND: High definition endoscopy is the accepted standard in colonoscopy. However, an important problem is missed polyps. AIMS: Our objective was to assess the additional adenoma detection rate between high definition colonoscopy with tone enhancement (digital chromoendoscopy) vs. white light high definition colonoscopy. METHODS: In this prospective randomized trial patients were included to undergo a tandem colonoscopy. The first exam was a white light colonoscopy with removal of all visualized polyps. The second examination was randomly assigned in a 1:1 ratio as either again white light colonoscopy (Group A) or colonoscopy with tone enhancement (Group B). Primary endpoint was the adenoma detection rate during the second withdrawal (sample size calculation - 40 per group). RESULTS: 67 lesions (Group A: n=34 vs. Group B: n=33) in 80 patients (mean age 61 years, male 64%) were identified on the first colonoscopy. The second colonoscopy detected 78 additional lesions: n=60 with tone enhancement vs. n=18 with white light endoscopy (p<0.001). Tone enhancement found more additional adenomas (A n=20 vs. B n=6, p=0.006) and identified significantly more missed adenomas per subject (0.5 vs. 0.15, p=0.006). CONCLUSIONS: High definition plus colonoscopy with tone enhancement detected more adenomas missed by white light colonoscopy.
Authors: Colin J Rees; Roisin Bevan; Katharina Zimmermann-Fraedrich; Matthew D Rutter; Douglas Rex; Evelien Dekker; Thierry Ponchon; Michael Bretthauer; Jaroslaw Regula; Brian Saunders; Cesare Hassan; Michael J Bourke; Thomas Rösch Journal: Gut Date: 2016-10-08 Impact factor: 23.059
Authors: James E East; Wendy S Atkin; Adrian C Bateman; Susan K Clark; Sunil Dolwani; Shara N Ket; Simon J Leedham; Perminder S Phull; Matt D Rutter; Neil A Shepherd; Ian Tomlinson; Colin J Rees Journal: Gut Date: 2017-04-27 Impact factor: 23.059
Authors: Helmut Neumann; Helmut Neumann Sen; Michael Vieth; Raf Bisschops; Florian Thieringer; Khan F Rahman; Thomas Gamstätter; Gian Eugenio Tontini; Peter R Galle Journal: United European Gastroenterol J Date: 2018-05-17 Impact factor: 4.623