| Background and aimsColorectal cancer is one of the most common cancers in the world.it is a serious threat to human health.Its incidence presents increasing trend.Colonoscopy is the usual preferred method for diagnosis and surveillance of colorectal neoplasms Early detection and removal of colorectal adenomas have been shown to be the most effective way of colorectal cancer prevention.Previous studies have shown that there is a polyp miss rate of 15-32%during back-to-back colonoscopies.The reasons for the miss rate may be technical(insufficient attentiveness during excessively fast instrument withdrawal or incomplete colonoscopy),but missed lesions may also be caused by the imaging method.Smaller lesions,particularly flat ones,may be missed as a result of their subtle appearance and limited contrast in relation to the surrounding mucosa.MethodsBetween August and December 2016,consecutive patients who underwent total colonoscopy were considered eligible for inclusion in the study.A total of 302 patients were randomized to undergo either Optical Enhancement or high-definition white light colonoscopy.152 patients underwent colonoscopy with Optical Enhancement and 150 with high-definition white light colonoscopy.Patients underwent colonoscopy with Optical Enhancement withdrawal versus high-definition white light colonoscopy withdrawal during endoscopic screening exam.Record the information of patients,Bowel preparation,withdrawal time and polyps.Primary outcome measurement was adenoma detection rate and polyp detection for Optical Enhancement versus high-definition white light colonoscopy.Secondary measurements included polyp size,pathology,and morphology.ResultsThere was also no significant difference in Patient's age and sex,Indications,percentage of sedation,the quality of bowel preparation and withdrawal time between the two groups The patients who were found to have at least one adenoma in the examination in the Optical Enhancement and high-definition white light colonoscopy group was 59 and 44(38.8%and 29.3%,p=0.082),respectively.The patients who were found to have at least one colorectal polyp was 81 and 68(53.3%vs 45.3%,p=0.167),Sessile adenomas were detected more frequently in the Optical Enhancement group than in the high-definition white light colonoscopy group(68 vs 39,p=0.042),There was also no significant difference in sessile adenomas(36 vs 35,p=0.201)or pedunculated adenomas(13 vs 15,p=0.233)between the two groups.Diminutive colorectal adenomas were detected more frequently in the Optical Enhancement group than in the high-definition white light colonoscopy group(76 vs 45,p=0.038),There was also no significant difference in adenomas which of 6-10mm(25 vs 28,p=0.101)or adenomas which large than 10mm(16 vs 16,p=0.398)between the two groups.When the two techniques were compared in consecutive subgroups of 75 study patients,adenoma rates in the Optical Enhancement group remained fairly stable(39.5%,34.2%,?42.1%,39.5%respectively),whereas these rates steadily increased in the high-definition white light colonoscopy group(23.7%,29.7%,31.6%,32.4%respectively).ConclusionThe increased adenoma detection rate means of Optical Enhancement were statistically not significant.Sessile adenomas and diminutive colorectal adenomas were detected more frequently in the Optical Enhancement group than in the high definition white light colonoscopy.Optical Enhancement is a reliable instrument in adenoma detection with a small learning curve. |
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