The Role Of I-scan High Definition Endoscopy In Screening Polypoid Lesions In Proximal Colon

BackgroundAs premalignant lesions of colorectal cancer,early detection and removal of colorectal adenomas can reduce the incidence of colorectal cancer.However,colorectal adenomas have high rate of missing detection,especially in right-side colon.Colorectal adenomas are often characterized by polypoid form,so how to effectively improve the detection rate of right-side colon polyp has been becoming the current focus and a difficult task.The quality indicators for colonoscopy include bowel preparation,cecal intubation rate,withdrawal time and adenoma detection rate.Dye-less chromoendoscopy as a new endoscopic technique is applied in clinical practice,but whether it is helpful to improve the polyp detection rate is still controversial.In this study,it is investigated that if i-Scan endoscopic technology has an effect on the polyp detection rate compared with white light endoscopic technology.ObjectiveTo explore whether i-Scan technique can improve the right-side colon polyp detection rate,especially adenoma detection rate.To assess the efficacy of the i-Scan application during screening colonoscopy compared with white light colonoscopy.MethodsPatients receiving i-Scan high definition colonoscopy examination from 2015 January to 2015 December in Beijing Shijitan Hospital,Capital Medical University were included.These patients were randomized into two groups in screening colonoscopy to undergo white light mode or i-Scanl mode respectively.Then,the size,form,location and pathology of the polypoid lesions in proximal colon detected were recorded.ResultsA total of 189 patients were included,with 96 patients randomly assigned to the i-Scan group,and 93 patients to the WLE group,There were no significant differences among the 2 studied groups in age,sex,or bowel preparation status.During the first withdrawal,the detected number of polyps per patient in i-Scan group and WLE group were 0.948±1.173,0.753±1.332,respectively(P=0.099).The polyp detection rate in i-Scan group and WLE group were 49.0%and 38.7%,respectively(P=0.156).There were no significant differences.During the second withdrawal,compared with WLE,more polyps were detected in i-Scan group(1.469 vs 1.011,P=0.028).The polyp detection rate during the second withdrawal in WLE and i-Scan group were 48.4%and 61.5%,respectively(P=0.071).The application of i-Scan did not improve the polyp detection rate compared with WLE.However,during the second withdrawal,the percentage of patients with multiple polyps in i-Scan group was significantly higher than white light group(37.5%vs 22.6%,P=0.025).During the second withdrawal,compared with WLE group,more adenomas were detected in i-Scan group(0.979 vs 0.624,P=0.039).The adenoma detection rates during the second withdrawal in WLE and i-Scan group were 35.5%and 47.9%,respectively(P=0.083).The application of i-Scan was not associated with an improvement in adenoma detection rate.However,during the second withdrawal,the percentage of patients with multiple adenomas in the i-Scan group was significantly higher than white light group(24.0%vs 11.8%,P=0.030)ConclusionThe i-Scan technology can increase the number of ployps and adenomas detection in proximal colon,but can not improve the ployp detection rate and adenoma detection rate.