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Your search keyword '"sessile serrated lesions"' showing total 2 results
Start Over Descriptor "sessile serrated lesions" Publisher escholarship, university of california
2 results on '"sessile serrated lesions"'

1. A prospective RCT comparing combined chromoendoscopy with water exchange (CWE) vs water exchange (WE) vs air insufflation (AI) in adenoma detection in screening colonoscopy

Author

Leung, JW, Yen, AW, Jia, H, Opada, C, Melnik, A, Atkins, J, Feller, C, Wilson, and Leung, FW

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Colo-Rectal Cancer, Cancer, Digestive Diseases, 4.2 Evaluation of markers and technologies, Adenoma, Aged, Air, Colon, Colonoscopy, Colorectal Neoplasms, Coloring Agents, Early Detection of Cancer, Female, Humans, Indigo Carmine, Insufflation, Intestinal Mucosa, Male, Mass Screening, Middle Aged, Prospective Studies, United States, United States Department of Veterans Affairs, Water, Adenoma detection, chromoendoscopy, screening colonoscopy, sessile serrated lesions, water exchange, Clinical sciences
Abstract

BackgroundA low adenoma detection rate (ADR) increases risks of interval cancers (ICs). Proximal colon flat polyps, e.g. serrated lesions (SLs), are difficult to find. Missed proximal colon flat lesions likely contribute to IC.AimsWe compared chromoendoscopy with water exchange (CWE), water exchange (WE) and air insufflation (AI) in detecting adenomas in screening colonoscopy.MethodsAfter split-dose preparation, 480 veterans were randomized to AI, WE and CWE.ResultsPrimary outcome of proximal ADR (55.6% vs 53.4% vs 52.2%, respectively) were similar in all groups. Adenoma per colonoscopy (APC) and adenoma per positive colonoscopy (APPC) were comparable. Detection rate of proximal colon SLs was significantly higher for CWE and WE than AI (26.3%, 23.6% and 11.3%, respectively, p = 0.002). Limitations: single operator; SLs only surrogate markers of but not IC.ConclusionsWhen an endoscopist achieves high-quality AI examinations with overall ADR twice (61.6%) the recommended standard (30%), use of WE and CWE does not produce further improvement in proximal or overall ADR. Comparable APC and APPC confirm equivalent withdrawal inspection techniques. WE alone is sufficient to significantly improve detection of proximal SLs. The impact of increased detection of proximal SLs by WE on prevention of IC deserves to be studied. This study is registered at ClinicalTrial.gov (NCT#01607255).

Published
2019

2. A prospective RCT comparing combined chromoendoscopy with water exchange (CWE) vs water exchange (WE) vs air insufflation (AI) in adenoma detection in screening colonoscopy

Author

Jia H, Feller C, Wilson, Andrew W. Yen, Felix W. Leung, Leung Jw, Andrey Melnik, Opada C, and Atkins J

Subjects
Male, Colonoscopy, Water exchange, Screening colonoscopy, Gastroenterology, Chromoendoscopy, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Mass Screening, Prospective Studies, Intestinal Mucosa, Coloring Agents, Early Detection of Cancer, chromoendoscopy, Cancer, medicine.diagnostic_test, Air, Middle Aged, Colo-Rectal Cancer, United States Department of Veterans Affairs, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Air insufflation, Colorectal Neoplasms, Adenoma, medicine.medical_specialty, Colon, Adenoma detection, screening colonoscopy, Indigo Carmine, 03 medical and health sciences, Internal medicine, medicine, Humans, Proximal colon, sessile serrated lesions, Aged, business.industry, Prevention, Water, Insufflation, Original Articles, medicine.disease, United States, water exchange, business, Digestive Diseases
Abstract

Background A low adenoma detection rate (ADR) increases risks of interval cancers (ICs). Proximal colon flat polyps, e.g. serrated lesions (SLs), are difficult to find. Missed proximal colon flat lesions likely contribute to IC. Aims We compared chromoendoscopy with water exchange (CWE), water exchange (WE) and air insufflation (AI) in detecting adenomas in screening colonoscopy. Methods After split-dose preparation, 480 veterans were randomized to AI, WE and CWE. Results Primary outcome of proximal ADR (55.6% vs 53.4% vs 52.2%, respectively) were similar in all groups. Adenoma per colonoscopy (APC) and adenoma per positive colonoscopy (APPC) were comparable. Detection rate of proximal colon SLs was significantly higher for CWE and WE than AI (26.3%, 23.6% and 11.3%, respectively, p = 0.002). Limitations: single operator; SLs only surrogate markers of but not IC. Conclusions When an endoscopist achieves high-quality AI examinations with overall ADR twice (61.6%) the recommended standard (30%), use of WE and CWE does not produce further improvement in proximal or overall ADR. Comparable APC and APPC confirm equivalent withdrawal inspection techniques. WE alone is sufficient to significantly improve detection of proximal SLs. The impact of increased detection of proximal SLs by WE on prevention of IC deserves to be studied. This study is registered at ClinicalTrial.gov (NCT#01607255).

Published
2019

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