Computer-assisted detection versus conventional colonoscopy for proximal colonic lesions: a multicenter, randomized, tandem-colonoscopy study.
Gastrointest Endosc
; 97(2): 325-334.e1, 2023 Feb.
Article
em En
| MEDLINE
| ID: mdl-36208795
ABSTRACT
BACKGROUND AND AIMS:
Computer-assisted detection (CADe) is a promising technologic advance that enhances adenoma detection during colonoscopy. However, the role of CADe in reducing missed colonic lesions is uncertain. The aim of this study was to determine the miss rates of proximal colonic lesions by CADe and conventional colonoscopy.METHODS:
This was a prospective, multicenter, randomized, tandem-colonoscopy study conducted in 3 Asian centers. Patients were randomized to receive CADe or conventional white-light colonoscopy during the first withdrawal of the proximal colon (cecum to splenic flexure), immediately followed by tandem examination of the proximal colon with white light in both groups. The primary outcome was adenoma/polyp miss rate, which was defined as any adenoma/polyp detected during the second examination.RESULTS:
Of 223 patients (48.6% men; median age, 63 years) enrolled, 7 patients did not have tandem examination, leaving 108 patients in each group. There was no difference in the miss rate for proximal adenomas (CADe vs conventional 20.0% vs 14.0%, P = .07) and polyps (26.7% vs 19.6%, P = .06). The CADe group, however, had significantly higher proximal polyp (58.0% vs 46.7%, P = .03) and adenoma (44.7% vs 34.6%, P = .04) detection rates than the conventional group. The mean number of proximal polyps and adenomas detected per patient during the first examination was also significantly higher in the CADe group (polyp 1.20 vs .86, P = .03; adenoma, .91 vs .61, P = .03). Subgroup analysis showed that CADe enhanced proximal adenoma detection in patients with fair bowel preparation, shorter withdrawal time, and endoscopists with lower adenoma detection rate.CONCLUSIONS:
This multicenter trial from Asia confirmed that CADe can further enhance proximal adenoma and polyp detection but may not be able to reduce the number of missed proximal colonic lesions. (Clinical trial registration number NCT04294355.).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Adenoma
/
Pólipos do Colo
/
Neoplasias do Colo
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China