Narrow-Band Versus White-Light High Definition Television Endoscopic Imaging for Screening Colonoscopy: A Prospective Randomized Trial

Adler, Andreas; Aschenbeck, Jens; Yenerim, Timur; Mayr, Michael; Aminalai, A; Drossel, R; Schröder, Andreas; Scheel, M; Wiedenmann, Bertram; Rösch, Thomas

doi:10.1053/j.gastro.2008.10.022

Cited by 184 publications

(140 citation statements)

References 37 publications

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“…The ADR of 62% using the water with indigo carmine method was higher than those derived from studies using other modalities, even those obtained with high definition colonoscopes 15,[21][22][23] , narrow band imaging (NBI) 24,27,28 or dye spray chromoendoscopy [35][36][37] . Conventional targeted dye-spray chromoendoscopy has been reported to require up to an average of 33 minutes in total procedure time 13 , 26 minutes in withdrawal time 10 , or a median withdrawal time of 25 minutes (range 8 -153 min) 37 .…”

Section: Discussionmentioning

confidence: 87%

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The water method combined with chromoendoscopy enhances adenoma detection

Leung¹,

Ransibrahmanakul²,

Toomsen³

et al. 2011

jig

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Background:The water method is easy-to-learn and improves colonoscopy outcomes. Dye-spray chromoendoscopy enhances ADR but has not been widely accepted for routine application in screening or surveillance colonoscopy. Hypothesis: With dye added to the water used in the water method, ADR can be enhanced compared with the water or air method alone. Objective: To compare ADR determined by the air method, water method alone, and water method with indigo carmine (0.008%) added. Design: Review of prospectively collected data in a performance improvement program. Setting: VA endoscopy unit. Patient: Screening or surveillance colonoscopy. Methods: Patients (n=50/group) underwent colonoscopy with each of the three methods. Water method involved warm water infusion in lieu of air insufflation coupled with removal of residual air by suction and residual feces by water exchange. ADR and procedural data were collected prospectively to monitor performance. Main Outcome Measurements: ADR. Results: ADR in the air method, water method alone and water method with indigo carmine were 36%, 40% and 62%, respectively. Water method with indigo carmine produced significantly higher ADR than the air or water method alone (p<0.05). Limitations: Non-randomized data, single VA site, retrospective comparison. Absence of significant difference between air and water methods could be a type II error due to small number of patients Conclusions: The approach with indigo carmine added to the water used in the water method yielded significantly higher ADR than the water or the air method alone. The data suggest that a prospective RCT to compare the different methods is warranted.

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Section: Discussionmentioning

confidence: 87%

“…Distal = distal to the splenic flexure. definition, wide-angle endoscope 15,[21][22][23][24][25] ; narrow band imaging [26][27][28] ; transparent hood attached to the tip of the colonoscope 26,29,30 withdrawal time >6 min 31,32 or modified (e.g. split-dose) bowel preparation 33,34 .…”

Section: Discussionmentioning

confidence: 99%

The water method combined with chromoendoscopy enhances adenoma detection

Leung¹,

Ransibrahmanakul²,

Toomsen³

et al. 2011

jig

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“…NBI is expected to result in better detection of colorectal adenomas and better distinction between neoplasms and nonneoplastic lesions. Recently, although several investigators in western countries have been trying to demonstrate its ability to detect colorectal adenomas, most randomized trials have reported negative results (Adler et al, 2008(Adler et al, , 2009). On the other hands, Japanese investigators have reported positive results in their articles (Inoue et al, 2008;Uraoka et al, 2008).…”

Section: Optical Methods For Minimizing the Overlooking Of Colorectalmentioning

confidence: 99%

Recent Advances in Diagnostic Endoscopy for Colorectal Neoplasm

Takeuchi¹,

Hanaoka²,

Hanafusa³

2011

Gastrointestinal Endoscopy

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“…The reasons for missed polyps included the quality of bowel preparation, lesion characteristics (location, number, shape, and size), the endoscopist's experience, and the operator's insertion and withdrawal techniques [41][42][43][44]. Although many clinical studies, including randomized controlled trials (RCTs), have confirmed reduced missed rates in colonoscopy using NBI techniques [45][46][47][48][49][50][51][52], one recent meta-analysis revealed that there was no statistically significant difference in the rates of adenoma detection rate between NBI and WL [53], and a large-scale multicenter Japanese study did not show an improvement with NBI [54]. Moreover, another systematic review including 8 RCTs showed that NBI did not improve detection of colorectal polyps when compared to WL [55].…”

Section: Adenoma Detection Ratementioning

confidence: 99%