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Cap-Assisted Chromoendoscopy Using a Mounted Cap Versus Standard Colonoscopy for Adenoma Detection

Authors
 Kim, Su Young  ;  Park, Hong Jun  ;  Kim, Hyun-Soo  ;  Park, Dong Il  ;  Cha, Jae Myung  ;  Park, Seun-Ja  ;  Choi, Hwang  ;  Shin, Jeong Eun  ;  Eun, Chang Soo  ;  Kim, Jin Oh  ;  Kim, Hyun Gun  ;  Kim, Seong-Eun  ;  Park, Cheol Hee  ;  Kim, Tae Il  ;  Hong, Sung Noh 
Citation
 AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol.115(3) : 465-472, 2020 
Journal Title
 AMERICAN JOURNAL OF GASTROENTEROLOGY 
ISSN
 0002-9270 
Issue Date
2020
Abstract
OBJECTIVES: Some neoplastic lesions remain undetected on colonoscopy. To date, no studies have investigated whether combining cap-assisted colonoscopy with chromoendoscopy increases the adenoma detection rate (ADR). This study aimed to compare cap-assisted chromoendoscopy (CAP/CHROMO) with standard colonoscopy (SC) with respect to their efficacy in detecting adenomas. METHODS: This prospective, multicenter, randomized controlled trial included asymptomatic subjects aged 45-75 years who underwent colonoscopy for the first time at 14 university hospitals. Subjects were randomized to either the CAP/CHROMO group (with 0.09% indigo carmine spraying using a cap-mounted catheter at the tip of the colonoscope) or the SC group. All polyps were resected, but only histologically confirmed neoplastic lesions were considered for analysis. The primary outcome was ADR, defined as the proportion of subjects with at least 1 adenoma. RESULTS: A total of 1,905 subjects were randomized to the CAP/CHROMO (n = 948) or SC (n = 957) group at 14 centers. Subjects' demographic characteristics were similar between both groups. The CAP/CHROMO group had significantly higher ADR than the SC group (54.4% vs 44.9%, P < 0.001). Significantly, more subjects with at least 1 proximal colon adenoma were identified by CAP/CHROMO (38.6%) than by SC (31.2%) (P = 0.001). The proximal serrated polyp detection rate by CAP/CHROMO was significantly higher in the female subgroup vs SC. However, advanced ADR was not different between the CAP/CHROMO and SC groups (9.3% vs 7.6%, P = 0.180). DISCUSSION: CAP/CHROMO markedly improved the ADR and enhanced the detection of proximal adenoma. CAP/CHROMO is feasible for routine application and will allow for a more effective surveillance program.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000434-202003000-00021&LSLINK=80&D=ovft
DOI
10.14309/ajg.0000000000000510
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175590
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