Polypdetectionratesusingmagnificationwithnarrowbandimagingandwhitelight

摘要： AIM:Tocomparetheyieldofadenomasbetweennarrowbandimagingandwhitelightwhenusinghighdefinition/magnification.METHODS:Thisprospective,non-randomizedcomparativestudywasperformedattheendoscopyunitofveteranaffairsmedicalcenterinPhoenix,Arizona.Consecutivepatientsundergoingfirstaverageriskcolorectalcancerscreeningcolonoscopywereselected.Twoexperiencedgastroenterologistsperformedalltheproceduresthatwereblindedtoeachothersfindings.Demographicdetailswererecorded.Dataarepresentedasmean±SEM.Proportionaldatawerecomparedusingtheχ2testandmeanswerecomparedusingtheStudentsttest.Tandemcolonoscopywasperformedinasequentialandsegmentalfashionusingoneof3strategies:whitelightfollowedbynarrowbandimaging[GroupA:whitelight(WL)→narrowbandimaging(NBI)];narrowbandimagingfollowedbywhitelight(GroupB:NBI→WL)and,whitelightfollowedbywhitelight(GroupC:WL→WL).Detectionrateofmissedpolypsandadenomaswereevaluatedinallthreegroups.RESULTS:Threehundredpatientswerestudied(100ineachGroup).Althoughthetotaltimeforthecolonoscopywassimilarinthe3groups(23.8±0.7,22.2±0.5and24.1±0.7minforGroupsA,BandC,respectively),itreachedstatisticalsignificancebetweenGroupsBandC(P<0.05).ThececalintubationtimeinGroupsBandCwaslongerthanforGroupA(6.5±0.4minand6.5±0.4minvs4.9±0.3min;P<0.05).ThewithdrawaltimeforGroupsAandCwaslongerthanGroupB(18.9±0.7minand17.6±0.6minvs15.7±0.4min;P<0.05).Overallmissrateforpolypsandadenomasdetectedinthreegroupsduringthesecondlookwas18%and17%,respectively(P=NS).Detectionrateforpolypsandadenomasafterfirstlookwithwhitelightwassimilarirrespectiveofthelightusedduringthesecondlook(WL→WL:13.7%forpolyps,12.6%foradenomas;WL→NBI:14.2%forpolyps,11.3%foradenomas).MissrateofpolypsandadenomashoweverwassignificantlyhigherwhenNBIwasusedfirst(29.3%and30.3%,respectively;P<0.05).Mostmissedadenomaswere≤5mminsize.Therewasonlyoneadvancedneoplasia(definedbysizeonly)missedduringthefirstlook.CONCLUSION:Ourdatasuggestthatthetandemnatureoftheprocedureratherthantheopticaltechniqueswasassociatedwiththedetectionofadditionalpolypsandadenomas. ... （共8页）