科研之友
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摘要
Background: Clinical demand for total colonoscopy is increasing. Several articles have reported on the usefulness of a cap for faster cecal intubation and reduced patient discomfort, but results for polyp and adenoma detection have been inconsistent. Objective: To assess the efficacy of a cap attached to the tip of a colonoscope for detection and resection of polyps by experienced colonoscopists. Design: Prospective, randomized, controlled trial. Setting: A tertiary referral center. Patients and Intervention: A total of 329 patients who underwent colonoscopic EMR were randomized to cap-assisted colonoscopy (CAC) (CAC group, n = 166) or regular colonoscopy (RC) (RC group, n = 163). Main Outcome Measurements: Cecal intubation time, total procedure time, required time for colonoscopic EMR of each polyp, and missing polyp rate. Results: The cecal intubation time in the CAC group and RC group was 5.3 +/- 3.3 minutes and 5.8 +/- 3.7 minutes, respectively (P = .170). The total procedure time in the CAC group and RC group was 23.0 +/- 15.5 minutes and 29.2 +/- 13.4 minutes, respectively (P = .626). The time required for colonoscopic EMR of each polyp in the CAC group and RC group was 3.5 +/- 4.5 minutes and 4.2 +/- 5.1 minutes, respectively (P = .010). The number of polyps during the initial colonoscopy in the CAC group and RC group was 2.2 +/- 1.7 and 2.0 +/- 1.8, respectively (P = .221). The number of detected polyps during colonoscopic EMR in the CAC group and RC group was 3.4 +/- 2.7 and 2.7 +/- 1.9 (P = .003). The number of missed polyps in the CAC group and RC group was 1.1 +/- 1.5 and 0.8 +/- 0.9 (P = .024). Limitation: Single-center experience. Conclusions: CAC may reduce the time required for colonoscopic EMR of each polyp and may also improve the polyp detection rate. (Gastrointest Endosc 2011;74:869-75.)
- 出版日期2011-10
