TY - JOUR
T1 - Improving serrated adenoma detection rate in the colon by electronic chromoendoscopy and distal attachment
T2 - systematic review and meta-analysis
AU - Aziz, Muhammad
AU - Desai, Madhav
AU - Hassan, Seemeen
AU - Fatima, Rawish
AU - Dasari, Chandra S.
AU - Chandrasekar, Viveksandeep Thoguluva
AU - Jegadeesan, Ramprasad
AU - Duvvuri, Abhiram
AU - Patel, Harsh
AU - Rai, Tarun
AU - Sathyamurthy, Anjana
AU - Kohli, Divyanshoo R.
AU - Vennalaganti, Prashanth
AU - Nawras, Ali
AU - Wallace, Michael
AU - Sharma, Prateek
N1 - Publisher Copyright:
© 2019
PY - 2019/11
Y1 - 2019/11
N2 - Background and Aims: The evidence for modification of conventional colonoscopy using either “distal attachments” (DAs; endocap, endocuff, and endoring) or “electronic chromoendoscopy” (EC; narrow-band imaging [NBI], iScan, blue-light imaging, autofluorescence imaging, and linked-color imaging) to improve the detection of serrated adenomas during colonoscopy has shown conflicting results. Methods: A comprehensive literature search was performed using Medline, Google Scholar, Embase, and Cochrane Library based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) comparing any DA or EC with high-definition white-light colonoscopy for detection of serrated adenomas (sessile serrated adenoma/polyp and traditional serrated adenoma) were included. The primary outcome was serrated adenoma detection rate (SADR) defined as the number of patients with at least 1 serrated adenoma of total patients in that group. The secondary outcome was the number of serrated adenomas per subject. Pooled rates were reported using risk ratio (RR) with 95% confidence interval. Results: Seventeen studies with 13,631 patients (56% men; age range, 50-66 years) met the inclusion criteria. The use of DAs (RR, 1.21; P = .45) and EC (RR, 1.29; P = .09) during colonoscopy did not show a significant improvement in SADR. The SADR using EC was 6.9% (4 studies) and that with NBI alone was 3.7% (3 studies). Conclusions: The results indicate that, except for NBI, the use of DAs or EC during colonoscopy does not improve detection of serrated adenomas in the colon. More RCTs evaluating NBI are needed to explore the effect.
AB - Background and Aims: The evidence for modification of conventional colonoscopy using either “distal attachments” (DAs; endocap, endocuff, and endoring) or “electronic chromoendoscopy” (EC; narrow-band imaging [NBI], iScan, blue-light imaging, autofluorescence imaging, and linked-color imaging) to improve the detection of serrated adenomas during colonoscopy has shown conflicting results. Methods: A comprehensive literature search was performed using Medline, Google Scholar, Embase, and Cochrane Library based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) comparing any DA or EC with high-definition white-light colonoscopy for detection of serrated adenomas (sessile serrated adenoma/polyp and traditional serrated adenoma) were included. The primary outcome was serrated adenoma detection rate (SADR) defined as the number of patients with at least 1 serrated adenoma of total patients in that group. The secondary outcome was the number of serrated adenomas per subject. Pooled rates were reported using risk ratio (RR) with 95% confidence interval. Results: Seventeen studies with 13,631 patients (56% men; age range, 50-66 years) met the inclusion criteria. The use of DAs (RR, 1.21; P = .45) and EC (RR, 1.29; P = .09) during colonoscopy did not show a significant improvement in SADR. The SADR using EC was 6.9% (4 studies) and that with NBI alone was 3.7% (3 studies). Conclusions: The results indicate that, except for NBI, the use of DAs or EC during colonoscopy does not improve detection of serrated adenomas in the colon. More RCTs evaluating NBI are needed to explore the effect.
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U2 - 10.1016/j.gie.2019.06.041
DO - 10.1016/j.gie.2019.06.041
M3 - Review article
C2 - 31288029
AN - SCOPUS:85071716867
SN - 0016-5107
VL - 90
SP - 721-731.e1
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 5
ER -