Back to Search
Start Over
Effect of water exchange method on adenoma miss rate of patients undergoing selective polypectomy: A randomized controlled trial
- Source :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 53(5)
- Publication Year :
- 2020
-
Abstract
- Background Adenomas may be missed in up to 40% of screening colonoscopies. Although the water exchange (WE) method can improve ADR, as shown in several RCTs, it remains uncertain whether it can increase the detection of missing adenomas compared with standard air-insufflated (AI) colonoscopy. Methods Patients aged 18–80 years who underwent selective polypectomy were randomly allocated to the WE or AI group. The primary endpoint was the adenoma miss rate (AMR), defined as the number of patients with one or more additional adenomas during the polypectomy procedure divided by the total number of patients in each group. Results A total of 450 patients were enrolled, with 225 in each group. The overall AMRs were 45.8% (103/225) in the WE group and 35.6% (80/225) in the AI group (p = 0.035). More patients in the WE group had at least one missed adenoma in the proximal colon (38.2% vs 24.4%, p = 0.002). The adenoma-level miss rate was also higher in the WE group than in the AI group (35.1% vs 29.0%, p = 0.036). Subgroup analysis showed that patients in the WE group had more missed adenomas located in the proximal colon or with flat shapes. Conclusions This study confirmed that substantial adenomas were missed in patients undergoing selective polypectomy. The WE method significantly improved the detection of missed adenomas, especially those located in the proximal colon or with flat shapes. (ClnicalTrials.gov number: NCT02880748)
- Subjects :
- Adenoma
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Colonoscopy
Colonic Polyps
Subgroup analysis
Water exchange
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
medicine
Clinical endpoint
Humans
Single-Blind Method
Prospective Studies
Miss rate
Hepatology
medicine.diagnostic_test
Missed Diagnosis
business.industry
Gastroenterology
Water
Middle Aged
medicine.disease
digestive system diseases
Polypectomy
Surgery
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
business
Subjects
Details
- ISSN :
- 18783562
- Volume :
- 53
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Accession number :
- edsair.doi.dedup.....55d7e44b84e8a6d38f86c2a1fda6de8c