Comparative study of conventional colonoscopy and pan-colonic narrow-band imaging system in the detection of neoplastic colonic polyps: a randomized, controlled trial |
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Authors: | Takuya Inoue Mitsuyuki Murano Naoko Murano Takanori Kuramoto Ken Kawakami Yosuke Abe Eijiro Morita Ken Toshina Hideo Hoshiro Yutaro Egashira Eiji Umegaki Kazuhide Higuchi |
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Institution: | (1) Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki 569-8686, Japan;(2) Department of Pathology, Osaka Medical College, Osaka, Japan |
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Abstract: | Background. Detection and removal of adenomas by colonoscopy is an important means for preventing cancer; however, small adenomas may
be missed during colonoscopy. The narrow-band imaging (NBI) system clearly enhances the microvasculature in neoplastic lesions,
making it appear as a dark complex. Therefore, the NBI system may improve the detection of colonic neoplasias. However, no
randomized, controlled trials have evaluated the efficacy of a pan-colonic NBI system in adenoma detection. We conducted a
randomized, controlled trial to determine the efficacy of the pancolonic NBI system in adenoma detection. Methods. Two hundred forty-three patients were randomized, 121 to conventional colonoscopy and 122 to pan-colonic NBI system. Demographics,
indication for colonoscopy, and quality of preparation were similar between groups. Results. Extubation time was not significantly different between the conventional colonoscopy and pan-colonic NBI system. The proportions
of patients with at least one adenoma and those with multiple adenomas were not significantly different between groups. However,
the pan-colonic NBI system significantly increased the total number of adenomas detected (P < 0.05) and the number of diminutive (<5 mm) adenomas detected (P < 0.05). The pan-colonic NBI system allowed detection of more diminutive adenomas in the distal colon than did conventional
colonoscopy (P < 0.01), and more patients in the NBI group had at least one diminutive adenoma than in the control group (P < 0.05). Conclusions. The pan-colonic NBI system improves the total number of adenomas detected, including significantly
more diminutive adenomas, without prolongation of extubation time. These results indicate that routine use of the NBI system
for surveillance of diminutive adenomas may be recommended. |
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Keywords: | narrow-band imaging conventional colonoscopy detection randomized controlled trial |
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