Comparing right colon adenoma detection rate during water exchange and air insufflation: a double-blind randomized controlled trial

Tseng, Chih‐Wei; Hsieh, Yu–Hsi; Koo, Malcolm; Leung, Felix W.

doi:10.1007/s10151-021-02537-1

Cited by 8 publications

(7 citation statements)

References 39 publications

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“…Compared with gas insufflation WE significantly increased overall advanced ADR, 5 right colon ADR 6 and serrated lesions detection rate 6 . WE decreased the miss rate of right colon adenomas 6,7 and serrated polyps 7 . WE produced significantly higher ADR than WI 8 .…”

Section: Discussionmentioning

confidence: 94%

“…In support of positive expert views on WE the following WAC reports (2019 to 2022) were worth noting as they continued to show superior outcomes with WE compared with gas insufflation or WI. Compared with gas insufflation WE significantly increased overall advanced ADR, 5 right colon ADR 6 and serrated lesions detection rate 6 . WE decreased the miss rate of right colon adenomas 6,7 and serrated polyps 7 .…”

Section: Discussionmentioning

confidence: 95%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

“…In this context, it is important to explore how WE could benefit screening colonoscopy practice during pandemic recovery. In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights 5–13 …”

Section: Introductionmentioning

confidence: 99%

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A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Endoscopy featured water-aided colonoscopy (WAC) as novel in the Innovation Forum in 2011. Gastrointestinal Endoscopy published a modified Delphi consensus review (MDCR) that supports WAC for clinical practice in 2021. We tested the hypothesis that experience was an important predictor of WAC use, either as water immersion (WI), water exchange (WE), or a combination of WI and WE. Methods: A questionnaire was sent by email to the MDCR authors with an in-depth knowledge of WAC. They responded and also invited colleagues and trainees without in-depth knowledge to respond. Logistic regression analysis was used with the reasons for WAC use treated as the primary outcome. Reports related to WAC post MDCR were identified. Results: Of 100 respondents, > 80% indicated willingness to adopt and modify practice to accommodate WAC. Higher adenoma detection rate (ADR) incentivized WE use. Procedure time slots ≤ 30 and > 30 min significantly predicted WI and WE use, respectively. Co-authors of the MDCR were significantly more likely to perform WAC (odds ratio [OR] = 7.5, P = 0.037). Unfamiliarity with (OR = 0.11, P = 0.02) and absence of good experience (OR = 0.019, P = 0.002) were associated with colonoscopists less likely to perform WAC. Reports related to WAC post MDCR revealed overall and right colon WE outcomes continued to improve. Network meta-analyses showed that WE was superior to Cap and Endocuff. On-demand sedation with WE shortened nursing recovery time. Conclusions: An important predictor of WAC use was experience. Superior outcomes continued to be reported with WE.* Kruskal-Wallis non-parametric test.CO 2 , carbon dioxide; WAC, water-aided colonoscopy; WE, water exchange colonoscopy; WI, water immersion colonoscopy.FW Leung et al.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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“…Colonoscopy and histological staining: An attending physician or an associate chief physician with >3 years of experience performed the colonoscopy using an Olympus GIF HQ290 colonoscope with a preoperative Boston bowel preparation scale score of ≥ 7 and a withdrawal time of ≥ 6 min[ 10 ]. The specimen was obtained by colonoscopy, following which it was fixed with 10% neutral buffered formalin and stained using hematoxylin and eosin.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

Qiao¹,

Liu²,

Zheng³

et al. 2023

World J Clin Cases

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BACKGROUND Colorectal cancer (CRC) is the third most common cancer worldwide, with the fourth highest mortality among all cancers. Reportedly, in addition to adenomas, serrated polyps, which account for 15%-30% of CRCs, can also develop into CRCs through the serrated pathway. Sessile serrated adenomas/polyps (SSAs/Ps), a type of serrated polyps, are easily misdiagnosed during endoscopy. AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types. METHODS From January 2021 to December 2021, patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital, affiliated with Shanghai University of Traditional Chinese Medicine. Thirty cases each of large intestine damp-heat (Da-Chang-Shi-Re, DCSR) syndrome and spleen-stomach weakness (Pi-Wei-Xu-Ruo) syndrome were reported. Baseline comparison of the general data, typical tongue coating, colonoscopy findings, and hematoxylin and eosin findings was performed in each group. The expression of the Wnt pathway-related proteins, namely β-catenin, adenomatous polyposis coli, and mutated in colorectal cancer, were analyzed using immunohistochemistry. RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types ( P = 0.001). The other aspects did not differ between the two groups. The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups, which was manifested as β-catenin protein translocation into the nucleus. However, SSAs/Ps patients with DCSR syndrome had more nucleation, higher β-catenin expression, and negative regulatory factor (adenomatous polyposis coli and mutated in colorectal cancer) expression ( P < 0.0001) than SSA/P patients with Pi-Wei-Xu-Ruo syndrome. In addition, the SSA/P size was linearly correlated with the related protein expression. CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis. A high-quality colonoscopic diagnosis was essential. The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.

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Polyp detection and false-positive rates by computer-aided analysis of withdrawal-phase videos of colonoscopy of the right-sided colon segment in a randomized controlled trial comparing water exchange and air insufflation

Tang

Lin

Hsieh

et al. 2022

Gastrointestinal Endoscopy

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Comparing right colon adenoma detection rate during water exchange and air insufflation: a double-blind randomized controlled trial

Cited by 8 publications

References 39 publications

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

Polyp detection and false-positive rates by computer-aided analysis of withdrawal-phase videos of colonoscopy of the right-sided colon segment in a randomized controlled trial comparing water exchange and air insufflation

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