Comparison Between Magnifying and High Resolution Colonoscopy for Diagnosis of Colorectal Lesions: A Prospective Randomized Brazilian Study

Oliveira, Lix Alfredo Reis de; Hipolito, Maristela; Thuler, Fernanda Prata Borges Martins; Ferrari, Ângelo Paulo

doi:10.1016/j.gie.2006.03.490

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“…The mucosal crypt pattern seen on magnifying colonoscopy has been said to predict the histopathology of colorectal lesions. Oliveira et al [16] compared magnifying colonoscopy and high-resolution colonoscopy for the diagnosis of colorectal lesions. The study included 1171 patients who were randomly assigned to undergo either magnifying colonoscopy (n = 744) or high-resolution colonoscopy (n = 427) for the management of neoplastic or non-neoplastic lesions of the colon.…”

Section: Technical Innovationsmentioning

confidence: 99%

Colon tumors and colonoscopy

Misra¹,

Dwivedi²

2006

Endoscopy

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IntroductionThe Digestive Disease Week (DDW) meeting held in Los Angeles in 2006 featured many abstracts on diverse colonoscopy topics, including the ease of cecal intubation; the detection and importance of treatment of diminutive colorectal polyps; and the role of submucosal dissection, with or without ligation, for colonic tumors, especially rectal carcinoids. Many studies aimed to clarify the role of high-resolution colonoscopy compared with magnifying colonoscopy, and the importance of narrow-band imaging and autofluorescence imaging in the detection and management of colonic tumors was also explored. Facilitating full-length colonoscopyThe primary aim of colonoscopy is to achieve full-length colonoscopy with cecal and ileal intubation within a minimum time frame, and with minimal pain or discomfort for the patient. With this in mind, various modifications to the instrument have been tried, such as varying its rigidity and adding on devices. This year's DDW sessions also included presentations describing various modifications that minimized pain and sedation needs, or reduced looping of the colonoscope. Ganz et al.[1] presented a new colonoscopic propulsion device (Softscope) that prevented colon looping and helped in the advancement of the colonoscope. This propulsion device is a short (6 cm), fluid-cushioned cylinder with a hollow core which perpetually involutes on itself via a proprietary drive mechanism. This can be attached to any colonoscope by placing the scope through the center of the device and tightening it in place just behind the bending section of the insertion tube. The device has a variable speed and can be run in either forward or backward direction. The device was found to prevent looping during ex-vivo and live porcine colonoscopy. Further studies need to be carried out to see if the results can be extrapolated to human clinical practice.Lee et al.[2] compared mucosectomy using cap-assisted colonoscopy with mucosectomy using conventional colonoscopy in a randomized controlled study and showed that both the cecal intubation time and the total colonoscopy time were significantly shorter in the cap-assisted colonoscopy group compared with the conventional colonoscopy group. Failure of cecal intubation related to looping and bending was twice as common in the conventional colonoscopy group as it was in the cap-assisted colonoscopy group. The primary end points in this study were the rate of complete examination, the cecal and terminal ileal intubation time, and the total colonoscopy time; the secondary end points were the endoscopist's satisfaction with the procedure, the level of difficulty of performing the polypectomy, and the patient's pain score on a 10-point visual analog scale. Improvement in colonoscopic examination was the aim of many studies. Haber & Whalen [3] demonstrated the utility of the 60-cm Shapelock guide (USGI Technology, San Clemente, California, USA) for completion of colonoscopic examinations in patients in whom the procedure had previously failed. This device facilitat...

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Section: Technical Innovationsmentioning

confidence: 99%