Wide angle colonoscopy with a prototype instrument: impact on miss rates and efficiency as determined by back-to-back colonoscopies

Rex, Douglas K.; Chadalawada, Vidyasree; Helper, Debra J.
September 2003
American Journal of Gastroenterology;Sep2003, Vol. 98 Issue 9, p2000
Academic Journal
: ObjectivePolyps are missed during conventional colonoscopy, even with meticulous technique. The aim of this study was to investigate whether a prototype wide angle colonoscope is associated with a reduced miss rate for polyps.: MethodsTwo studies were performed. In study 1, a total of 50 patients underwent back-to-back, same-day colonoscopy by a single examiner with the prototype wide angle colonoscope and with a standard colonoscope, with the order of scopes randomized. In study 1, an attempt was made to keep examination time with the two colonoscopes equal. In study 2, a total of 20 patients were examined, 10 by the same colonoscopist who performed study 1 and 10 by a second colonoscopist. In study 2, examiners tried to perform the examinations as quickly as accuracy would allow.: ResultsIn study 1, the miss rate for all polyps was lower with the wide angle colonoscope (20% vs 31%; p = 0.046), although the mean examination time with the wide angle instrument was shorter (6.75 min vs 7.64 min; p = 0.0005). There was no significant difference in detection of adenomas. Polyps, including adenomas, were missed in the peripheral endoscopic field more frequently with the standard colonoscope. In study 2, wide angle colonoscopy was associated with reductions in examination time of 25% and 30% for the two examiners, respectively. Miss rates were the same for one colonoscopist but were higher for the other colonoscopist when the wide angle instrument was used.: ConclusionA prototype wide angle colonoscope did not eliminate polyp miss rates. Wide angle colonoscopy has the potential to reduce examination time and improve visualization of the periphery of the endoscopic field of view, but improvements in resolution are needed.


Related Articles

  • Standard, high-definition colonoscopy detection rates similar in community setting.  // Hem/Onc Today;1/10/2013, Vol. 14 Issue 1, p8 

    The article discusses the results of a study by digestive disease specialist Asheesh Ray of Missouri, that compared standard-definition colonoscopies (SDC) and high-definition colonoscopies (HDC) which found that HDC was not able to significantly improve adenoma or polyp detection rates over SDC.

  • ADENOMA MARKERS OR BUSY WORK? Johnson, David A.; Cattau Jr., Edward L. // American Journal of Gastroenterology;Jun1991, Vol. 86 Issue 6, p783 

    Presents an abstract concerning the risk for colon adenomas in patients with rectosigmoid hyperplastic polyps. Prevalence of proximal adenomas in patients without distal hyperplastic polyps; Association of rectosigmoid adenomas with proximal adenomas; Limitation in the administration of...

  • Endoscopic colorectal cancer screening: screening modality vs. screening interval. Kessler, William R.; Nehme, Omar S. // American Journal of Gastroenterology;Dec2003, Vol. 98 Issue 12, p2796 

    In this study by Shoen et al., the benefit of repeat sigmoidoscopy performed 3 yr after a negative examination was assessed. The patient population was composed of participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). The mean age was 65.7 yr and 61.6% were...

  • Findings on Optical Colonoscopy After Positive CT Colonography Exam. Cornett, Daniel; Barancin, Courtney; Roeder, Brent; Reichelderfer, Mark; Frick, Terrance; Gopal, Deepak; Kim, David; Pickhardt, Perry J.; Taylor, Andrew; Pfau, Patrick // American Journal of Gastroenterology;Aug2008, Vol. 103 Issue 8, p2068 

    BACKGROUND & AIMS: The aim of this study is to evaluate the findings on optical colonoscopy (OC) after a positive CT colonography (CTC) exam and characterize the type of polyps seen on OC but not reported by CTC. METHODS: Over an 18-month period a total of 159 asymptomatic adults had polyps seen...

  • Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer. East, J. E.; Suzuki, N.; Stavrinidis, M.; Guenther, I.; Thomas, H. J. W.; Saunders, B. P. // Gut;Jan2008, Vol. 57 Issue 1, p65 

    Background: Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal...

  • Trainees' adenoma detection rate is higher if ≥10 minutes is spent on withdrawal during colonoscopy. Gromski, Mark; Miller, Christopher; Lee, Suck-Ho; Park, Eun; Lee, Tae; Park, Sang-Heum; Chung, Il-Kwun; Kim, Sun-Joo; Hwangbo, Young // Surgical Endoscopy;May2012, Vol. 26 Issue 5, p1337 

    Background: It has been demonstrated that prolonged colonoscopic withdrawal times (WT; >6 min) are beneficial for the adenoma detection rate (ADR) for experienced endoscopists. There are little data, however, to guide the appropriate colonoscopic withdrawal times for trainees. The purpose of...

  • Serrated Adenoma is a Risk Factor for Subsequent Adenomatous Polyps. Emily Glazer; Vidushi Golla; Robin Forman; Hongfa Zhu; Gabriel Levi; Henry Bodenheimer // Digestive Diseases & Sciences;Aug2008, Vol. 53 Issue 8, p2204 

    Abstract   Background Serrated adenomas (SA) are histologically defined by the presence of both hyperplastic and adenomatous features. These uncommon polyps are thought to play an important role in the development of sporadic colorectal cancers (CRC) with microsatellite instability (MSI)....

  • Quo Vadis. Karnam, Umaprasanna; Barkin, Jami S.; Johnson, David // American Journal of Gastroenterology;Jan2001, Vol. 96 Issue 1, p245 

    In the first prospective, multicenter Veterans Affairs (VA) cooperative study colonoscopy was performed to determine the prevalence and location of advanced colonic neoplasms and the risk of advanced proximal neoplasia in asymptomatic patients (age range 50-75 yr) with and without distal...

  • High definition colonoscopy finds polyps better than standard. Yoffee, Lynn // Medical Device Daily;10/30/2009, Vol. 13 Issue 210, p1 

    The article focuses on the report made by gastroenterologists at Mayo Clinic about the detection of polyps using high-definition (HD) colonoscopy. Presented at the American College of Gastroenterology, the report suggested that HD colonoscopy is more sensitive than standard colonoscopy in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics