| Cap-fitted colonoscopy: a randomized, tandem colonoscopy study of adenoma miss rates. | |
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MedLine Citation:
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PMID: 20579648 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Failures of adenoma detection diminish the effectiveness of colonoscopy. OBJECTIVE: This study investigated the impact of cap-fitted colonoscopy (CFC) on the adenoma miss rate at colonoscopy. DESIGN: Randomized, tandem colonoscopy study. SETTING: University hospital. PATIENTS: This study involved patients undergoing elective screening or surveillance colonoscopy. INTERVENTION: Patients were randomized to undergo cap-fitted (n = 52) or regular, high-definition (n = 48) colonoscopy before undergoing a second colonoscopy by the alternate method. During CFC, a plastic cap or hood was attached to the tip of the colonoscope, which was used to flatten haustral folds and improve mucosal exposure. MAIN OUTCOME MEASUREMENTS: The primary outcome measure was the miss rate for adenomas between patients who underwent CFC first and patients who underwent regular colonoscopy first. RESULTS: A total of 238 adenomas were detected in 67 patients (67%), with a combined overall miss rate of 27.7%, comprising 66 missed adenomas in 38 patients. Patients undergoing initial CFC had a significantly lower miss rate for all adenomas compared with that of patients undergoing regular colonoscopy (21% vs 33%, P = .039). Miss rates with CFC were significantly lower for adenomas of ≤5 mm (22% vs 35%; P = .037). There was no significant difference in per-patient miss rates between the initial CFC group (51%, n = 18) and the initial regular colonoscopy group (63%, n = 20, P = .36). LIMITATIONS: Single-center study with two endoscopists. CONCLUSION: CFC reduces miss rates for all adenomas and specifically for small adenomas. (Clinical trial registration number: NCT00577083). |
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Authors:
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David G Hewett; Douglas K Rex |
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Publication Detail:
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Type: Journal Article Date: 2010-06-25 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 72 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 775-81 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Gastroenterology/Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00577083 |
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| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2010 Oct;72(4):782-3
[PMID:
20883855
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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