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Article: Efficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trial
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TitleEfficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trial
 
AuthorsLee, YT2 1
Lai, LH2
Hui, AJ2
Wong, VWS2
Ching, JYL2
Wong, GLH2
Wu, JCY2
Chan, HLY2
Leung, WK2
Lau, JYW2
Sung, JJY2
Chan, FKL2
 
Issue Date2009
 
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
CitationAmerican Journal Of Gastroenterology, 2009, v. 104 n. 1, p. 41-46 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2008.56
 
AbstractOBJECTIVES: Colonoscopy cannot be completed in up to 10 of cases. We postulate that cap-assisted colonoscopy (CAC), by fitting a mucosectomy cap to the tip of a colonoscope, could improve the outcome. METHODS: We conducted a prospective randomized controlled trial in two regional endoscopy centers. All colonoscopies were performed by experienced colonoscopists. Patients 18 years or older undergoing their first colonoscopy were recruited. Patients were randomized to the CAC group or to the regular colonoscopy (RC) group. The first successful cecal intubation rate, rescue cecal intubation rate, cecal intubation and total colonoscopy times, and polyp detection rate were compared. RESULTS: One thousand patients were enrolled (mean age 52.6 years, 46 men). There was no statistically significant difference in the first successful cecal intubation rate between CAC and RC groups (96.2 vs. 94.6, P0.23). The cecal intubation and total colonoscopy times were shorter in the CAC group than in the RC group (6.0±4.0min vs. 7.2±4.8min, P<0.001; 14.7±8.6min vs. 16.7±10.3min, P0.001). The adenoma detection rate was significantly lower in the CAC group than in the RC group (30.5 vs. 37.5, P0.018), but there was no significant difference in the detection of advanced lesions. In case of failing cecal intubation, use of CAC as a rescue method could achieve a higher success rate than RC (66.7 vs. 21.1, P0.003). CONCLUSIONS: Among experienced colonoscopists, CAC did not improve the initial cecal intubation rate and had a lower adenoma detection rate. However, it shortened the cecal intubation time and performed better as a rescue method. Its utilization should be reserved for selected cases, especially when initial cecal intubation fails. © 2009 by the American College of Gastroenterology.
 
ISSN0002-9270
2013 Impact Factor: 9.213
 
DOIhttp://dx.doi.org/10.1038/ajg.2008.56
 
ISI Accession Number IDWOS:000262265800009
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLee, YT
 
dc.contributor.authorLai, LH
 
dc.contributor.authorHui, AJ
 
dc.contributor.authorWong, VWS
 
dc.contributor.authorChing, JYL
 
dc.contributor.authorWong, GLH
 
dc.contributor.authorWu, JCY
 
dc.contributor.authorChan, HLY
 
dc.contributor.authorLeung, WK
 
dc.contributor.authorLau, JYW
 
dc.contributor.authorSung, JJY
 
dc.contributor.authorChan, FKL
 
dc.date.accessioned2012-09-05T05:28:59Z
 
dc.date.available2012-09-05T05:28:59Z
 
dc.date.issued2009
 
dc.description.abstractOBJECTIVES: Colonoscopy cannot be completed in up to 10 of cases. We postulate that cap-assisted colonoscopy (CAC), by fitting a mucosectomy cap to the tip of a colonoscope, could improve the outcome. METHODS: We conducted a prospective randomized controlled trial in two regional endoscopy centers. All colonoscopies were performed by experienced colonoscopists. Patients 18 years or older undergoing their first colonoscopy were recruited. Patients were randomized to the CAC group or to the regular colonoscopy (RC) group. The first successful cecal intubation rate, rescue cecal intubation rate, cecal intubation and total colonoscopy times, and polyp detection rate were compared. RESULTS: One thousand patients were enrolled (mean age 52.6 years, 46 men). There was no statistically significant difference in the first successful cecal intubation rate between CAC and RC groups (96.2 vs. 94.6, P0.23). The cecal intubation and total colonoscopy times were shorter in the CAC group than in the RC group (6.0±4.0min vs. 7.2±4.8min, P<0.001; 14.7±8.6min vs. 16.7±10.3min, P0.001). The adenoma detection rate was significantly lower in the CAC group than in the RC group (30.5 vs. 37.5, P0.018), but there was no significant difference in the detection of advanced lesions. In case of failing cecal intubation, use of CAC as a rescue method could achieve a higher success rate than RC (66.7 vs. 21.1, P0.003). CONCLUSIONS: Among experienced colonoscopists, CAC did not improve the initial cecal intubation rate and had a lower adenoma detection rate. However, it shortened the cecal intubation time and performed better as a rescue method. Its utilization should be reserved for selected cases, especially when initial cecal intubation fails. © 2009 by the American College of Gastroenterology.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationAmerican Journal Of Gastroenterology, 2009, v. 104 n. 1, p. 41-46 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2008.56
 
dc.identifier.doihttp://dx.doi.org/10.1038/ajg.2008.56
 
dc.identifier.epage46
 
dc.identifier.isiWOS:000262265800009
 
dc.identifier.issn0002-9270
2013 Impact Factor: 9.213
 
dc.identifier.issue1
 
dc.identifier.pmid19098847
 
dc.identifier.scopuseid_2-s2.0-60749087179
 
dc.identifier.spage41
 
dc.identifier.urihttp://hdl.handle.net/10722/163230
 
dc.identifier.volume104
 
dc.languageeng
 
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Gastroenterology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshCecum
 
dc.subject.meshColonoscopes
 
dc.subject.meshColonoscopy - Methods
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshIntubation
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.titleEfficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trial
 
dc.typeArticle
 
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<contributor.author>Wong, VWS</contributor.author>
<contributor.author>Ching, JYL</contributor.author>
<contributor.author>Wong, GLH</contributor.author>
<contributor.author>Wu, JCY</contributor.author>
<contributor.author>Chan, HLY</contributor.author>
<contributor.author>Leung, WK</contributor.author>
<contributor.author>Lau, JYW</contributor.author>
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Author Affiliations
  1. Hong Kong Baptist Hospital
  2. Chinese University of Hong Kong