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Article: Efficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trial

TitleEfficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trial
Authors
Issue Date2009
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 2009, v. 104 n. 1, p. 41-46 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/163230
ISSN
2014 Impact Factor: 10.755
2014 SCImago Journal Rankings: 3.376
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, YTen_US
dc.contributor.authorLai, LHen_US
dc.contributor.authorHui, AJen_US
dc.contributor.authorWong, VWSen_US
dc.contributor.authorChing, JYLen_US
dc.contributor.authorWong, GLHen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorChan, HLYen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorLau, JYWen_US
dc.contributor.authorSung, JJYen_US
dc.contributor.authorChan, FKLen_US
dc.date.accessioned2012-09-05T05:28:59Z-
dc.date.available2012-09-05T05:28:59Z-
dc.date.issued2009en_US
dc.identifier.citationAmerican Journal Of Gastroenterology, 2009, v. 104 n. 1, p. 41-46en_US
dc.identifier.issn0002-9270en_US
dc.identifier.urihttp://hdl.handle.net/10722/163230-
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.en_US
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_US
dc.relation.ispartofAmerican Journal of Gastroenterologyen_US
dc.subject.meshCecumen_US
dc.subject.meshColonoscopesen_US
dc.subject.meshColonoscopy - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIntubationen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.titleEfficacy of cap-assisted colonoscopy in comparison with regular colonoscopy: A randomized controlled trialen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1038/ajg.2008.56en_US
dc.identifier.pmid19098847en_US
dc.identifier.scopuseid_2-s2.0-60749087179en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-60749087179&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume104en_US
dc.identifier.issue1en_US
dc.identifier.spage41en_US
dc.identifier.epage46en_US
dc.identifier.isiWOS:000262265800009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, YT=8041471500en_US
dc.identifier.scopusauthoridLai, LH=36860424200en_US
dc.identifier.scopusauthoridHui, AJ=36753047500en_US
dc.identifier.scopusauthoridWong, VWS=7202525502en_US
dc.identifier.scopusauthoridChing, JYL=7005086238en_US
dc.identifier.scopusauthoridWong, GLH=9248570900en_US
dc.identifier.scopusauthoridWu, JCY=8041471100en_US
dc.identifier.scopusauthoridChan, HLY=25722700100en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridLau, JYW=13907867100en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US

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