Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome : a randomized controlled trial with tandem colonoscopy
Riu Pons, Fausto (Hospital del Mar (Barcelona, Catalunya))
Andreu, Montserrat (Universitat Pompeu Fabra)
Naranjo-Hans, Dolores (Institut Hospital del Mar d'Investigacions Mèdiques)
Álvarez-González, Marco Antonio (Universitat Autònoma de Barcelona. Departament de Medicina)
Seoane, Agustín (Institut Hospital del Mar d'Investigacions Mèdiques)
Dedeu, Josep Maria (Universitat Autònoma de Barcelona. Departament de Medicina)
Barranco, Luis E (Institut Hospital del Mar d'Investigacions Mèdiques)
Bessa Caserras, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2020
Resum:	It is unknown whether narrow-band imaging (NBI) could be more effective than high-definition white-light endoscopy (HD-WLE) in detecting serrated lesions in patients with prior serrated lesions > 5 mm not completely fulfilling serrated polyposis syndrome (SPS) criteria. We conducted a randomized, cross-over trial in consecutive patients with prior detection of at least one serrated polyp ≥10 mm or ≥ 3 serrated polyps larger than 5 mm, both proximal to the sigmoid colon. Five experienced endoscopists performed same-day tandem colonoscopies, with the order being randomized 1:1 to NBI-HD-WLE or HD-WLE-NBI. All tandem colonoscopies were performed by the same endoscopist. We included 41 patients. Baseline characteristics were similar in the two cohorts: NBI-HD-WLE (n = 21) and HD-WLE-NBI (n = 20). No differences were observed in the serrated lesion detection rate of NBI versus HD-WLE: 47. 4% versus 51. 9% (OR 0. 84, 95% CI: 0. 37-1. 91) for the first and second withdrawal, respectively. Equally, no differences were found in the polyp miss rate of NBI versus HD-WLE: 21. 3% versus 26. 1% (OR 0. 77, 95% CI: 0. 43-1. 38). Follow-up colonoscopy in nine patients (22%) allowed them to be reclassified as having SPS. In patients with previous serrated lesions, the serrated lesion detection rate was similar with NBI and HD-WLE. A shorter surveillance colonoscopy interval increases the detection of missed serrated polyps and could change the diagnosis of SPS in approximately one in every five patients.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Colonoscopy ; Colonic polyps ; Optical imaging ; Narrow-band imaging
Publicat a:	BMC Gastroenterology, Vol. 20 (april 2020) , ISSN 1471-230X

DOI: 10.1186/s12876-020-01257-4
PMID: 32299380

9 p, 752.2 KB

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