Withdrawal Time and Use of Wide-angle Endoscope to Increase the Adenoma Detection Rate of Screening Colonoscopy
Condition: ColoRectal Cancer; Colon Polyp
MeSH terms: Colorectal Neoplasms; Adenoma; Colonic Polyps
Study type: Observational

Summary: 
      Colonoscopy outcome is strictly related to the adenoma detection rate (ADR). An endoscopy
      withdrawal time >6min has been suggested to increase the ADR since it allows for thorough
      evaluation of the several hidden areas of the colon. The FUSE, full spectrum endoscopy
      system, has been demonstrated to reduce the rate of missed lesions due to its wide-angle
      view. In the present study the authors evaluate the impact of WT on ADR for High Definition
      Standard Endoscopes with just a single imager to the FUSE endoscope.
    

Detailed description: 
      Introduction Colonoscopy outcome is strictly related to the adenoma detection rate. An
      endoscopy withdrawal time >6min has been suggested to increase the adenoma detection rate
      since it allows for accurate evaluation of the several hidden areas of the colon. The FUSE
      endoscope has been demonstrated also to reduce the rate of missed lesions due to its wide
      angle view.

      Aim of the study to evaluate the impact on the adenoma detection rate either of the use of a
      FUSE endoscope or of interventions directed at optimizing withdrawal time.

      to assess the impact of different factors in influencing the withdrawal time

      Methods A prospective non-randomized observational single-center study involving consecutive
      outpatients, aged 18-85 yr, undergoing colonoscopy with different indications. Previous
      abdominal colon resection, obstruction, inadequate preparation and incomplete examination
      were exclusion criteria.

      In a 3-month period 4 expert endoscopists will performed 500 colonoscopies either with
      standard endoscope or with FUSE without a dedicated withdrawal time protocol. Colonoscopy
      withdrawal times will be measured without the endoscopists' knowledge of being monitored.

      During a subsequent 3-month period the same endoscopists will perform further 500
      colonoscopies with standard and FUSE scopes using dedicated inspection techniques and a
      minimum 6-minute withdrawal time. In this second phase withdrawal times will be again
      measured, but endoscopists will be aware of being monitored.

      The following parameters will be recorded:

        -  Demographic and general characteristics

        -  Indications to colonoscopy

        -  Colonoscopy findings

        -  Quality of preparation: Boston scale

        -  Time to reach the coecum

        -  Withdrawal time The adenoma detection rate and the mean adenomas per patients will be
           calculated.
    

Intervention name(s): Colonoscopy
Intervention type(s): Procedure
Intervention description(s): Colonoscopy performed in adult consecutive patients for different indications
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Adult outpatients undergoing colonoscopy for different indications
      
Keywords: colorectal cancer; Colon polyp; Colonoscopy; Adenoma detection rate