Adenoma Colon Polyp
Conditions
Brief summary
Although colonoscopy with polypectomy can prevent up to 80% of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Optimizing the detection of adenomas and sessile serrated lesions in the right colon is crucial to increase the effectiveness of colonoscopy in colorectal cancer prevention. Last generation Fuji videocolonscopes incorporates the Linked Color Imaging (LCI), a recently developed technology that differentiates the red colour spectrum more effectively than White Light imaging thanks to its optimal pre-process composition of light spectrum and advanced signal processing. The increased colour contrast results in more accurate delineation of abnormal inflammatory or neoplastic findings of colonic mucosa. Preliminary data suggest that LCI may be improve the detection of neoplastic lesion of colon. The investigators performe a tandem prospective study to compare the right colon adenoma miss rates of LCI colonoscopy with those of conventional white light colonoscopy. Therefore participants scheduled for colonoscopy for the assessment of symptoms or for colorectal cancer screening/surveillance receive the examination of the right colon twice, in a back to back fashion, with standard white light (WL) and with LCI. Patients are randomly assigned (1:1), via computer-generated randomisation with block size of 20, to which procedure is done first. The endoscopist are masked to group allocation until immediately before the cecum is reached. Examinations are performed with Fuji videocolonscopes series 700 (EC-760R, EC-760ZP).
Interventions
DEVICELCI (Linked color imaging)
Colonoscope withdrawal was performed in the right colon evaluating the mucosa using LCI (Linked color imaging)
Sponsors
Valduce Hospital
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Subject)
Intervention model description
Participants scheduled for colonoscopy for the assessment of symptoms or for colorectal cancer screening/surveillance receive the examination of the right colon twice, in a back-to-back fashion, with standard white light (WL) and with LCI (Linked Color Imaging). Patients are randomly assigned (1:1), via computer-generated randomisation with block size of 20, to which procedure is done first.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* all outpatients referred for colonoscopy
Exclusion criteria
* inadequatete bowel preparation (Boston Bowel Preparation Scale (BBPS) \< 2 in one colonic segment) * previous colonic resection * inflammatory bowel disease * ereditary polyposic syndromes * patients on antithrombotics precluding polyp recetion * absence of informed consent * inpatients or patients undergoing urgent colonscopy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Right colon adenoma miss rate | One year | Number of adenomas identified during the second right coloninspection/ overall number of adenomas identified during the first and the second right colon inspection |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Right colon advanced adenomas (size>1 cm and/or high grade displasia and/or villous component) miss rate | One year | Number of advanced adenomas identified during the second right coloninspection/ overall number of advanced adenomas identified during the first and the second right colon inspection |
| Right colon sessile serrated lesions miss rate | One year | Number of sessile serrated lesions identified during the second right coloninspection/ overall number of sessile serrated lesions identified during the first and the second right colon inspection |
Countries
Italy
Outcome results
None listed