کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6088126 | 1207688 | 2016 | 6 صفحه PDF | دانلود رایگان |
BackgroundSingle site studies in male Veterans in the U.S. reported increased detection of presumptive cancer precursors (adenomas, hyperplastic polyps) in the proximal colon (cecum-splenic flexure) by water exchange.AimsAssess the reproducibility of the observation.MethodsAnalysis of secondary outcomes collected prospectively in 3 similarly designed randomized controlled trials using water exchange, water immersion and insufflation (air or carbon dioxide). Main outcome: detection rates of adenomas and hyperplastic polyps in proximal, transverse and right colon (cecum-ascending).Results704 males (173 screening) were evaluated. In the proximal colon, WE showed increased detection of small adenomas (p = 0.009) and adenomas plus hyperplastic polyps (p = 0.015) (vs insufflation); increased detection of adenomas plus hyperplastic polyps of any size (p = 0.045) and of small size (p = 0.04) (vs water immersion). In the right colon water exchange increased detection of small adenomas (19% vs 12.1%, p = 0.04) (vs insufflation); small adenomas (19% vs 12%, p = 0.038), adenomas plus hyperplastic polyps of any size (25% vs 16.7%, p = 0.028) and of small size (23.7% vs 14.6%, p = 0.012) (vs water immersion). Water exchange significantly improved bowel cleanliness. Sedation had no impact on lesion detection.ConclusionsWater exchange is a superior insertion technique for detection of adenomas and hyperplastic polyps primarily in the right colon, especially those of small size.
Journal: Digestive and Liver Disease - Volume 48, Issue 6, June 2016, Pages 638-643