Cap-assisted Colonoscopy May Improve Detection Of Colonic Adenoma

Abjective:To investigate the clinical usefulness of the cap-assisted colonoscopy for adenoma detection rate(ADR),caecal intubation rate,caecal intubation time.Methods:Patients for colonoscopy between September 2014 and November 2015 in Shandong province Qianfo Hill hospital were enrolled to this randomized controlled trial.There were1285 cases admitting for screening,Which were 1:1 randomised to either CAC(638)or SC(647).The evaluated outcomes was cacal intubation rate according to the 1285 cases.However a total of 1150 cases(CAC(572 cases)or SC(578 cases))conforming to the requirement.The evaluated outcomes were adenoma detection rate,intubation time.And the evaluated outcomes were comparable according to the endoscopy level,the diameter and the appearance of the adenoma.Results:1.Caceal intubation rateA tolal of 1285 participants were randomly allocated to CAC(N=638)or SC(N=647).Caceal intubation rate was comparable in the two groups(99.7% vs 98.2%;P<0.05).2.Caceal intubation timeA tolal of 1150 participants were randomly allocated to CAC(N=572)or SC(N=578).Caceal intubation time was significantly lower in the CAC group:5.27±1.98 min with CAC vs 5.81±2.14 min with SC(P<0.05)(values mean±SD).Meanwhile,the intubarion time was comparable according to the level of the endoscopy.CAC dose reduce caecal intubation time for the endoscopy,who dose the colonoscopy less than 3000 cases.3.Adenoma detection rateThe proportion of subjects with at least one adenoma(ADR)was significantly higher in the CAC group:42% with CAC group vs 35% with SC(P<0.05).The ADR in the rightcolon was higher in the CAC group:31% with CAC group vs 19% with SC(P<0.05).But the ADR of the left colon was similar in the two groups(25% vs 26%).Meanwhile,ADR was comparable according to the level of the endoscopy.4.The detection of adenoma according to the diameter and the appearance.The polyp detection with small size(<6mm)was higher in the CAC group:(0.64±1.02)per subject with CAC vs(0.46±0.89)per subject with SC(P<0.05)(values mean±SD),while there was no impact in the big size(≥ 6mm).The dection of Yamada-I and Yamada-II adenama were higher in the CAC group(P<0.05).5.ComplicationsSubjects were contacted 2 weeks after the colonoscopy.There were non-colonoscopyrelated complications occurred in the two groups.Conclusion1.Cap-assisted colonoscopy significantly increased adenoma detection rate,especially in the right colon.Though the effect was influenced by the level of the endoscopy.Capassisted colonoscopy may increased adenoma detection rate for the endoscopy,who dose the colonoscopies between 500 and 3000 cases.But Cap-assisted colonoscopy just increased adenoma detection rate for the endoscopy,who dose the colonoscopies more than3000 cases2.Cap-assisted colonoscopy could increase the detection of small size adenoma(<6mm).And it could increase the detection of Yamada-I and Yamada-II adenoma.3.Cap-assisted colonoscopy did increase the caceal intubation rate.4.Cap-assisted colonoscopy shorted the caceal intubation time especially for the trainees.