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Full‐spectrum versus standard colonoscopy for improving polyp detection rate: A systematic review and meta‐analysis
Author(s) -
Facciorusso Antonio,
Del Prete Valentina,
Buccino Vincenzo,
Valle Nicola Della,
Nacchiero Maurizio Cosimo,
Muscatiello Nicola
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13859
Subject(s) - colonoscopy , medicine , withdrawal time , meta analysis , confidence interval , adenoma , insertion time , endoscopy , intubation , gastroenterology , colorectal cancer , surgery , cancer , airway
Background and Aim Full‐spectrum endoscopy represents a new endoscopic platform allowing a panoramic 330 degree view of the colon, but evidence of its superiority over standard colonoscopy is still lacking. Our study is the first meta‐analysis comparing the efficacy of full‐spectrum endoscopy with standard colonoscopy. Methods Through a systematic literature review until May 2017, we identified eight randomized‐controlled trials. Primary outcomes were polyp detection rate and adenoma detection rate, while cecal intubation time and total colonoscopy time were secondary outcomes. Direct meta‐analysis was performed using a random effects model. Results No difference in terms of polyp detection rate and adenoma detection rate was found (risk ratio: 1.00, 95% confidence interval 0.89–1.12, P = 0.96, and 1.05, 0.94–1.17, P = 0.40, respectively). Adenoma miss rate resulted significantly in favor of full‐spectrum endoscopy (risk ratio: 0.35, 0.25–0.48, P < 0.01), although the difference was not significant for greater (>5 mm) and pedunculated lesions (risk ratio: 0.38, 0.09–1.60, P = 0.19, and risk ratio: 0.15, 0.01–3.00, P = 0.21, respectively). Cecal intubation time was not different between the two techniques (mean standardized difference: 0.22 min, −1.18 to 1.62, P = 0.76), while total colonoscopy time was significantly shorter when adopting full‐spectrum endoscopy (mean difference: −2.60, −4.60 to −0.61, P = 0.01). Sensitivity analysis confirmed all the findings. Conclusions Full‐spectrum endoscopy appears as a promising and reliable technology able to significantly decrease the number of adenomas missed and procedural times, while its superiority over standard colonoscopy in terms of adenoma detection rate results is still unclear.