Indigocarmine added to the water exchange method enhances adenoma detection - a RCT

Area of Science:

• Gastroenterology
• Endoscopy
• Cancer Prevention

Background:

• Chromoendoscopy and the water method are known to improve adenoma detection during colonoscopy.
• Further enhancements to existing techniques are crucial for increasing the efficacy of colorectal cancer screening.

Purpose of the Study:

• To evaluate if adding indigocarmine dye to the water method enhances adenoma detection rates compared to the standard water method alone.
• To test the hypothesis that indigocarmine augmentation improves adenoma identification during screening colonoscopies.

Main Methods:

• A randomized controlled trial (RCT) involving 168 patients undergoing screening colonoscopy.
• Two endoscopists utilized either the standard water method or the water method with 0.008% indigocarmine.
• Techniques included water infusion for scope insertion and water exchange for clear visualization.

Main Results:

• No significant differences in patient demographics or cecal intubation success rates were observed between groups.
• The adenoma detection rate was significantly higher in the indigocarmine group (62%) compared to the water-only group (44%) (p=0.03).
• One colon cancer was detected in each arm of the study.

Conclusions:

• The addition of 0.008% indigocarmine to the water method significantly improves adenoma detection during screening colonoscopies.
• This modified water method represents a valuable advancement in endoscopic polyp detection.
• Indigocarmine-enhanced water method offers a promising strategy for improving colorectal cancer screening efficacy.