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Published on: October 16, 2013
A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model
Nazia Hasan1, Seth A Gross1, Ian M Gralnek2
1Division of Gastroenterology, New York University Langone Medical Center, New York, New York, USA.
Background:
Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures.
Objective:
To compare the diagnostic yield of balloon-assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model.
Design:
Prospective, cohort study.
Setting:
International gastroenterology meeting.
Subject:
A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps").
Interventions:
Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-assisted colonoscopy.
Main Outcome Measurements:
Detection of simulated polyps.
Results:
The median polyp detection rate for all simulated polyps was significantly higher with balloon-assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P < .0001). The significantly higher simulated polyp detection rate with balloon-assisted versus standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P < .0001) and obscured polyps (88.0% vs 25.0%; P < .0001).
Limitations:
Non-randomized design, use of a colon model, and simulated colon polyps.
Conclusion:
As compared with standard colonoscopy, balloon-assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology.
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