Trembling Technique for Improving Colonic Adenoma Detection Rate by Enhancing Mucosal Exposure during Withdrawal: A...

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Improving adenoma detection rate (ADR) requires visualizing the hidden colon mucosa.
• Standard colonoscopy (SC) has limitations in visualizing all areas.
• A novel trembling technique (TC) was developed to enlarge the visual field.

Purpose of the Study:

• To compare the ADR of the novel trembling technique (TC) with standard colonoscopy (SC).
• To evaluate the effectiveness of TC in enhancing polyp and adenoma detection during colonoscopy.

Main Methods:

• A prospective study involving 426 patients undergoing screening or surveillance colonoscopy.
• Four experienced endoscopists performed colonoscopies using either TC (n=225) or SC (n=201).
• Patients had not undergone colonoscopy for over 3 years.

Main Results:

• The TC group demonstrated a significantly higher ADR (65.3% vs. 47.8%) and polyp detection rate (78.7% vs. 65.7%) compared to the SC group.
• Adenoma number per colonoscopy was greater in the TC group (1.96 vs. 1.08).
• Multivariate analysis identified male sex, age, and TC as significant factors associated with ADR.

Conclusions:

• Cap-assisted colonoscopy with the trembling technique significantly improves the detection of adenomas, diminutive polyps, and hyperplastic polyps.
• The TC method offers a valuable advancement for enhancing colonoscopic surveillance and screening.
• TC is associated with increased withdrawal time, suggesting more thorough examination.