Narrow-band imaging does not improve detection of colorectal polyps when compared to conventional colonoscopy: a randomized controlled trial and meta-analysis of published studies

BMC Gastroenterology

Research Article

Diego Aponte¹  Luis C Sabbagh²  Sylvia de Aguiar³  Ludovic Reveiz⁴ 

[1] Gastroenterology Department, Clínica Colombia, Bogota, Colombia;Gastroenterology Department, Clínica Reina Sofía, Sanitas University Foundation, Bogota, Colombia;General Practice Department, Clínica Reina Sofía, Bogota, Colombia;Research Institute, Sanitas University Foundation, Bogota, Colombia;

关键词: Randomized controlled trial;    colonoscopy;    polyps;    narrow-band imaging;   

DOI  :  10.1186/1471-230X-11-100

 received in 2010-02-16, accepted in 2011-09-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA colonoscopy may frequently miss polyps and cancers. A number of techniques have emerged to improve visualization and to reduce the rate of adenoma miss.MethodsWe conducted a randomized controlled trial (RCT) in two clinics of the Gastrointestinal Department of the Sanitas University Foundation in Bogota, Colombia. Eligible adult patients presenting for screening or diagnostic elective colonoscopy were randomlsy allocated to undergo conventional colonoscopy or narrow-band imaging (NBI) during instrument withdrawal by three experienced endoscopists. For the systematic review, studies were identified from the Cochrane Library, PUBMED and LILACS and assessed using the Cochrane risk of bias tool.ResultsWe enrolled a total of 482 patients (62.5% female), with a mean age of 58.33 years (SD 12.91); 241 into the intervention (NBI) colonoscopy and 241 into the conventional colonoscopy group. Most patients presented for diagnostic colonoscopy (75.3%). The overall rate of polyp detection was significantly higher in the conventional group compared to the NBI group (RR 0.75, 95%CI 0.60 to 0.96). However, no significant differences were found in the mean number of polyps (MD -0.1; 95%CI -0.25 to 0.05), and the mean number of adenomas (MD 0.04 95%CI -0.09 to 0.17). Meta-analysis of studies (regardless of indication) did not find any significant differences in the mean number of polyps (5 RCT, 2479 participants; WMD -0.07 95% CI -0.21 to 0.07; I2 68%), the mean number of adenomas (8 RCT, 3517 participants; WMD -0.08 95% CI -0.17; 0.01 to I2 62%) and the rate of patients with at least one adenoma (8 RCT, 3512 participants, RR 0.96 95% CI 0.88 to 1,04;I2 0%).ConclusionNBI does not improve detection of colorectal polyps when compared to conventional colonoscopy (Australian New Zealand Clinical Trials Registry ACTRN12610000456055).

【 授权许可】

CC BY   
© Sabbagh et al; licensee BioMed Central Ltd. 2011