10 research outputs found
大腸腫瘍性病変の拾い上げ診断における透明フードを併用した自家蛍光内視鏡の有用性:前向き無作為化比較試験
BACKGROUND:
Colonoscopy is one of the most reliable methods for detection of colorectal neoplasms, but conventional colonoscopy can miss some lesions.
OBJECTIVE:
To evaluate the efficacy of autofluorescence imaging (AFI) with a transparent hood (TH) for detection of colorectal neoplasms.
DESIGN:
A 2 × 2 factorial designed, prospective, randomized, controlled trial.
SETTING:
This study was conducted at the Osaka Medical Center for Cancer and Cardiovascular Diseases, a tertiary cancer center.
PATIENTS:
A total of 561 patients.
INTERVENTIONS:
Patients were allocated to 1 of 4 groups: (1) white light imaging (WLI) alone--colonoscopy using WLI without a TH; (2) WLI+TH--colonoscopy using WLI with a TH; (3) AFI alone--colonoscopy using AFI without a TH; and (4) AFI+TH--colonoscopy using AFI with a TH. Eight colonoscopists used each allocated method.
MAIN OUTCOME MEASUREMENT:
The difference in neoplasm detection rate (number of detected neoplasms per patient) between the WLI alone and AFI+TH groups.
RESULTS:
Neoplasm detection rate (95% confidence interval) in the AFI+TH group was significantly higher than in the WLI alone group (1.96 [1.50-2.43] vs 1.19 [0.93-1.44]; P = .023, Tukey-Kramer multiple comparison test). Relative detection ratios (95% confidence interval) for polypoid neoplasms based on Poisson regression model were significantly increased by mounting a TH (1.69 [1.34-2.12], P < .001), and relative detection ratios for flat neoplasms were significantly increased by AFI observation (1.83 [1.24-2.71], P = .002).
LIMITATIONS:
Open trial performed in single cancer referral center.
CONCLUSION:
AFI colonoscopy with a TH detected significantly more colorectal neoplasms than did conventional WLI colonoscopy without a TH.博士(医学)・乙1327号・平成26年3月17