Our previous study (Am. J. Gastroenterol. 2017 04;112(4)) showed that water exchange (WE) colonoscopy was able to increase the detection of flat adenomas as well as overall ADR. We hypothesized that WE based whole-colon acetic acid(AA) staining might be useful to improve the detection of flat lesions compared with WE alone.
Water exchange colonoscopy was performed as described previously (Am. J. Gastroenterol. 2017 04;112(4)). Patients were randomly allocated to WE group or WE+AA group. In WE+AA group, water containing 1% of AA was used during insertion of colonoscopy instead of water alone. A bottle of 20ml pure AA was placed abutting the water pump, which make it possible to keep patients blinded to group allocation. Endoscopist using a high-definition wide-angle Olympus or Fujinum colonoscope performed all of the colonoscopies, with a withdrawal time of at least 6 min. The observation was initially performed without the assistance of cap or the use of magnification or electronic staining (NBI, BLI, LCI or AFI et al.). Scopolamine butylbromide or glucogon was not routinely administrated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
300
The water exchange colonoscopy is used during insertion procedure, in which the water contains 1% acetic acid, and the liquid is absorbed during the withdrawal process for observation.
The water exchange colonoscopy is used during insertion procedure, and the liquid is absorbed during the withdrawal process for observation.
Department of Gastroenterology, Second Affiliated Hospital, Lanzhou University
Lanzhou, Gansu, China
RECRUITINGDepartment of Holistic Integrative Medicine, Shenzhen Hospital of Southern Medical University
Shenzhen, Guangdong, China
RECRUITINGDepartment of Gastroenterology, Huaihe Hospital of Henan University
Kaifeng, Henan, China
Number of flat polyps per patient
average numbers of flat polyps, defined by Paris classification IIa/IIb/IIc, for each patient
Time frame: 9 months
Overall ADR
Adenoma detection rate, defined as the proportion of subjects with at least one adenoma of any size, in each group.
Time frame: 9 months
Advanced ADR
Advanced adenoma detection rate. Advanced adenoma: any with 3 or more adenomas of any size, 1 or more large adenomas 1 cm, or 1 or more adenomas with villous architecture or highgrade dysplasia.
Time frame: 9 months
SSA/P detection rate
SSA/P detection rate, defined as the proportion of subjects with at least one sessile serrated adenoma/polyp (SSA/P) of any size, in each group.
Time frame: 9 months
Flat neoplasms located in proximal colon
Low-grade adenoma, adenoma with villous components, high-grade adenoma, noninvasive carcinoma, and invasive carcinoma in proximal colon
Time frame: 9 months
Adverse events
the rate of bleeding and perforation during colonoscopy procedure and abdominal pain, diarrhea, hematochezia and change of defecation habit Within one week.
Time frame: 9 months
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Department of Gastroenterology, Shaanxi Second People's Hospital
Xi'an, Shaanxi, China
RECRUITING