IMPACT OF ENDOSCOPY SYSTEM, HIGH-DEFINITION AND VIRTUAL CHROMOENDOSCOPY IN DAILY ROUTINE COLONOSCOPY

Aims:

To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested including high-definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed to investigate their use for the detection of polyps in patients referred for colonoscopy in a large tertiary hospital.

Methods:

Demographic, endoscopic and histological data from 2134 consecutive colonoscopies were collected prospectively. Patients were randomly assigned to 3 endoscopy systems (Fujinon, Olympus and Pentax) in combination with 4 modalities (white light colonoscopy (WLC, n = 582), high-definition WLC (HD-WLC, n = 653), virtual chromoendoscopy (VC, n = 349) and high-definition virtual chromoendoscopy (HD-VC, n = 550)).

Results:

Average adenoma detection ratio (ADR) was 34.9% with an adenoma per colonoscopy rate (APCR) of 2.1. No significant differences were noted between the 3 endoscopy systems. Moreover, no differences in ADR or APCR were observed between WLC, HD-WLC, VC and HD-VC. HD-WLC resulted in a significantly higher percentage of sessile serrated adenomas (8.2% vs. 3.8% in WLC, p < 0.01) and adenocarcinomas (2.6% vs. 0.5% in WLC).

Conclusions:

No significant differences in ADR or APCR between different endoscopy systems, high-definition and/or virtual chromoendoscopy could be observed in routine colonoscopies in the general population. High-definition endoscopy was associated with significantly higher detection rate of serrated adenomas and adenocarcinomas.