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      A novel colonoscope with panoramic visualization detected more simulated polyps than conventional colonoscopy in a live swine model

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          Abstract

          Background and study aims: The Aer-O-Scope™ Colonoscope System (AOS) combines panoramic 360° view with standard forward view. We assessed the AOS’s ability to identify lesions implanted in live swine, compared to conventional colonoscopy (CC).

          Patients and methods: Twelve swine colons were surgically ligated and beads sewn within. Five procedures (3 AOS and 2 CC) were performed on each swine and findings reported. Physicians were blinded to number, size, and color of beads. The sequence of procedures and physicians was randomized. Pigs, physicians, and colonoscopes were randomly alternated between examination rooms, maintaining physician blindness. Two independent blinded physicians interpreted procedure videos offline.

          Results: A total of 259 /273 (94.9 %) of lesions were visualized by AOS compared to 158 /182 with CC (86.8 %) ( P = 0.002). Miss rates of lesions ≥ 6 mm were 2.6 % and 10.5 %, respectively ( P = 0.022), and 6.9 % and 15.1 %, respectively, for lesions < 6 mm ( P = 0.031). Mean agreement between AOS and CC for lesion detection was 88.3 %. The benefit of AOS was maintained in offline video review.

          Conclusions: AOS, featuring panoramic 360° view, demonstrated high detection rates for simulated colonic lesions in a live swine model.

          Most cited references9

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          Quality indicators for colonoscopy and the risk of interval cancer.

          Although rates of detection of adenomatous lesions (tumors or polyps) and cecal intubation are recommended for use as quality indicators for screening colonoscopy, these measurements have not been validated, and their importance remains uncertain. We used a multivariate Cox proportional-hazards regression model to evaluate the influence of quality indicators for colonoscopy on the risk of interval cancer. Data were collected from 186 endoscopists who were involved in a colonoscopy-based colorectal-cancer screening program involving 45,026 subjects. Interval cancer was defined as colorectal adenocarcinoma that was diagnosed between the time of screening colonoscopy and the scheduled time of surveillance colonoscopy. We derived data on quality indicators for colonoscopy from the screening program's database and data on interval cancers from cancer registries. The primary aim of the study was to assess the association between quality indicators for colonoscopy and the risk of interval cancer. A total of 42 interval colorectal cancers were identified during a period of 188,788 person-years. The endoscopist's rate of detection of adenomas was significantly associated with the risk of interval colorectal cancer (P=0.008), whereas the rate of cecal intubation was not significantly associated with this risk (P=0.50). The hazard ratios for adenoma detection rates of less than 11.0%, 11.0 to 14.9%, and 15.0 to 19.9%, as compared with a rate of 20.0% or higher, were 10.94 (95% confidence interval [CI], 1.37 to 87.01), 10.75 (95% CI, 1.36 to 85.06), and 12.50 (95% CI, 1.51 to 103.43), respectively (P=0.02 for all comparisons). The adenoma detection rate is an independent predictor of the risk of interval colorectal cancer after screening colonoscopy. 2010 Massachusetts Medical Society
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            Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies.

            The miss rate of colonoscopy for neoplasms is poorly understood. The aim of this study was to determine the miss rate of colonoscopy by same day back-to-back colonoscopy. Two consecutive same day colonoscopies were performed in 183 patients. The patients were randomized to undergo the second colonoscopy by the same or a different endoscopist and in the same or different position. The overall miss rate for adenomas was 24%, 27% for adenomas or = 1 cm. Patients with two or more adenomas at the first examination were more likely than patients with no or one adenoma detected at the first examination to have one or more adenomas at the second examination (odds ratio, 3.3; 95% confidence interval, 1.69-6.46). Right colon adenomas were missed more often (27%) than left colon adenomas (21%), but the difference was not significant. There was evidence of variation in sensitivity between endoscopists, but significant miss rates for small adenomas were found among essentially all endoscopists. Using current colonoscopic technology, there are significant miss rates for adenomas or = 1 cm. The results suggest the need for improvements in colonoscopic technology.
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              Factors influencing the miss rate of polyps in a back-to-back colonoscopy study.

              In patients undergoing colonoscopy, 22 % - 28 % of polyps and 20 % - 24 % of adenomas are missed. It is unclear which factors contribute to polyp miss rates, but colorectal cancer detected within 3 years after colonoscopy may originate from missed lesions. The aim of the current study was to determine patient- and polyp-related factors that influence the miss rates of polyps and adenomas during colonoscopy.
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                Author and article information

                Journal
                Endosc Int Open
                Endosc Int Open
                10.1055/s-0034-1377934
                Endoscopy International Open
                © Georg Thieme Verlag KG (Stuttgart · New York )
                2364-3722
                2196-9736
                December 2015
                06 October 2015
                : 3
                : 6
                : E642-E645
                Affiliations
                [1 ]Tel Aviv Medical Center, Tel-Aviv, Israel.-
                [2 ]Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
                [3 ]GI View Ltd, Ramat Gan, Israel.
                Author notes
                Corresponding author: Nathan Gluck, MD, PhD Tel-Aviv Sourasky Medical Center Research Center for Digestive Disorders and Liver Diseases 6 Weizmann StTel-Aviv 64239Israel9723-69742829723-6974622 nathang@ 123456tlvmc.gov.il
                Article
                10.1055/s-0034-1393080
                4683140
                d4be1ec0-5dcf-4a6d-ae6b-7deb65ddab58
                © Thieme Medical Publishers
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