New colonoscope provides ground-breaking view of colon

May 18, 2013

A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal time for colonoscopies and exploring safer methods for removing polyps.

During colonoscopy, doctors use a device called a colonoscope to examine the colon. This screening test for colorectal cancer allows a doctor to look for called adenomas in the colon and rectum. A study featuring a new colonoscope that allows doctors to see more of the colon shows promise that could revolutionize colorectal .

Researchers compared both the adenoma miss rate using the new colonoscope with the miss rate of a traditional colonoscope. The miss rate for the new colonoscope was only 7.6 percent as compared to 41.7 percent for the traditional colonoscope, in this study.

"It's always our goal to minimize miss rates in colonoscopy," said Professor Ian M. Gralnek of the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and senior physician at the department of gastroenterology, Rambam Health Care Campus and Elisha Hospital in Haifa, Israel. "These results show us a way to achieve that and improve the efficacy of colorectal cancer screening and surveillance colonoscopy."

Developed by EndoChoice, the Full Spectrum Endoscopy (FUSE) colonoscope maintains the identical technical features of the standard colonoscope, but allows the endoscopist to view 330 degrees, compared to the 170 degree viewing angle of the traditional colonoscope.

The study randomly assigned 197 patients for tandem colonoscopies using either the standard or the FUSE first. In addition to a significantly lower adenoma miss rate, results showed a significantly higher adenoma detection rate favoring FUSE. Professor Gralnek credits FUSE's improved imaging technology with these findings as adenomas can be difficult to detect with only forward-viewing capabilities.

" often hide behind folds in the colon and can be very difficult to find with a forward-viewing scope," Professor Gralnek said.

"Lower adenoma miss rates have important implications for patient surveillance," he added. The additional information FUSE provides to doctors may allow them to adjust patients' surveillance intervals according to risk level, ultimately helping to prevent incremental colorectal cancers. The FUSE scope could be available as early as this summer.

Colonoscopy withdrawal time makes a big difference for diagnosis

DDW also features other advances in colonoscopy relating not to what doctors see, but to how long they look. Researchers at Stanford University compared a three-minute versus six-minute withdrawal time during colonoscopy. The polyp miss rate was almost twice as high during the shorter procedure.

"The de facto standard of care for colonoscopy withdrawal time, which is six minutes, was based on a single observational study," said Sheila Kumar, research fellow in Stanford's division of gastroenterology and hepatology. "More data were needed to ensure that we are providing the best care possible. Our findings provide evidence-based support that prolonging withdrawal time significantly decreases polyp miss rates at colonoscopy."

Dr. Kumar's research represents the first randomized controlled trial examining the effect of colonoscopy withdrawal times on polyp miss rates. The study was conducted with patients undergoing colonoscopies at Stanford and the Palo Alto Veterans Administration Hospital. Patients were randomized to an initial three-minute or six-minute colonoscopy withdrawal time. Patients then underwent a "second look" six-minute withdrawal to determine if polyps were missed with the first look.

"The study design also allowed for data collection for screenings up to 12 minutes long, by combining data for the first and second withdrawal," Dr. Kumar said. "Future comparisons could help to confirm the optimal time parameters of a colonoscopy."

A safer polypectomy option for high-risk patients

In another study, researchers at Showa Inan General Hospital in Komagane, Japan, found that a particular method of polypectomy—called a "cold snare" technique—is safer for patients on anticoagulants.

When a colon or rectal polyp is detected during , a polypectomy is often recommended to remove the growth. But for patients who use anticoagulants, or blood thinners, polypectomies carry higher risk because of bleeding that occurs during excision of the polyp and recovery.

"The results of our study represent an important opportunity for patients whose options have been severely limited up to this point," said Akira Horiuchi, chief of the hospital's Digestive Disease Center.

The study compared the bleeding associated with the conventional polypectomy technique and the cold snare technique. With the first, the polyp is snared with a wire and then cut using electrocautery. The cold snare technique mechanically cuts off the polyp without electrocautery.

With the latter method, bleeding was seen in only about 5 percent of cases compared to 23 percent of cases using the conventional technique. No delayed bleeding was associated with the cold snare technique, whereas 14 percent of the conventional patients required hemostasis afterward. Polyp removal rates were identical for both approaches.

"These differences are exciting and encouraging," Dr. Horiuchi said. "We think the study paves the way for future research to validate a safer option for many patients."

Explore further: Use of a retroflexion technique during colonoscopy in the right side of the colon improves polyp detection

Related Stories

Use of a retroflexion technique during colonoscopy in the right side of the colon improves polyp detection

August 4, 2011
A new study from researchers in Indiana reports that use of a retroflexion technique in the right side of the colon during colonoscopy is safe and results in the detection of additional adenomatous (precancerous) polyps in ...

National screening benchmarks for finding polyps during a colonoscopy might be too low

February 19, 2013
Current national guidelines provide benchmarks regarding the number of polyps physicians should detect, on average, during a colonoscopy. Recent studies at Mayo Clinic's campus in Florida suggest these benchmarks may be too ...

Post-polyp detection, CRC risk ID'd by colonoscopy factors

August 21, 2012
(HealthDay) -- In the community setting, after colonoscopic polyp detection, colonoscopy-related factors such as incomplete polyp removal and lack of surveillance colonoscopies are more important than polyp characteristics ...

Brief class on easy-to-miss precancerous polyps ups detection, study shows

January 8, 2013
Most people know a colonoscopy requires some preparation by the patient. Now, a Mayo Clinic physician suggests an additional step to lower the risk of colorectal cancer: Ask for your doctor's success rate detecting easy-to-miss ...

Recommended for you

Vitamin C may encourage blood cancer stem cells to die

August 17, 2017
Vitamin C may "tell" faulty stem cells in the bone marrow to mature and die normally, instead of multiplying to cause blood cancers. This is the finding of a study led by researchers from Perlmutter Cancer Center at NYU Langone ...

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

Scientists develop novel immunotherapy technology for prostate cancer

August 17, 2017
A study led by scientists at The Wistar Institute describes a novel immunotherapeutic strategy for the treatment of cancer based on the use of synthetic DNA to directly encode protective antibodies against a cancer specific ...

Scientists develop blood test that spots tumor-derived DNA in people with early-stage cancers

August 16, 2017
In a bid to detect cancers early and in a noninvasive way, scientists at the Johns Hopkins Kimmel Cancer Center report they have developed a test that spots tiny amounts of cancer-specific DNA in blood and have used it to ...

Toxic formaldehyde is produced inside our own cells, scientists discover

August 16, 2017
New research has revealed that some of the toxin formaldehyde in our bodies does not come from our environment - it is a by-product of an essential reaction inside our own cells. This could provide new targets for developing ...

Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer

August 16, 2017
In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs—designed to halt cancer ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.