Die Detektion von Neoplasien bei der Koloskopie: Was kommt noch?

Zusammenfassung

Das Langzeitziel der Koloskopie ist die Vermeidung des kolorektalen Karzinoms. Bei der Koloskopie werden viele kleine und einige größere Polypen und Adenome übersehen. Die Rate übersehener flacher Läsionen ist höher als die von sessilen und gestielten Läsionen. Technische Fortschritte wie z. B. die Chromoendoskopie oder das Narrow Band Imaging können dabei helfen, die Detektion kleiner flacher Läsionen zu verbessern. Dennoch wird die Koloskopie untersucherabhängig bleiben, so dass individuelle Adenome-Detektionsraten ermittelt werden sollten.

Abstract

That long term goal of colonoscopy is to avoid colorectal cancer but colonoscopy misses many small and some large polypes and adenomas. The miss rate of flat lesions is higher than that of sessile and pedunculated lesions. Technical advanees, for example chromoendoscopy or narrow band imaging may improre detection of small flat lesions. Nevertheless colonoscopy is likely to remain operator-dependent. Therefore we must measure individual adenoma detection rates.

Schlüsselwörter

Koloskopie - Neoplasien

Key words

colonoscopy - neoplasia

Literatur

• 1 Heresbach D, Barrioz T, Lapalus G et al. Miss rate of colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies.  Endoscopy. 2008;  40 284-290
• 2 Hixson J, Fennerty B, Sampliner R E et al. Prospective study of the frequency and size distribution of polyps missed by colonoscopy.  Journal of the National Cancer Institute. 1990;  82 1769-1772
• 3 Rex D, Cutler C S, Lemmel G T et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies.  Gastroenterology. 1997;  112 24-28
• 4 Rex D, Chadalawada V, Helper D J. Wide angle colonoscopy with a prototype instrument: Impact on miss rates and efficiency determined by back-to-back colonoscopies.  Am J Gastroenterol. 2003;  98 2000-2005
• 5 Deenadayalu V P, Chadalawada V, Rex D K. 170 degrees wide-angle colonoscope: effect on efficiency and miss rates.  Am J Gastroenterol. 2004;  99 2138-2142
• 6 Kaltenbach T R, Freidland S, Soetikno R M. A new benchmark in the colorectal neoplasm miss rate during colonoscopy: results of a randomized controlled trial of wide angle view (170°) colonoscopy comparing narrow band imaging and white light.  Gastrointest Endosc. 2007;  65 AB 127
• 7 Saitoh Y, Waxman I, West A et al. Prevalence and distinctive biological features of flat colorectal adenomas in a North American population.  Gastroenterology. 2001;  120 1657-1665
• 8 Hurlstone D, Cross S, Adam I et al. A prospective clinicopathological and endoscopic evaluation of flat and depressed colorectal lesions in the United Kingdom.  Am J Gastroenterol. 2003;  98 2543-2549
• 9 Jaramillo E, Watanabe M, Slezak P, Rubio C. Flat neoplastic lesions of the colon and rectum detected by high-resolution video endoscopy and chromoscopy.  Gastrointest Endosc. 1995;  42 114-122
• 10 Rembacken B, Fujii T, Cairns A et al. Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK.  Lancet. 2000;  355 1211-1214
• 11 Tsuda S, Veress B, Toth E, Fork F. Flat and depressed colorectal tumours in southern Swedish population: a prospective chromoendoscopic and histopathological study.  Gut. 2002;  51 550-555
• 12 Brooker J, Saunders B, Shah S et al. Total colonic dye-spray increases the detection of diminutive adenomas during routine colonoscopy: a randomized controlled trial.  Gastrointest Endosc. 2002;  56 333-338
• 13 Stoffel E M, Stockwell D H, Normolle D P et al. Chromoendoscopic colonoscopy detects more adenomas than conventional colonoscopy: a randomized trial of back-to-back colonoscopies.  Gastroenterology. 2006;  130 AGA 48-AGA48
• 14 Kiesslich R, von Bergh M, Hahn M et al. Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.  Endoscopy. 2001;  33 1001-1006
• 15 Winawer S J, Zauber A G, Fletcher R H et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society.  Gastroenterology. 2006;  130 1872-1885
• 16 Haseman J H, Lemmel G T, Rahmani E Y, Rex D K. Failure of colonoscopy to detect colorectal cancer: evaluation of 47 cases in 20 hospitals.  Gastrointest Endosc. 1997;  45 451-455
• 17 Bressler B, Paszat F, Chen Z et al. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis.  Gastroenterology. 2007;  132 96-102
• 18 Barclay R L, Vicari J J, Doughty A S et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.  N Engl J Med. 2006;  355 2533-2541
• 19 Chen S C, Rex D K. Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy.  Am J Gastroenterol. 2007;  102 856-561
• 20 Atkin W, Rogers P, Cardwell C et al. Wide variation in adenoma detection rates at screening flexible sigmoidoscopy.  Gastroenterology. 2004;  126 1247-1256
• 21 Sanchez W, Harewood G C, Petersen B T. Evaluation of polyp detection in relation to procedure time of screening or surveillance colonoscopy.  Am J Gastroenterol. 2004;  99 1941-1945
• 22 Schoenfeld P, Lipscomb S, Crook J et al. Accuracy of polyp detection by gastroenterologists and nurse endoscopists during flexible sigmoidoscopy: a randomized trial.  Gastroenterology. 1999;  117 312-318
• 23 Hoff G, Bretthauer M, Grotmol T et al. Differences in detection rates of colorectal polyps and adenomas among endoscopists in population-based flexible sigmoidoscopy screening.  Gastrointest Endosc. 2002;  55 AB 214-AB214
• 24 Rex D K. Maximizing detection of adenomas and cancers during colonoscopy.  Am J Gastroenterol. 2006;  101 2866-2877
• 25 Adler A, Papanikolaou I S, Pohl H et al. Narrow band imaging (NBI) influences the learning curve for conventional endoscopy – final results of a prospective randomized study in the detection of colorectal adenomas.  Gastrointest Endosc. 2007;  65 AB 116-AB116
• 26 Rex D K, Helbig C C. High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging.  Gastroenterology. 2007;  133 42-47
• 27 Fatima H, Rex D K, Rothstein R et al. Cecal insertion and withdrawal times with wide-angle versus standard colonoscopes: a randomized controlled trial.  Clin Gastroenterol Hepatol. 2008;  6 109-114
• 28 Matsushita M, Hajiro K, Okazaki K et al. Efficacy of total colonoscopy with a transparent cap in comparison with colonoscopy without the cap.  Endoscopy. 1998;  30 444-447
• 29 Kondo S, Yamaji Y, Yamada A et al. Usefulness of hood attached to the tip of colonoscope for detection of colorectal polyps.  Gastrointest Endosc. 2006;  63 AB 213-AB213
• 30 Lee Y, Hui A J, Wong V W et al. A randomized controlled trial study comparing cap-assisted colonoscopy versus conventional colonoscopy: a preliminary result.  Gastrointest Endosc. 2006;  63 AB 226-AB226
• 31 Triadafilopoulos G. A novel retrograde-viewing auxiliary imaging device (“Third Eye Retroscope®”) improves the detection of simulated polyps in anatomical models of the colon.  Gastrointest Endosc. 2006;  63 AB 103-AB103
• 32 Rostom A, Jolicoeur E, Dube C et al. A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy.  Gastrointest Endosc. 2006;  64 544-552
• 33 Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A et al. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study.  World J Gastroenterol. 2006;  12 6161-6166
• 34 Aoun E, Abdul-Baki H, Azar C et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation.  Gastrointest Endosc. 2005;  62 213-218
• 35 Rex D K, Petrini J L, Baron T H et al. Quality indicators for colonoscopy.  Am J Gastroenterol. 2006;  101 873-885