COMPARISON OF CAP ASSISTED COLONOSCOPY IN TOTAL WATER IMMERSION AND GAS ENVIRONMENT

Aims Compare underwater colonoscopy using distal cap with cap assisted colonoscopy in a gaseous environment for high resolution endoscopes.

Methods Was performed prospective analysis of 232 screening colonoscopies performed during 2018 and early 2019. All studies were performed in one single center by the same endoscopist.

Patients were randomized into 2 groups: experimental group, 118 patients – procedure performed in total water immersion, coupled with the use of distal cap (TWCA – total water cap assisted colonoscopy); control group, 114 patients – procedure in the gas atmosphere (carbon dioxide) using distal cap (CA – CO₂ cap assisted colonoscopy). Average quality of bowel prepapation estimated by BBPS was in the two groups – 8.9 points.

Results Analysis of the results was conducted by indicators as polyp detection rate (PDR), adenoma detection rate (ADR), serrated adenoma detection rate (SADR), advanced adenoma detection rate (AADR). In terms of ADR and PDR revealed significant differences between the control and experimental groups:

PDR – 88,1% vs. 71,6% (p = 0,008) – ARR = 14,5% (CI 4,3–24,4%) p = 0,05;

ADR – 61,8% vs. 38.5% (p < 0,0001) – ARR = 23,3% (CI 10,4–35,1%) p = 0,05.

In terms of SADR – 28,8% vs. 24,5% (p = 0,562), AADR – 8,5% vs. 7,8% (p = 0,936).

Conclusions TWCA colonoscopy has the advantage in detection of polyps. Statistically significant benefits identified in the detection of tubular adenomas and polyps in general. The tendency to improve the performance of detecting serrated adenomas needs further study in larger samples. No significant difference in finding advanced adenomas were detected, which seems logical, since the visibility of large lesions is easier in any environment.