The Efficacy of Pan‐Indigo Carmine Chromoendoscopy by Water‐Jet Pump in the Detection of Colorectal Lesions: A Randomized Controlled Trial
Huimin Tian, Can Cui, Qiuyu Wang, Ruixin Zhang, Yiyuan Sun, Mingming Zhang, Rui JiABSTRACT
Background
Pump‐based chromoendoscopy is recommended for the surveillance of dysplasia associated with inflammatory bowel disease. This study was designed to compare the efficacy of pump‐based pan chromoendoscopy (PCE) with white‐light endoscopy (WLE) for the detection of colorectal neoplasia in patients at high risk of colorectal cancer (CRC).
Method
This randomized controlled trial prospectively recruited 366 participants who were randomly allocated in a 1:1 ratio to the WLE group and the PCE group. Primary outcome: adenoma detection rate (ADR); secondary outcome: mean number of adenomas per procedure (MAP), sessile serrated lesion detection rate (SDR), flat adenoma detection rate (FDR), and advanced adenoma detection rate (AADR).
Result
The ADR was significantly higher with PCE (86/167, 51.5%) versus WLE (57/165, 34.5%; RR 1.49 [95% 1.15 to 1.93]: p = 0.002). The FDR and SDR were significantly higher in PCE than in WLE (50.3% vs. 32.1% RR 1.57 [95% 1.20 to 2.05] p = 0.001; 10.8% vs. 2.4% RR 4.45 [95% CI 1.54 to 12.86] p = 0.002).
Conclusions
This study demonstrated that using a novel spraying technique with low‐concentration indigo carmine during colonoscopy achieved a significantly higher detection rate for colorectal lesions. Moreover, PCE significantly increased ADR, particularly for flat adenomas and the detection rate of sessile serrated lesions.
Trial Registration
ClinicalTrials.gov identifier: NCT06596317