セッション情報 ワークショップ10(消化器内視鏡学会・消化器病学会・消化器がん検診学会合同)

患者にやさしい大腸内視鏡検査の工夫

タイトル 内W10-16指:

Endocuff:a new device for improving colonic adenoma detection

演者 J-F.  Rey(Department of Hepatology and Gastroenterology Institut Arnault Tzanck)
共同演者 A. T. R.  Axon(University of Leeds, United Kingdom)
抄録 Although colonoscopy is considered the most effective test for colorectal cancer screening, it remains an imperfect tool for the detection of adenoma. One reason for missing lesions is inability to visualize the proximal side of haustral folds and flexures. Cap-assisted colonoscopy improves adenoma detection (1).
We report a newly designed distal cuff. The disposable Endocuff is manually applied to the very distal part of the colonoscope but does not overlap the tip. Lateral projections flare out during extubation retracting haustral folds thus enabling visualisation of their proximal surfaces and the mucosa hidden behind them. It is particularly useful for proximal colon and sigmoid loop.
We have tested the new device on 47 patients with standard (Olympus CF 180H) or pediatric (Olympus PCF180H) colonoscopes with the following comments:
- Expansion of the device during withdrawal extended the field of view and provided better visualisation of the dark side of the fold.
- Insertion is not impaired by the extension of the distal rigid part of the colonoscope. This is not the case with usual plastic cap.
- No side effects occurred during the procedure.
In summary, if cap-assisted colonoscopy improves adenoma detection, Endocuff should be a recommended device.
(1) Rastogi A, Bansal A, Rao DS. Gut 2012;61:402-8.
索引用語 2012Dr.Ray, JDDW2012