Introduction: Exposure of the hidden colon mucosa is essential for improving the adenoma detection rate (ADR) by visualizing blind area. For enlarging the visual field, we innovated a unique trembling technique (TC) by shaking the operating hand slightly during colonoscope withdrawal and compared the ADR of TC with that of a standard colonoscopy (SC). Methods: This prospective study was performed between October 2017 and October 2019 by four experienced endoscopists. Enrolled total patients (426, TC=225 plus SC=201) who underwent screening or surveillance colonoscopy who did not perform the procedure for over 3 yrs. Results: No differences were observed in age, sex or indications between TC and SC. The bowel preparation scores were higher in the SC group than in the TC group. Mean withdrawal time of TC (18.5 ± 6.3 min) was over two folds higher than that of SC (8.5 min± 3.3 min) (P<0.001). The TC group showed a significantly higher ADR and polyp detection rate than the SC group (TC 65.3% vs. SC 47.8%; P< 0.001: TC 78.7% vs. SC 65.7%; P= 0.003). Adenoma number per colonoscopy of TC (1.96 ± 2.55) was greater than that of SC (1.08 ± 1.68) (P<0.001). In multivariate analysis, the factors associated with ADR were male sex (P=0.014), age (P<0.001), and trembling technique (P<0.001). Hyperplastic polyps (HPs) were more frequently detected in the TC group than in the SC group (P=0.001). Conclusion: The unique cap-assisted colonoscopy with trembling technique helps identify more adenomas, diminutive polyps and HPs than the standard colonoscopy.
Choi et al. (Tue,) studied this question.