title: Hood-assisted colonoscopy is more effective in detection of colorectal adenomas than narrow-band imaging.
abstract: OBJECTIVE
  Colonoscopy, using either a transparent retractable extension device or narrow band imaging, is thought to improve colon adenoma detection. We compared the abilities of a transparent retractable extension device and narrow band imaging to detect colorectal adenomas.
  
  
  METHODS
  One hundred and seven patients with colonic adenomas that were detected by traditional colonoscopy were randomly assigned to groups that underwent a second colonoscopy that used either a transparent retractable extension or narrow band imaging; adenomas were removed. The principal outcome parameters were the number, size, shape, and location of adenomas detected. The patients' demographic characteristics, indications for colonoscopy, and cecal intubation times were similar between groups.
  
  
  RESULTS
  Use of the transparent retractable extension resulted in detection of 31% more adenomas than the initial procedure (P < .0001). The majority of newly discovered adenomas were sessile (79%; 26/33) and less than 5 mm in size (73%; 24/33). There was no significant increase in adenoma detection (5%) between first colonoscopy and second colonoscopy using narrow band imaging. Additional adenomas were found in 40.7% of patients that were examined using the transparent hood (22/54) versus 13.2% of those examined using narrow band imaging (7/53) (P = .0028).
  
  
  CONCLUSIONS
  Colonoscopy with a transparent retractable extension significantly improved the adenoma detection rate compared with repeat colonoscopy using narrow band imaging.
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan. horiuchi.akira@sihp.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kato
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ichise
authors.forename: Masashi
authors.initials: M
authors.lastname: Kajiyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity