Effect of a retrograde-viewing device on adenoma detection rate during colonoscopy: the TERRACE study.
BACKGROUND
Although colonoscopy is currently the optimal method for detecting colorectal polyps, some are missed. The Third Eye Retroscope provides an additional retrograde view that may detect polyps behind folds.


OBJECTIVE
To determine whether the addition of the Third Eye Retroscope to colonoscopy improves the adenoma detection rate.


METHODS
Prospective, multicenter, randomized, controlled trial.


METHODS
Nine European and U.S. centers.


METHODS
Of 448 enrolled subjects, 395 had data for 2 procedures.


METHODS
Subjects underwent same-day tandem examinations with standard colonoscopy (SC) and Third Eye colonoscopy (TEC). Subjects were randomized to SC followed by TEC or TEC followed by SC.


METHODS
Detection rates for all polyps and adenomas with each method.


RESULTS
In the per-protocol population, 173 subjects underwent SC and then TEC, and TEC yielded 78 additional polyps (48.8%), including 49 adenomas (45.8%). In 176 subjects undergoing TEC and then SC, SC yielded 31 additional polyps (19.0%), including 26 adenomas (22.6%). Net additional detection rates with TEC were 29.8% for polyps and 23.2% for adenomas. The relative risk of missing with SC compared with TEC was 2.56 for polyps (P < .001) and 1.92 for adenomas (P = .029). Mean withdrawal times for SC and TEC were 7.58 and 9.52 minutes, respectively (P < .001). The median difference in withdrawal times was 1 minute (P < .001). The mean total procedure times for SC and TEC were 16.97 and 20.87 minutes, respectively (P < .001).


CONCLUSIONS
Despite randomization and a large cohort, there was disparity in polyp prevalence between the 2 groups of subjects.


CONCLUSIONS
The Third Eye Retroscope increases adenoma detection rate by visualizing areas behind folds. (


BACKGROUND
NCT01044732.).
University Medical Center Utrecht, Utrecht, The Netherlands.
Anke M
AM
Leufkens
Daniel C
DC
DeMarco
Amit
A
Rastogi
Paul A
PA
Akerman
Kassem
K
Azzouzi
Richard I
RI
Rothstein
Frank P
FP
Vleggaar
Alessandro
A
Repici
Giacomo
G
Rando
Patrick I
PI
Okolo
Olivier
O
Dewit
Ana
A
Ignjatovic
Elizabeth
E
Odstrcil
James
J
East
Pierre H
PH
Deprez
Brian P
BP
Saunders
Anthony N
AN
Kalloo
Bradley
B
Creel
Vikas
V
Singh
Anne Marie
AM
Lennon
Peter D
PD
Siersema
D000230:Adenocarcinoma / Q000175:diagnosis*; D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis*; D020685:Colonoscopes; D003113:Colonoscopy / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult