title: Comparison of adenoma detection and miss rates between a novel balloon colonoscope and standard colonoscopy: a randomized tandem study.
abstract: OBJECTIVE
  Although colonoscopy is the "gold standard" for colorectal cancer screening, a significant number of adenomas are still missed during standard colonoscopy, often because they are hidden behind colonic folds and flexures. The aim of this study was to assess the ability of a novel balloon colonoscope (G-EYE endoscope; Smart Medical Systems, Ra'anana, Israel) to increase adenoma detection and reduce the miss rate compared with standard colonoscopy.
  
  
  METHODS
  This was a multicenter, randomized, prospective, controlled study in patients (age ≥ 40 years) undergoing colonoscopy for screening or diagnostic work-up (including surveillance). Patients underwent same-day, back-to-back tandem colonoscopy. Patients in Group A underwent standard colonoscopy followed by balloon colonoscopy, and patients in Group B underwent balloon colonoscopy followed by the standard technique. The adenoma detection and miss rates were compared between the two colonoscopy procedures.
  
  
  RESULTS
  A total of 126 patients were enrolled and randomized into Group A (n = 60) or Group B (n = 66). The adenoma miss rate of balloon colonoscopy was significantly lower than that of standard colonoscopy (7.5 % vs. 44.7 %; P = 0.0002). The detection of additional adenomas by balloon colonoscopy was significant (81.0 %; P = 0.0002), in particular, the relative amount of adenomas detected in the ascending colon by balloon colonoscopy was 41 % versus 14 % for standard colonoscopy.
  
  
  CONCLUSIONS
  A novel balloon colonoscopy technique detected significantly more adenomas than standard colonoscopy, and missed fewer adenomas. Balloon colonoscopy has the potential to increase the effectiveness of colorectal cancer screening and surveillance colonoscopy.
authors.affiliation: Institute of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.affiliation: Division of Gastroenterology, NYU Langone Medical Center, New York, New York, United States.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Gross
authors.affiliation: Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Gralnek
authors.affiliation: Institute of Gastroenterology, Laniado Hospital, Netanya, Israel.
authors.forename: Beni
authors.initials: B
authors.lastname: Shpak
authors.affiliation: Division of Gastroenterology, NYU Langone Medical Center, New York, New York, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Pochapin
authors.affiliation: Department of Internal Medicine and Gastroenterology, St. Marienkrankenhaus Frankfurt, Frankfurt, Germany.
authors.forename: Arthur
authors.initials: A
authors.lastname: Hoffman
authors.affiliation: Department of Gastroenterology, Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Mizrahi
authors.affiliation: Institute of Gastroenterology, Laniado Hospital, Netanya, Israel.
authors.forename: Yosef S
authors.initials: YS
authors.lastname: Rochberger
authors.affiliation: Institute of Gastroenterology, Laniado Hospital, Netanya, Israel.
authors.forename: Menachem
authors.initials: M
authors.lastname: Moshkowitz
authors.affiliation: Institute of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Erwin
authors.initials: E
authors.lastname: Santo
authors.affiliation: Institute of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Alaa
authors.initials: A
authors.lastname: Melhem
authors.affiliation: Institute of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Roman
authors.initials: R
authors.lastname: Grinshpon
authors.affiliation: Institute of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Jorge
authors.initials: J
authors.lastname: Pfefer
authors.affiliation: Department of Internal Medicine and Gastroenterology, St. Marienkrankenhaus Frankfurt, Frankfurt, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Kiesslich
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D044682:Colon, Ascending; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D020685:Colonoscopes; D003113:Colonoscopy / Q000295:instrumentation* / Q000379:methods; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method