Full Spectrum vs. Standard Forward-viewing Colonoscopy

NCT ID: NCT02117674

Last Updated: 2015-12-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

246 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2015-08-31

Brief Summary

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The aim of this study is to evaluate FUSE-colonoscopy in terms of feasibility and its possible additive contribution in the detection of important lesions, namely polyps and cancers, compared to the standard "forward-viewing" approach, with and without the addition of the right-colon retroflexion technique, in a series of patients undergoing back-to-back screening or surveillance colonoscopies in a randomized fashion.

Detailed Description

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We changed the anticipated number of subjects enrollment for study: NCT02117674 from 120 to 200 based on the following sample size estimation:

Tandem colonoscopies studies results, show that novel endoscopic technologies detect about 20% more adenomas than those conventional colonoscopy does (missed adenomas). Since FUSE colonoscopy cannot be considered as a perfect examination, we hypothesize that conventional colonoscopy will detect one third of the missed adenomas that FUSE detects in a similar setting. Therefore a sample size of 120 adenomas achieves 80% power to detect an odds ratio of 3.0 using a two-sided McNemar test with a significance level of 0.05. The odds ratio is equivalent to a difference between two paired proportions of 14% which occurs when the proportion of detected missed adenomas during FUSE is 21% and the proportion of missed adenomas during conventional colonoscopy is 7%. During one year period before the study initiation, our colonoscopy performance quality data show that we detect a mean number of adenomas per patient equal of 0.7 in a population similar to the one recruited in our study. Therefore, 172 patients overall will be required to detect 120 adenomas. Given the uncertainty of our estimation and in order to cope with patients exclusions, withdrawals and unexpected incomplete colonoscopies, we decided to recruit 200 patients.

A more extensive description regarding the investigators study is provided in the following fields.

Conditions

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Colon Neoplasms

Keywords

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colonoscopy adenoma detection rate full spectrum colonoscopy right colon retroflexion feasibility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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standard forward-viewing colonoscopy

polyp detection with standard forward-viewing colonoscopy polyp detection in the right colon with scope retroflexion

Group Type ACTIVE_COMPARATOR

standard forward-viewing colonoscopy

Intervention Type PROCEDURE

examination of the colon with a conventional colonoscope

full-spectrum colonoscopy

Intervention Type PROCEDURE

examination of the colon with full-spectrum colonoscope

right colon retroflexion

Intervention Type PROCEDURE

examination of the right colon with scope retroflexion (both with conventional and fuse scope)

full-spectrum colonoscopy

polyp detection with full-spectrum colonoscopy polyp detection in the right colon with scope retroflexion

Group Type ACTIVE_COMPARATOR

standard forward-viewing colonoscopy

Intervention Type PROCEDURE

examination of the colon with a conventional colonoscope

full-spectrum colonoscopy

Intervention Type PROCEDURE

examination of the colon with full-spectrum colonoscope

right colon retroflexion

Intervention Type PROCEDURE

examination of the right colon with scope retroflexion (both with conventional and fuse scope)

Interventions

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standard forward-viewing colonoscopy

examination of the colon with a conventional colonoscope

Intervention Type PROCEDURE

full-spectrum colonoscopy

examination of the colon with full-spectrum colonoscope

Intervention Type PROCEDURE

right colon retroflexion

examination of the right colon with scope retroflexion (both with conventional and fuse scope)

Intervention Type PROCEDURE

Other Intervention Names

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conventional colonoscopy fuse endoscopy retroflexion

Eligibility Criteria

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Inclusion Criteria

* adults undergoing elective screening or surveillance colonoscopy
* symptomatic adults with indication for colonoscopy

Exclusion Criteria

* age over 80 years
* poor overall health (ASA III, IV)
* recent abdominal surgery
* presence of abdominal wall hernias
* active colitis
* multiple right colon diverticula
* previous bowel resection
* inflammatory bowel disease
* polyposis syndromes
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Attikon Hospital

OTHER

Sponsor Role lead

Responsible Party

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ATHANASIOS SIOULAS

Dr

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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KONSTANTINOS TRIANTAFYLLOU, Prof

Role: STUDY_DIRECTOR

Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital, University of Athens, Greece

GEORGE ALEXANDRAKIS, Dr

Role: STUDY_DIRECTOR

417 NIMTS VETERANS HOSPITAL

Locations

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417 Nimts Veterans Hopsital

Athens, , Greece

Site Status

Hepatogastroenterology Unit, 2nd Department of Internal Medicine and Research Unit, Attikon University General Hospital

Athens, , Greece

Site Status

Countries

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Greece

References

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Hewett DG, Rex DK. Miss rate of right-sided colon examination during colonoscopy defined by retroflexion: an observational study. Gastrointest Endosc. 2011 Aug;74(2):246-52. doi: 10.1016/j.gie.2011.04.005. Epub 2011 Jun 15.

Reference Type BACKGROUND
PMID: 21679946 (View on PubMed)

Gralnek IM, Segol O, Suissa A, Siersema PD, Carr-Locke DL, Halpern Z, Santo E, Domanov S. A prospective cohort study evaluating a novel colonoscopy platform featuring full-spectrum endoscopy. Endoscopy. 2013 Sep;45(9):697-702. doi: 10.1055/s-0033-1344395. Epub 2013 Aug 12.

Reference Type BACKGROUND
PMID: 23939509 (View on PubMed)

Papanikolaou IS, Apostolopoulos P, Tziatzios G, Vlachou E, Sioulas AD, Polymeros D, Karameris A, Panayiotides I, Alexandrakis G, Dimitriadis GD, Triantafyllou K. Lower adenoma miss rate with FUSE vs. conventional colonoscopy with proximal retroflexion: a randomized back-to-back trial. Endoscopy. 2017 May;49(5):468-475. doi: 10.1055/s-0042-124415. Epub 2017 Jan 20.

Reference Type DERIVED
PMID: 28107765 (View on PubMed)

Other Identifiers

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FUSE-001

Identifier Type: -

Identifier Source: org_study_id