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2015 ; 3
(6
): E636-41
Nephropedia Template TP
gab.com Text
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English Wikipedia
Mechanisms of hyoscine butylbromide to improve adenoma detection: A case-control
study of surface visualization at simulated colonoscope withdrawal
#MMPMID26716127
East JE
; Saunders BP
; Burling D
; Tam E
; Boone D
; Halligan S
; Taylor SA
Endosc Int Open
2015[Dec]; 3
(6
): E636-41
PMID26716127
show ga
BACKGROUND AND STUDY AIMS: Antispasmodics may improve mucosal visualization
during colonoscope withdrawal, potentially improving polyp and adenoma detection.
Meta-analysis and case-control studies suggest a 9?% to 13?% relative increase in
adenoma and polyp detection. We aimed to assess the impact of hyoscine
butylbromide on the expected visualization during colonoscope withdrawal using a
CT colonography (CTC) simulation. PATIENTS AND METHODS: Datasets from a previous
CTC study examining the effect of antispasmodic were re-analyzed with customised
CTC software, adjusted to simulate a standard colonoscopic view. Eighty-six
patients received intravenous (IV) hyoscine butylbromide 20?mg, 40?mg or no
antispasmodic. Main outcome measurements at unidirectional flythrough, simulating
colonoscope withdrawal, were percentage colonic surface visualization, numbers
and sizes of unseen areas, and colonic length. RESULTS: Use of antispasmodic was
associated with a significant relative increase in percentage surface
visualization of 2.6?% to 3.9?%, compared with no antispasmodic, P?0.006. Total
numbers of missed areas and intermediate sized (300?-?1000?mm(2)) missed areas
were significantly decreased, by approximately 20?%. There were no differences
between the 20-mg and 40-mg doses. Mean colonic length (161?-?169?cm) was
unchanged by antispasmodic. CONCLUSIONS: IV hyoscine butylbromide at simulated
colonoscope withdrawal was associated with significant increases in surface
visualization, which might explain up to half the improvement in adenoma
detection seen in clinical studies.