Is it better to wear a hood?

▶ Horiuchi A, Nakayama Y, Kato N, et al. Hood-assisted colonoscopy is more effective in detection of colorectal adenomas than Narrow-Band Imaging. Clin Gastroenterol Hepatol. Published Online First: 6 August 2009.

Optical Colonoscopy remains the gold standard for identifying and removing colonic polyps. Efforts continue to identify the best techniques and technology to maximise polyp detection. Horiuchi et al. compared colonoscopy utilising a transparent retractable extension (TRE) device (the hood) and colonoscopy with narrow band imaging (NBI) in the detection of colonic polyps. Hood devices potentially increase polyp detection by flattening haustral folds and effectively allowing visualisation behind the fold while NBI utilises a narrow spectrum of light to visualise mucosal vascular pattern. Patients with adenoma identified at index colonoscopy (n=107) were randomised to undergo a second colonoscopy within 3 months using either TRE or NBI. All second procedures were performed by one colonoscopist blinded to the results of the first procedure. There was no difference in demographic characteristics, caecal intubation time or indication for the two groups. There was a 31% increase in adenoma detection with TRE compared to the index procedure (p<0.0001) and an insignificant increase (5%) using NBI. There was a significant difference in the proportion of individuals with newly identified adenoma 40.7% with TRE versus 13.2% with NBI (p=0.0028). Colonoscopy with TRE took significantly longer (25 vs 21 min, p=0.04) this was attributed to the greater number of polyps identified and removed. No complications occurred. The authors conclude that TRE …