Surgical Endoscopy

, Volume 32, Issue 6, pp 2676–2682 | Cite as

The use of high definition colonoscopy versus standard definition: does it affect polyp detection rate?

  • John Richardson
  • Anthony Thaventhiran
  • Hugh Mackenzie
  • Benjamin Stubbs
Article

Abstract

Background

Polyp detection rate (PDR) during lower gastrointestinal endoscopy (LGIE) is of clinical importance. Detecting adenomatous polyps early in the adenoma–carcinoma sequence can halt disease progression, enabling treatment at a favourable stage. High definition colonoscopy (HDC) has been used in our hospital alongside standard definition equipment since 2011. We aim to determine what affect the use of HDC has on PDR.

Methods

Post-hoc analysis of a prospectively maintained database on all patients undergoing LGIE was performed (01/01/2012–31/12/2015), n = 15,448. Analysis tested the primary outcome of HD’s effect on PDR across LGIE and secondary outcome stratified this by endoscopist group (Physician (PE), Surgeon (SE) and Nurse Endoscopist (NE)).

Results

Of 15,448 patients, 1353 underwent HDC. Unmatched analysis showed PDR increased by 5.3% in this group (p < 0.001). Matched analysis considered 2288 patients from the total cohort (1144 HDC) and showed an increase of 1% in PDR with HDC (p = 0.578). Further unmatched analysis stratified by endoscopist groups showed a PDR increase of 1.8% (p = 0.375), 5.4% (p = 0.008) and 4.6% (p = 0.021) by PE, SE and NE respectively. Matched analysis demonstrated an increase of 1% (p = 0.734) and 1.5% (p = 0.701) amongst PE and NE, with a decrease of 0.6% (p = 0.883) by SE.

Conclusion

The introduction of HDC increased PDR across all LGIE in our hospital, though this was not clinically significant. This marginal benefit was present across all endoscopist groups with no group benefiting over another in matched analysis.

Keywords

Polyp detection rate Polyp size High definition colonoscopy Standard definition colonoscopy 

Notes

Compliance with ethical standards

Disclosure

Drs. John Richardson, Anthony Thaventhiran, Hugh Mackenzie and Benjamin Stubbs have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2017_5962_MOESM1_ESM.docx (495 kb)
Supplementary material 1 (DOCX 494 KB)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • John Richardson
    • 1
  • Anthony Thaventhiran
    • 1
  • Hugh Mackenzie
    • 1
  • Benjamin Stubbs
    • 1
  1. 1.Dorset County Hospital NHS Foundation TrustDorchesterUK

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