Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial
Clinics
;
72(7): 395-399, July 2017. tab
Artigo
em Inglês
| LILACS
| ID: biblio-890716
ABSTRACT
OBJECTIVES:
The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions.METHODS:
In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern.RESULTS:
A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR) and the adenoma detection rate (ADR) were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01). In the placebo group 281 lesions were diagnosed (202 adenomas) and in the hyoscine group 282 lesions were detected (189 adenomas) (p=0.23). The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively). No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11; p<0.01 vs OR 2.3 95% CI 1.1 - 4.6; p=0.02).CONCLUSION:
The use of hyoscine before beginning the withdrawal of the colonoscope does not seem to enhance the PDR and the ADR.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Brometo de Butilescopolamônio
/
Pólipos do Colo
/
Colonoscopia
/
Neoplasias do Colo
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clinics
Assunto da revista:
Medicina
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Santa Casa de Caridade Bagé/BR
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