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Comparison of the number of adenomas missed by the first exploration of the right colon by LCI (linked color imaging) or by white light during a colonoscopy, according to the order of randomization.
All patients consecutively admitted for routine colonoscopy will be included in this prospective randomized crossover study. After randomization, a first exploration of the right colon will be performed in linked color imaging (LCI) or white light imaging (WLI) depending of the randomization. Every polyp will be resected as soon it will be detected. After this first examination, colon will be explored a second time with a light system different from the one used for the first exploration. If a polyp will be detected during the second exploration, it will be counted as a polyp missed by the first exploration method.
A- Inclusion criteria:
Exclusion criteria:
History of recto-colic resection Inadequate preparation (none under Boston score <2) Patient referred for resection of a polyp in place, known IBD (inflammatory bowel disease) or known polyposis
B- Exclusion criteria:
Purposes of the study:
Compare, when exploring the number of adenomas missed by the first exploration of the right colon by LCI or by white light, according to the order of randomization.
Evaluation criteria :
Main criterion:
- Missed right colon adenomas by first exploration in LCI-WLI and WLI-LCI groups
Secondary criteria
Number of patients:
The expected rate of "missed adenomas" of the colon is about 20%, based on published data. Considering as relevant an 8% reduction in this rate of "missed adenomas" of the right colon by the LCI, the expected rate for LCI is therefore 12%.
With a risk of the first species of 5% (bilateral test), a power of 80%, 329 patients per group should be included in the study. Taking into account the rate lost to follow-up of 5%, we expect a total of 700 patients.
Duration of the study:
1-2 years
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| WLI-LCI group | Active Comparator | a first exploration of the right colon will be done in white light (WLI) then a second exploration will be done in LCI |
|
| LCI-WLI group | Active Comparator | a first exploration of the right colon will be done in LCI and a second exploration will be done in white light (WLI) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| exploration in white light (WLI) | Procedure | Exploration of the right colon done in white light (WLI) |
|
| Measure | Description | Time Frame |
|---|---|---|
| the number of missed adenomas during the first exploration of the right colon | Number of polyps diagnosed on the second exploration and not removed (because not diagnosed) during the first exploration | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| The factors influencing these missed polyp rates | Time of exploration (in seconds) | 1 day |
| The factors influencing these missed polyp rates | Boston scale (0 to 9) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David KARSENTI, MD | Société Française d'Endoscopie Digestive | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinique Paris-Bercy | Charenton-le-Pont | 94220 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38740373 | Derived | Karsenti D, Perrod G, Perrot B, Queneherve L, Chabrun E, Koch S, Vanbiervliet G, Rahmi G, Velut G, Moreno-Garcia M, Cavicchi M, Dray X. Impact of linked color imaging on the proximal adenoma miss rate: a multicenter tandem randomized controlled trial (the COCORICO trial). Endoscopy. 2024 Oct;56(10):759-767. doi: 10.1055/a-2324-8807. Epub 2024 May 13. |
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| ID | Term |
|---|---|
| D003111 | Colonic Polyps |
| ID | Term |
|---|---|
| D007417 | Intestinal Polyps |
| D011127 | Polyps |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
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the patient will be randomized and included in one of two groups: WLI-LCI group: a first exploration of the right colon will be done in white light (WLI) then a second exploration will be done in LCI LCI-WLI group: a first exploration of the right colon will be done in LCI and a second exploration will be done in white light (WLI)
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| Exploration in LCI | Procedure | Exploration of the right colon in linked color imaging (LCI) |
|
| 1 day |
| The characteristics of the missed polyps | Size in millimeters | 1 day |
| The characteristics of the missed polyps | type : Adenoma polyp / Advanced neoplasia polyp / Serrated polyp / Hyperplastic polyp | 1 day |
| Adenoma Detection Rate (ADR) | given by the first exploration technique decided by randomization: percentage of colonoscopy with one or more adenoma of the right colon | 1 day |
| Advanced Neoplasia Detection Rate (ANDR) | given by the first exploration technique decided by randomization: percentage of colonoscopy with one or more advanced neoplasia of the right colon | 1 day |
| Serrated Polyp Detection Rate (SPDR) | given by the first exploration technique decided by randomization: percentage of colonoscopy with one or more serrated polyp of the right colon | 1 day |