The impact of full-spectrum endoscopy on pathological lesion detection in different regions of the colon: a randomised, controlled trial

INTRODUCTION: Colonoscopy is crucial for detecting and localising pathological lesions within the colon. Colonoscopy quality is defined by the caecal intubation rate, withdrawal time, adenoma detection rate, and polyp detection rate. The newly introduced full-spectrum endoscope (FUSE(®)) provides a 330° field of view, allowing endoscopists to observe more colonic anatomy. It is intended to increase detection of pathological lesions, especially those situated behind the haustral folds of the bowel. This diagnostic modality should increase the adenoma detection rate (ADR), especially in the right hemicolon. The aim of this study was to explore the efficacy of FUSE for detecting pathologic lesions in different colonic regions. MATERIAL AND METHODS: The study enrolled 408 patients who were randomised to either a standard frontal view (SFV) or the novel full-spectrum colonoscopy. Analysis was performed among three broad regions of the colon: right, transverse, and left colon, according to the Boston Bowel Preparation Scale. RESULTS: FUSE yielded a higher diverticula detection rate (DDR) in the right and middle colon (DDR-R (p < 0.05), DDR-T (p < 0.05), DDR-L (p = 0.862)). ADR (p = 0.761), advanced ADR (aADR) (p = 0.950), and DDR (p = 0.967) in respective regions of the colon were similar between the groups; however, the total number of adenomas detected with FUSE was higher in the right and middle regions of the colon compared with those detected by SFV (p < 0.05). CONCLUSIONS: Full-spectrum colonoscopy allows for effective recognition of pathological lesions in the right and middle regions of the colon. Although full-spectrum colonoscopy did not statistically affect ADR, the absolute number of adenomas detected was higher compared with classical endoscopy.