¿Cómo puede ayudarle la tecnología de Olympus a aumentar la ADR?

Los primeros estudios con EVIS EXERA III y EVIS LUCERA ELITE indican que la NBI mejora la detección de las lesiones en el colon. (20,21) Un estudio clínico comparativo y aleatorio realizado en un centro con EVIS EXERA III demostró que la ADR aumentaba aprox. del 14% al 48,3% si se usaba el NBI, en comparación con la luz blanca. (20) Así mismo, en un estudio clínico comparativo y aleatorio realizado en varios centros, la combinación de la tecnología NBI con el sistema EVIS LUCERA ELITE redujo la tasa de omisión de pólipos en un 29 %. (21) Por lo tanto, los dos sistemas contribuyen de forma eficaz a mejorar la detección. El registro eficiente de la histología de los pólipos es fundamental para poder hacer un seguimiento de la ADR. En este sentido, tres grandes metaanálisis demuestran que el diagnóstico óptico con ayuda de la tecnología NBI es factible y cumple los criterios de la estrategia PIVI de la ASGE para implementar una estrategia de tipo «RESECAR Y DEJAR» y «RESECAR Y ELIMINAR» para pólipos colorrectales diminutos (< 5 mm). (22,23,24)

El doble enfoque también puede ser importante para el proceso de diagnóstico: el NBI de doble enfoque no solo era muy preciso en el diagnóstico óptico, sino que también aumentaba el coeficiente de decisiones de alta confianza en un 14%. (25)

La Sociedad Europea de Endoscopia Gastrointestinal (ESGE) implementó el diagnóstico óptico de pólipos colorrectales diminutos en sus directrices (26) , lo que puede ser importante no solo para el proceso diagnóstico, sino también para proporcionar una forma más sencilla de supervisar el ADR y elevar el nivel de calidad de las colonoscopias de diagnóstico.

¿Por qué resulta difícil determinar la ADR?

La ADR es un indicador acumulativo sobre el que influyen una serie de factores demográficos, procedimentales y relacionados con el equipo. Por ejemplo, la ADR varía en función del sexo (15) y presenta diferencias entre centros dependiendo de los datos demográficos de los pacientes. Asimismo, se ha demostrado que existen diversos factores de procedimiento, como el tiempo de espera (47) , la calidad de la preparación (17) , la citación (18) , el uso de la colonoscopia con lavado de agua (19) y el uso de equipos de HDTV (20) , que aumentan considerablemente la ADR.

Para poder registrar y realizar un seguimiento de la ADR resulta imprescindible disponer de datos histológicos. Por tanto, es necesario dedicar tiempo y esfuerzos adicionales para poder ajustar los registros de los pacientes una vez conocidos los resultados histológicos.

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Ensayos clínicos

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