Hasta un 86% menos en biopsias
¿Cómo puede ayudar la tecnología de Olympus?
¿Cómo puede ayudar la tecnología de Olympus a reducir el número de biopsias?
El NBI se ha sometido a numerosos estudios para evaluar su capacidad de detectar y diagnosticar lesiones gastrointestinales: La precisión diagnóstica del NBI para lesiones colorrectales es superior al 90%. Por ello, el NBI con doble enfoque puede ayudar a reducir la necesidad de biopsias antes del tratamiento. El doble enfoque aumentó el coeficiente de decisiones de alta confianza. (9)Por ello, el NBI con doble enfoque puede ayudar a reducir la necesidad de lesiones por biopsia antes del tratamiento.
El NBI ha demostrado ser una modalidad fiable para biopsias dirigidas en casos de síndrome de Barrett, identificando más neoplasia con menos biopsias. (10,11) Aunque la biopsia no puede evitarse por completo, el NBI puede mejorar la calidad y la rentabilidad de los procesos de control de los casos con síndrome de Barrett.
Las Agencias europeas y americanas de gastroenterología han optado por el uso del NBI para el diagnóstico óptico de pólipos colorrectales (ESGE, ASGE, NICE)
(25,26
,48) y la biopsia dirigida para los controles del síndrome de Barrett (ASGE).
(46) La biopsia selectiva con tecnología NBI también se está investigando para otras indicaciones gastrointestinales y parece una herramienta prometedora para mejorar los resultados clínicos.
(12,13)
¿Qué problemas surgen con las biopsias?
Aunque las biopsias solo son pequeñas intervenciones quirúrgicas con un riesgo mínimo para el paciente (1), esto puede ser diferente en los pacientes medicados con anticoagulantes. (1) En conjunto, las biopsias son valiosas para estratificar el riesgo con índices muy bajos de complicaciones. El mayor inconveniente es el coste del análisis histológico.
Según las directrices actuales, las biopsias se llevan a cabo en puntos aleatorios para hacer el seguimiento de pacientes con síndrome de Barrett, con lesiones gástricas o con alto riesgo de CCR (p. ej., con enfermedad inflamatoria intestinal). (2,3,4) La mayoría de estas biopsias no contienen tejido displásico, ya que no son selectivas, lo que se traduce en unos costes altos y una capacidad de detección moderada, lo que justifica la necesidad de buscar una técnica más eficiente. (5,6)
Un sistema: EVIS EXERA III
La endoscopia del futuro a su alcance
Un sistema: EVIS EXERA III
La endoscopia del futuro a su alcance
«El NBI es la única cromoendoscopia virtual que usa una clasificación validada y reconocida internacionalmente, la clasificación NICE, y se puede usar en la práctica clínica diaria.»
Prof. Thierry Ponchon
Edouard Herriot Hospital
Director de departamento, Dpto. de enfermedades digestivas
Lyon, France
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Ensayos clínicos
- 1.Update on Endoscopic Tissue Sampling Devices.
- 2.The Role of Endoscopy in Barrett‘s Esophagus and Other Premalignant Conditions of the Esophagus.
- 3.American Gastroenterological Association Institute Guideline on the Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions
- 4.The Role of Endoscopy in Inflammatory Bowel Disease
- 5.The Seattle Protocol Does Not More Reliably Predict the Detection of Cancer at the Time of Esophagectomy Than a Less Intensive Surveillance Protocol
- 6.Random Biopsies Taken During Colonoscopic Surveillance of Patients with Longstanding Ulcerative Colitis: Low Yield and Absence of Clinical Consequences
- 7.Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging
- 8.Endoscopic Prediction of Deep Submucosal Invasive Carcinoma: Validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) Classification
- 9.Narrow-Band Imaging with Dual Focus Magnification in Differentiating Colorectal Neoplasia
- 10.Standard Endoscopy with Random Biopsies Versus Narrow Band Imaging Targeted Biopsies in Barrett‘s Oesophagus: A Prospective, International, Randomised Controlled Trial
- 11.Advanced Imaging Technologies Increase Detection of Dysplasia and Neoplasia in Patients with Barrett‘s Esophagus: A Meta-Analysis and Systematic Review
- 12.White-Light or Narrow-Band Imaging Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study
- 13.Narrow Band Imaging with Magnification Endoscopy for Celiac Disease: Results from a Prospective, Single-Center Study
- 14.Adenoma Detection Rate and Risk of Colorectal Cancer and Death
- 15.Improving Measurement of the Adenoma Detection Rate and Adenoma Per Colonoscopy Quality Metric: The Indiana University Experience
- 16.Impact of Bowel Preparation with Low-Volume (2-Liter) and Intermediate-Volume (3-Liter) Polyethylene Glycol on Colonoscopy Quality: A Prospective Observational Study
- 17.Adenoma Detection Rate Is not Influenced by the Timing of Colonoscopy When Performed in Half-Day Blocks
- 18.A Patient-Blinded Randomized, Controlled Trial Comparing Air Insufflation, Water Immersion, and Water Exchange During Minimally Sedated Colonoscopy
- 19.High Definition Colonoscopy vs. Standard Video Endoscopy for the Detection of Colonic Polyps: A Meta-Analysis
- 20.Detection of Colorectal Adenoma by Narrow Band Imaging (HQ190) vs. High-Definition White Light Colonoscopy: A Randomized Controlled Trial
- 21.Next-Generation Narrow Band Imaging System for Colonic Polyp Detection: A Prospective Multicenter Randomized Trial
- 22.Narrow Band Imaging to Differentiate Neoplastic and Non-Neoplastic Colorectal Polyps in Real Time: A Meta-Analysis of Diagnostic Operating Characteristics
- 23.Diagnostic Performance of Narrowed Spectrum Endoscopy, Autofluorescence Imaging, and Confocal Laser Endomicroscopy for Optical Diagnosis of Colonic Polyps: A Meta-Analysis
- 24.ASGE Technology Committee Systematic Review and Meta-Analysis Assessing the ASGE PIVI Thresholds for Adopting Real-Time Endoscopic Assessment of the Histology of Diminutive Colorectal Polyps
- 25.Real-Time Optical Diagnosis for Diminutive Colorectal Polyps Using Narrow-Band Imaging: The VALID Randomised Clinical Trial
- 26.Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019
- 27.An Analysis of the Learning Curve to Achieve Competency at Colonoscopy Using the JETS Database
- 28.Patient Pain During Colonoscopy: An Analysis Using Real-Time Magnetic Endoscope Imaging
- 29.Magnetic Endoscopic Imaging Versus Standard Colonoscopy in a Routine Colonoscopy Setting: A Randomized, Controlled Trial.
- 30.Magnetic Endoscopic Imaging Versus Standard Colonoscopy: Meta-Analysis of Randomized Controlled Trials
- 31.Magnetic Endoscopic Imaging as an Adjuvant to Elective Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- 32.Does “Responsive Insertion Technology” Improve Practice of Colonoscopy? Results of a Randomized Study
- 33.Conscious Sedation and Analgesia in Colonoscopy [...]
- 34.Safety Analysis of Endoscopist-Directed [...]
- 35.Position Change During Colonoscope Withdrawal Increases Polyp and Adenoma Detection in the Right but not in the Left Side of the Colon: Results of a Randomized Controlled Trial
- 36.Variable Stiffness Colonoscope Versus Regular Adult Colonoscope: Meta-Analysis of Randomized Controlled Trials
- 37.[...] Sedation for Colonoscopy with a New Ultrathin or a Standard Endoscope: A Prospective Randomized Controlled Study
- 38.Long-Term Colorectal-Cancer Incidence and Mortality after Lower Endoscopy
- 39.The Comparative Cost-Effectiveness of Colorectal Cancer Screening Using Faecal Immunochemical Test Versus Colonoscopy
- 40.Trends in Adenoma Detection Rates During the First 10 Years of the German Screening Colonoscopy Program
- 41.Global Epidemiology of Barrett‘s Esophagus
- 42.Cost Considerations in Implementing a Screening and Surveillance Strategy for Barrett‘s Oesophagus
- 43.Preliminary Feasibility Study Using a Novel Narrow-Band Imaging System with Dual Focus Magnification Capability in Barrett‘s Esophagus: Is the Time Ripe to Abandon Random Biopsies?
- 44.Carbon Dioxide Insufflation Versus Conventional Air Insufflation for Colonoscopy: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials
- 45.Reduced Pain During Screening Colonoscopy with an Ultrathin Colonoscope: A Randomized Controlled Trial
- 46.ASGE guideline on screening and surveillance of Barrett's esophagus
- 47.Longer Withdrawal Time Is Associated With a Reduced Incidence of Interval Cancer After Screening Colonoscopy.
- 48.Virtual chromoendoscopy to assess colorectal polyps during colonoscopy
- 49.Narrow-Band Imaging for Detection of Neoplasia at Colonoscopy: A Meta-analysis of Data From Individual Patients in Randomized Controlled Trials
- 50.Impact of 2 generational improvements in colonoscopes on adenoma miss rates: results of a prospective randomized multicenter tandem study