Published online Mar 21, 2019. doi: 10.3748/wjg.v25.i11.1378
Peer-review started: December 3, 2018
First decision: January 30, 2019
Revised: February 13, 2019
Accepted: February 22, 2019
Article in press: February 22, 2019
Published online: March 21, 2019
An ultrathin endoscope has low luminous intensity, low image resolution, and difficulty in operation. However, the ultrathin endoscopy is a useful tool for screening endoscopy because of its low invasion.
Recently endoscopic technology has markedly advanced. The improvement of the diagnostic ability of ultrathin endoscope has also improved. Evaluating the diagnostic ability of the ultrathin endoscope is warranted.
In this study, early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source was compared with that of the conventional endoscope.
The study subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients (37.3%), and the conventional endoscope was used in 235 patients (62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.
The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and 7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.
The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.