Endoscopia con NBI : una meta-analisi sull’accuratezza

 A meta-analysis for evaluating the accuracy of endoscopy with narrow band imaging in detecting colorectal adenomas.Xi-Feng Jin, Tong-Hai Chai, Jun-Wen Shi, Xiu-Cheng Yang, Qing-Yan .Journal of Gastroenterology and Hepatology 2011: advance online publication   Background and Aims To determine whether the use of narrow-band imaging (NBI) system could enhance the accuracy of adenoma detection during an endoscopic examination of the colon and rectum. Methods MEDLINE, EMBASE, and the Cochrane Library databases were searched along with a hand search of abstracts from relevant conferences up to June 2011. The rates of adenoma and flat adenoma detection, and withdrawal time were analyzed using Review Manager 4.2. Results A total of 3049 subjects in eight trials were included. Meta-analysis revealed that there was no statistically significant difference in the rates of adenoma detection between the NBI group and the white light colonoscopy group (pooled RR:1.09, 95% CI:1.00–1.19, P = 0.05). However, after exclusion of HDTV modalities, the rate of adenoma detection by NBI was significantly higher than that by white light, particularly for patients with one adenoma (pooled RR 1.36, 95% CI 1.07–1.71, P = 0.02). Endoscopy with the NBI system significantly increased the rate of flat adenoma detection (pooled RR 1.96, 95% CI 1.09–3.52, P = 0.02). However, endoscopy with NBI had longer withdrawal time than that with white light (pooled WMD: 0.90, 95% CI: 0.38 –1.42, P = 0.0006). Conclusions Endoscopy with NBI seems to improve the detection of flat adenomas, particularly with high-definition technology, but prolongs the withdrawn time. These results indicate that endoscopy routinely using the NBI system for the surveillance of adenomas may be recommended after the technique is further modified.

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