Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial

Authors

  • Carlos Eduardo Oliveira dos Santos Santa Casa de Caridade Bagé; Departamento de Endoscopia e Gastroenterologia
  • Hamilton Moreira Faculdade Evangélica do Paraná; Programa de Pôs graduação em Princípios de Cirurgia
  • Julio Carlos Pereira-Lima Santa Casa de Misericórdia de Porto Alegre; Departamento de Gastroenterologia e Endoscopia
  • Carmen Australia Paredes Marcondes Ribas Faculdade Evangélica do Paraná; Programa de Pôs graduação em Princípios de Cirurgia
  • Fernanda de Quadros Onófrio Santa Casa de Misericórdia de Porto Alegre; Departamento de Gastroenterologia e Endoscopia
  • Alexandre Eduardo Augusti Czecko Faculdade Evangélica do Paraná; Programa de Pôs graduação em Princípios de Cirurgia
  • Rafael Koerich Ramos Faculdade Evangélica do Paraná; Programa de Pôs graduação em Princípios de Cirurgia
  • Caroline Aragão de Carvalho Faculdade Evangélica do Paraná; Programa de Pôs graduação em Princípios de Cirurgia

DOI:

https://doi.org/10.6061/clinics/2017(07)01

Keywords:

Colonoscopy, Adenoma, Colonic Polyps, Scopolamine Hydrobromide

Abstract

OBJECTIVES: The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions. METHODS: In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern. RESULTS: A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR) and the adenoma detection rate (ADR) were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01). In the placebo group 281 lesions were diagnosed (202 adenomas) and in the hyoscine group 282 lesions were detected (189 adenomas) (p=0.23). The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively). No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11; p<0.01 vs OR 2.3 95% CI 1.1 - 4.6; p=0.02). CONCLUSION: The use of hyoscine before beginning the withdrawal of the colonoscope does not seem to enhance the PDR and the ADR.

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Published

2017-07-01

Issue

Section

Clinical Sciences

How to Cite

Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial. (2017). Clinics, 72(7), 395-399. https://doi.org/10.6061/clinics/2017(07)01