CLINICS

Clinics (Sao Paulo). 2017 July; 72(7): 395-399.
doi:10.6061/clinics/2017(07)01

Copyright © 2017 CLINICS

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

Carlos Eduardo Oliveira dos Santos I * , Hamilton Moreira II , Julio Carlos Pereira-Lima III , Carmen Australia Paredes Marcondes Ribas II , Fernanda de Quadros Onófrio III , Alexandre Eduardo Augusti Czecko II , Rafael Koerich Ramos II , Caroline Aragão de Carvalho II

Departamento de Endoscopia e Gastroenterologia, Santa Casa de Caridade, Bage, RS, BR

Programa de Pos graduacao em Principios de Cirurgia, Faculdade Evangelica do Parana, Curitiba, PR, BR

Departamento de Gastroenterologia e Endoscopia, Hospital Santa Casa, Porto Alegre, RS, BR

*Corresponding author. E-mail: ddendo@uol.com.br

received September 30, 2016; revised November 29, 2016; accepted January 13, 2017.

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.

Keywords: Colonoscopy, Adenoma, Colonic Polyps, Scopolamine Hydrobromide


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