Mo1999 - Development of an Updated Score Chart to Predict the Risk of Chronic Mesenteric Ischemia Based on a Multicenter Cohort of 666 Patients

minimizing distention and maximizing cleanliness.Infused water is removed predominantly during insertion (GIE 2012;76:657).Pooled data of RCT showed WE achieved significantly higher overall ADR than air insufflation (AI) and water immersion, but the finding was limited by the predominance of diminutive lesions accounting for the increase (JCG, 2017, in press).Until recently, individual studies reporting the impact of WE on advanced ADR were only of small sample sizes.Aim: To assess the impact of WE on advanced ADR compared with AI.Method: To increase sample size, we pooled our data from 5 previously published RCT with advanced ADR data.We tested the hypothesis that WE significantly increased advanced ADR compared to AI.As control observation, pooled overall ADR data were similarly analyzed.Results: Data of 5407 patients were pooled.Table 1 shows more screening patients in the AI group and longer insertion time in the WE group.Table 2 shows there were variations in advanced and overall ADR based on the sites of the RCT.The trends towards an increase in both measures by WE demonstrated in the early RCT with small sample sizes were confirmed to be statistically significant when larger RCT were completed.A significantly higher advanced ADR in the WE group (7.8%) compared with the AI group (5.3%); a 47% improvement (p<0.001) was achieved.A significantly higher overall ADR in the WE group (27.4%) compared with the AI group (20.9%); an improvement of 31% (p<0.001) was also observed.Discussion: The improvement in overall ADR attested to the higher quality of WE (compared to AI) colonoscopy.The combined data also revealed a significant increase in advanced ADR, the clinically more relevant precursors of colon cancers, by WE compared with AI.Conclusion: The promise of WE in preventing colorectal cancers by enhancing advanced ADR justifies its adoption to ensure quality improvement in colonoscopy programs.