Imperial College London
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Dr James Kinross

Faculty of Medicine, Department of Surgery & Cancer

Reader in General Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1947j.kinross

 
 
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Location

 

1029Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lewis:2022:10.3399/BJGPO.2022.0036,
author = {Lewis, J and Askari, A and Mehta, A and Razak, Y and Patel, P and Misra, R and Tilney, H and Ahmed, T and Ahmed, M and Syeed, A and Camilleri-Brennan, J and Nicholls, RJ and Kinross, JM},
doi = {10.3399/BJGPO.2022.0036},
journal = {BJGP Open},
title = {A novel digital rectoscope for the triage of lower gastrointestinal symptoms in primary care: a prospective multicentre feasibility study.},
url = {http://dx.doi.org/10.3399/BJGPO.2022.0036},
volume = {6},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Access to community rectoscopy might help to ease the burden on hospital services and reduce costs for the NHS. To assess this, a prospective multicentre observational phase I feasibility study of a novel digital rectoscope and telestration software for the triage of lower gastrointestinal (GI) symptoms was undertaken. AIM: To determine if digital rectoscopy is feasible, acceptable, and clinically safe. DESIGN & SETTING: Evaluation of clinician case reports and patient questionnaires from patients recruited from five primary care centres. METHOD: Adults meeting 2-week wait (2WW) criteria for suspected lower GI cancer, suspected new diagnosis, or flare-up of inflammatory bowel disease (IBD) were enrolled. Examinations were performed by primary care practitioners using the LumenEye rectoscope. The CHiP platform allowed immediate remote review by secondary care. A prospective analysis was performed of patient and clinician experiences, diagnostic accuracy, and cost. RESULTS: A total of 114 patients were recruited and 110 underwent the procedure (46 [42%] females and 64 [58%] males). No serious adverse events were reported. Eighty-two (74.5%) patients reported that examination was more comfortable than expected, while 104 (94.5%) felt the intervention was most convenient if delivered in the community. Clinicians were confident of their assessment in 100 (87.7%) examinations. Forty-eight (42.1%) patients subsequently underwent colonoscopy, flexible sigmoidoscopy, or computed tomography virtual colonoscopy (CTVC). The overall sensitivity and specificity of LumenEye in identifying rectal pathology was 90.0% and 88.9%. It was 100% and 100% for cancer, and 83.3% and 97.8% for polyps. Following LumenEye examination, 19 (17.3%) patients were discharged, with projected savings of 11 305 GBP. CONCLUSION: Digital rectoscopy in primary care is safe, acceptable, and can reduce referrals. A phase III randomised controlled trial is indicated to define its utility in r
AU  - Lewis,J
AU  - Askari,A
AU  - Mehta,A
AU  - Razak,Y
AU  - Patel,P
AU  - Misra,R
AU  - Tilney,H
AU  - Ahmed,T
AU  - Ahmed,M
AU  - Syeed,A
AU  - Camilleri-Brennan,J
AU  - Nicholls,RJ
AU  - Kinross,JM
DO  - 10.3399/BJGPO.2022.0036
PY  - 2022///
TI  - A novel digital rectoscope for the triage of lower gastrointestinal symptoms in primary care: a prospective multicentre feasibility study.
T2  - BJGP Open
UR  - http://dx.doi.org/10.3399/BJGPO.2022.0036
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35728817
VL  - 6
ER  -
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