Diagnostic Yield and Safety of Advanced Endoscopic Technologies in a Retrospective Cohort of 14,000 Gastrointestinal Procedures at a Tertiary Center

Aim: Technological advancements in gastrointestinal (GI) endoscopy have substantially improved the diagnostic and therapeutic management of GI disorders.High-definition (HD) imaging, narrow-band imaging (NBI), and artificial intelligence (AI)-assisted systems represent transformative innovations aimed at increasing lesion detection and reducing human error.To evaluate the clinical impact of advanced endoscopic technologies, including HD endoscopy, NBI, and AI-assisted detection systems, on polyp detection rates and procedural safety in a high-volume, real-world setting.Method: This retrospective single-center study included 14,000 patients who underwent endoscopic procedures between January 2018 and December 2022.The primary outcome was the adenoma detection rate (ADR) across different imaging modalities.Secondary outcomes included lesion characteristics and complication rates.Data were analyzed using SPSS version 25.0, with significance set at p<0.05.Results: Across 8,000 colonoscopies, the ADR was 18.4% for standard HD endoscopy (n=4,000), 27.2% for NBI (n=2,000), and 33.4% for AI-assisted systems (n=4,000).Recognition of small (5 mm) and flat lesions (p<0.05) was substantially improved with AI-assisted detection.Complication rates remained low (1%) and comparable across modalities, with no increase in adverse events associated with advanced technologies. Conclusion:Polyp detection is substantially enhanced with NBI and AI-assisted endoscopy without compromising safety, offering promising adjuncts to standard endoscopic practice.The integration of such innovations may reduce interval cancer risk and support more consistent quality in GI diagnostics.