Original articleClinical endoscopyRight-sided adenoma detection with retroflexion versus forward-view colonoscopy
Section snippets
Methods
A prospective multicenter cohort study was performed across 3 tertiary care and 2 private hospitals from January 2013 to January 2014. Five study endoscopists who routinely perform right-sided colonic retroflexion were involved with baseline endoscopic performance listed in Table 1. A standardized data sheet capturing patient demographics, procedure indication, whether retroflexion was successful, reasons behind failure to perform the maneuver, adverse events, and polyp characteristics was
Results
A total of 1351 patients was recruited over the study period. Patient demographics were a male-to-female ratio of 1:1.03, mean age of 59.97 years (range, 18-91 years), and the predominant indication was colon cancer screening (39.4% [532/1351]). The adult colonoscope was predominantly used across our cohort (94.4% [1276/1351]). Complete patient details are shown in Table 2.
Discussion
We undertook a multicenter prospective cohort study to evaluate whether right-sided retroflexion significantly improved the ADR. The emerging medical literature indicates that although colonoscopy has had a positive impact on preventing colon cancer, this effect is substantially reduced in the right side of the colon.18, 19, 20, 21 In Australia, colon cancer is the second-most commonly diagnosed malignancy, despite having 1 of the highest rates of colonoscopy.22 Retroflexion in the right side
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2022, Gastrointestinal EndoscopyCitation Excerpt :The adenoma miss rate in our observational series was close to 10%, similar to the current study. Multiple studies since then have shown that a second examination in the right colon is warranted, especially after finding at least 1 adenoma in the right colon.13,21 Available data indicate a second forward-facing withdrawal is as effective as performing the second examination in retroflexion.11
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 748.