Τίτλος:
Diagnostic yield of scope retroflexion in the right colon: A prospective cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Techniques have been implemented to improve colonoscopy adenoma detection rate (ADR) in the right colon. Aims & methods: We prospectively examined the additional diagnostic yield of right colon examination with colonoscope retroflexion in consecutive, symptomatic and screening-surveillance patients. Right colon was examined in forward-view first and thereafter, retroflexion was performed to re-inspect it. Results: Right colon examination in retroflexion was achieved in 620 (92%) patients. Increased inserted scope length to the cecum (OR: 0.48 [95%CI: 0.27-0.84]) and elderly status (OR: 0.53 [95%CI: 0.430-0.94]) predicted retrofexion failure. Forward-view colonoscopy detected 134 polyps and 112 adenomas in 105 and 85 patients, respectively. Scope retroflexion revealed 7 missed (6 adenomas - 2 advanced) polyps in 7 patients; indicating 4.96 (95%CI: 1.37-8.55)% and 5.1 (95%CI: 1.12-9.05)% per-polyp and per-adenoma miss rates, respectively. In ITT analysis, per-patient polyp and adenoma miss rates were 1.041% and 0.89%, respectively. Among screening-surveillance patients, retroflexion detected 3 missed adenomas (2 advanced) in 3 patients, resulting in changed surveillance schedule in 2 of them (5.12 per 1000 screening-surveillance patients). Early study termination was favored by low right colon ADR improvement and lacking substantial surveillance interval change. Conclusion: The additional diagnostic yield of scope retroflexion in the right colon is questionable. © 2015 Editrice Gastroenterologica Italiana S.r.l.
Συγγραφείς:
Triantafyllou, K.
Tziatzios, G.
Sioulas, A.D.
Beintaris, I.
Gouloumi, A.-R.
Panayiotides, I.G.
Dimitriadis, G.D.
Περιοδικό:
Digestive and Liver Disease
Λέξεις-κλειδιά:
adult; aged; Article; cecum; colon adenoma; colon polyp; colonoscope retroflexion; colonoscopy; controlled study; diagnostic test accuracy study; diagnostic value; digestive system examination; disease surveillance; female; flexible colonoscope; human; major clinical study; male; predictive value; priority journal; adenoma; adolescent; ascending colon; cohort analysis; Colonic Neoplasms; Colonic Polyps; colonoscopy; cross-sectional study; early cancer diagnosis; feasibility study; middle aged; pathology; procedures; prospective study; very elderly; young adult, Adenoma; Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Colon, Ascending; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Cross-Sectional Studies; Early Detection of Cancer; Feasibility Studies; Female; Humans; Male; Middle Aged; Prospective Studies; Young Adult
DOI:
10.1016/j.dld.2015.11.024
