Diagnostic yield of scope retroflexion in the right colon: A prospective cohort study

Triantafyllou, Konstantinos; Tziatzios, Georgios; Sioulas, Athanasios D.; Beintaris, Iosif; Gouloumi, Alina‐Roxani; Panayiotides, Ioannis G.; Dimitriadis, George

doi:10.1016/j.dld.2015.11.024

Cited by 25 publications

(29 citation statements)

References 36 publications

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“…We summarized data from the previous studies on retroflexion in the right colon (Table S1, Supporting Information) . Four studies, except Lee's study, performed retroflexion after one‐time FV observation.…”

Section: Discussionmentioning

confidence: 99%

Impact of retroflexion in the right colon after repeated forward‐view examinations

et al. 2018

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Background and AimRight colon polyps can especially be overlooked when they are located on the backs of haustral folds. Previous studies have reported that repeated forward‐view examinations in the right colon were effective in reducing adenoma miss rates. The aim of this study was to clarify the impact of retroflexion in the right colon after repeated forward‐view examinations.MethodsThis multicenter, prospective, observational study was conducted at three institutions in Kumamoto, Japan, between February 2014 and December 2015. Subjects who were over 40 years old and scheduled for colonoscopy were recruited. For the forward view, after cecal intubation, the colonoscope was withdrawn to the hepatic flexure. The colonoscope was sequentially reinserted to the cecum and then withdrawn to the hepatic flexure. For the retroflexion view (RV), the colonoscope was reinserted to the cecum, retroflexed, and then withdrawn to the hepatic flexure. All polyps were resected at the time of detection. The primary outcome of this study was the adenoma miss rate for the repeated forward‐view examinations.ResultsOf the 777 enrolled participants, retroflexion was successful in 730 (94.0%). The repeated forward‐view withdrawal technique detected 291 adenomas, while the third withdrawal in the RV detected 53. The adenoma miss rate for the repeated forward‐view withdrawal was 15.4%. No severe adverse events occurred during retroflexion.ConclusionBecause adenomas located on potential blind spots can be missed when only using forward‐view examinations, retroflexion in the right colon after repeated forward‐view examinations might improve colonoscopy detection rates.

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Section: Discussionmentioning

confidence: 99%

Impact of retroflexion in the right colon after repeated forward‐view examinations

et al. 2018

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“…When retroflexion was performed in the right colon after standard inspection and polypectomy, the additional diagnostic yield was minimal [43,44]. Adenoma detection rate only improved from 25 to 26 % in one study [44].…”

Section: Does Retroflexion In the Right Colon Improve Adr?mentioning

confidence: 89%

“…Once the scope is retroflexed, the proximal side of the folds can be examined and polyps removed while in this position. Retroflexion may not be feasible if the colonoscope shaft has loops as indicated by greater than 100 cm insertion of the endoscope to the cecum [43].…”

Section: Retroflexion In the Right Colonmentioning

confidence: 99%

Can Technology Improve the Quality of Colonoscopy?

Thirumurthi

Ross

Raju

2016

Curr Gastroenterol Rep

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In order for screening colonoscopy to be an effective tool in reducing colon cancer incidence, exams must be performed in a high-quality manner. Quality metrics have been presented by gastroenterology societies and now include higher adenoma detection rate targets than in the past. In many cases, the quality of colonoscopy can often be improved with simple low-cost interventions such as improved procedure technique, implementing split-dose bowel prep, and monitoring individuals' performances. Emerging technology has expanded our field of view and image quality during colonoscopy. We will critically review several technological advances in the context of quality metrics and discuss if technology can really improve the quality of colonoscopy.

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“…In addition, although there was no statistical difference, more subjects in the RF group were recommended for short‐term surveillance compared with the SF group (12.5% vs 7.5%, respectively). Several clinical studies on the efficacy of a second examination of the right‐sided colon have been published recently 10,14–18,24,25 . However, most evaluated only retroflexion as the modality for the second examination, and only four studies evaluated RF examination 10,16–18 .…”

Section: Discussionmentioning

confidence: 99%

“…The retroflexion technique was expected to improve visualization of the proximal aspects of folds and increases adenoma/polyp detection of the right‐sided colon. Although the technique is relatively safe, the failure rate increases according to patient characteristics (age and sex), and there is a possibility of complications because of excessive bending 14,15 . In addition, according to other studies, the yield of right‐sided colon adenoma/polyp was not significantly different when the repeat examination was performed using retroflexion versus the forward view 10,16 .…”

Section: Introductionmentioning

confidence: 85%

Efficacy of repeat forward‐view examination of the right‐sided colon during colonoscopy: A prospective randomized controlled trial

Kim

Lee

Chung

et al. 2020

J of Gastro and Hepatol

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Background and Aim: Generally, colonoscopy is less effective for detecting colorectal adenomas in the right-sided colon compared with the distal colon. Repeat forward-view (RF) examination of the right-sided colon has been suggested to increase the adenoma detection rate (ADR). However, studies investigating the efficacy of RF examination are lacking. Thus, the aim of this study was to determine whether RF examination in the right-sided colon enhances right-sided ADR. Methods: We performed a prospective, randomized controlled trial, including asymptomatic subjects who underwent screening colonoscopy. Subjects were randomized to the RF group, in which the right-sided colon was examined twice in the forward view, or to the standard forward-view (SF) group, in which the right-sided colon was examined once in the forward view. The primary outcome was the right-sided ADR on RF examination of the right-sided colon. Results: A total of 640 subjects completed the study protocol (RF group, n = 320; SF group, n = 320). The right-sided ADR in the RF group was significantly higher than that in the SF group (17.5% vs 11.9%, respectively; P = 0.044). In the RF group, an additional 31 adenomas were found, resulting in an increased detection rate of adenomas of 38.3% compared with the first forward view. The ADR of the whole colon was similar between the groups. Conclusions: In our prospective randomized controlled trial, RF examination of the right-sided colon, which can be easily performed in clinical practice, was associated with an increased rate of detection of right-sided ADR.

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Diagnostic yield of scope retroflexion in the right colon: A prospective cohort study

Cited by 25 publications

References 36 publications

Impact of retroflexion in the right colon after repeated forward‐view examinations

Impact of retroflexion in the right colon after repeated forward‐view examinations

Can Technology Improve the Quality of Colonoscopy?

Efficacy of repeat forward‐view examination of the right‐sided colon during colonoscopy: A prospective randomized controlled trial

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