Colonoscopic withdrawal time and adenoma detection in the right colon

Background and Aims. Simethicone (SIM), as an antifoaming agent, has been shown to improve bowel preparation during colonoscopy. However, the optimal timing of SIM addition remained undetermined. We aimed to investigate the optimal timing of SIM addition to polyethylene glycol (PEG) to improve bowel preparation. Methods. Eligible patients were randomly assigned to two groups: the SIM evening group (SIM addition to PEG in the evening of the day prior to colonoscopy) and the SIM morning group (SIM addition to PEG in the morning of colonoscopy). The primary outcome was Bubble Scale (BS). The secondary outcomes were Boston Bowel Preparation Scale (BBPS) and adenoma detection rate (ADR). Results. A total of 419 patients were enrolled in this study. The baseline characteristics of the patients were similar in both groups. No significant differences were observed in terms of BS (8.76 ± 0.90 vs. 8.65 ± 1.16, P = 0.81), ADR (34.1% vs. 30.8%, P = 0.47), Boston Bowel Preparation Scale (BBPS) (8.59 ± 0.94 vs. 8.45 ± 1.00, P = 0.15), and withdrawal time (8.22 ± 2.04 vs. 8.01 ± 2.51, P = 0.094) between the two groups. Moreover, safety and compliance were similar in both groups. However, the SIM evening group was associated with shorter cecal intubation time (3.80 ± 1.81 vs. 4.42 ± 2.03, P < 0.001), higher BS (2.95 ± 0.26 vs. 2.88 ± 0.38, P = 0.04) in the right colon, and diminutive ADR (62.5% vs. 38.6%, P = 0.022) in the right colon, when compared to the SIM evening group. Conclusions. The SIM addition to PEG in the evening of the day prior to colonoscopy can shorten cecal intubation time and improve BS scores and diminutive ADR of the right colon compared with the SIM addition to PEG in the morning of colonoscopy in bowel preparation.

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Sa1142 Withdrawal Time Improves Adenoma Detection Rates During Retroflexion in the Right Colon

Gastroenterology ◽

10.1016/s0016-5085(12)60849-x ◽

2012 ◽

Vol 142 (5) ◽

pp. S-227

Author(s):

Srinivas Gaddam ◽

Thomas G. Hollander ◽

Steven A. Edmundowicz ◽

Dayna S. Early

Keyword(s):

Right Colon ◽

Withdrawal Time ◽

Detection Rates ◽

Adenoma Detection ◽

Adenoma Detection Rates ◽

The Right

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Impact of second forward-view examination on adenoma detection rate during unsedated colonoscopy: a randomized controlled trial

BMC Gastroenterology ◽

10.1186/s12876-021-01783-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keshu Shan ◽

Hongpeng Lu ◽

Zhixin Zhang ◽

Jiarong Xie ◽

Lu Xu ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Detection Rate ◽

Controlled Trial ◽

Lesion Detection ◽

Adenoma Detection Rate ◽

Right Colon ◽

Randomized Controlled ◽

Adenoma Detection ◽

Advanced Lesion ◽

The Right

Abstract Objectives Colorectal cancer on the right side of the colon has been suggested to be harder to detect by colonoscopy. The aim of this study was to evaluate whether a second forward-view examination of the right side of the colon could increase the adenoma detection rate (ADR) and/or polyp detection rate (PDR). Methods This was a single-centre randomized controlled trial. Patients undergoing colonoscopy were recruited and randomly assigned to the second forward-view examination (SFE) group, in which the right side of the colon was examined twice or the traditional colonoscopy (TC) group in which the colonoscopy was performed in a standard manner. The primary outcome was the ADR of right colon. The overall PDR and ADR, PDR of the right colon, per-adenoma miss rate of the right colon, and advanced lesion detection rate were also recorded and compared. Results A total of 392 patients were included in the study (SFE group 197 vs. TC group 195). The ADR and PDR of the right colon in the SFE group were significantly higher than those in the TC group (ADR 10.7% vs. 5.1%; P = 0.042); PDR 17.8% vs. 9.7%, P = 0.021). No significant difference was found in overall PDR/ADR, or advanced lesion detection rate between the two groups. Conclusions This prospective controlled study revealed that a second forward-view examination could modestly increase the ADR and PDR of the right colon during unsedated colonoscopies. This simple, safe and time-effective technique might be recommended for routine unsedated colonoscopy. Trial registration: Clinical Trials.gov, NCT03619122. Registered on 7/8/2018.

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1181 A RANDOMIZED, CONTROLLED TRIAL COMPARING THE ADENOMA DETECTION AND MISS RATES WITH WATER EXCHANGE AND AIR INSUFFLATION IN THE RIGHT COLON BY COLONOSCOPIST BLINDED TO THE INSERTION METHOD.

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.896 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB108

Author(s):

Yu-Hsi Hsieh ◽

Chih Wei Tseng ◽

Felix W. Leung

Keyword(s):

Randomized Controlled Trial ◽

Water Exchange ◽

Controlled Trial ◽

Right Colon ◽

Randomized Controlled ◽

Adenoma Detection ◽

Insertion Method ◽

The Right ◽

Air Insufflation

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Impact of Retroflexion Vs. Second Forward View Examination of the Right Colon on Adenoma Detection: A Comparison Study

The American Journal of Gastroenterology ◽

10.1038/ajg.2015.21 ◽

2015 ◽

Vol 110 (3) ◽

pp. 415-422 ◽

Cited By ~ 53

Author(s):

Vladimir M Kushnir ◽

Young S Oh ◽

Thomas Hollander ◽

Chien-Huan Chen ◽

Gregory S Sayuk ◽

...

Keyword(s):

Comparison Study ◽

Right Colon ◽

Adenoma Detection ◽

The Right

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Longer Retroflexion Duration Significantly Improves Adenoma Detection Rate in the Right Colon: A Multicenter Prospective Pragmatic Clinical Trial

The American Journal of Gastroenterology ◽

10.14309/00000434-201810001-00182 ◽

2018 ◽

Vol 113 (Supplement) ◽

pp. S103

Author(s):

Fahad F. Mir ◽

Hasan Badar ◽

Muhammad Shafiq ◽

Jamie Varghese ◽

Wendell Clarkston ◽

...

Keyword(s):

Clinical Trial ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Right Colon ◽

Pragmatic Clinical Trial ◽

Adenoma Detection ◽

The Right

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Linked color imaging reduces the miss rate of neoplastic lesions in the right colon: a randomized tandem colonoscopy study

Endoscopy ◽

10.1055/a-0580-7405 ◽

2018 ◽

Vol 50 (04) ◽

pp. 396-402 ◽

Cited By ~ 20

Author(s):

Silvia Paggi ◽

Giuseppe Mogavero ◽

Arnaldo Amato ◽

Emanuele Rondonotti ◽

Alida Andrealli ◽

...

Keyword(s):

Color Contrast ◽

Right Colon ◽

Color Imaging ◽

Colon Adenoma ◽

Detection Rates ◽

Adenoma Detection ◽

Significant Difference ◽

Neoplastic Lesions ◽

Linked Color Imaging ◽

The Right

Abstract Background Linked color imaging (LCI) is a newly developed image-enhancing endoscopy technology that provides bright endoscopic images and increases color contrast. We investigated whether LCI improves the detection of neoplastic lesions in the right colon when compared with high definition white-light imaging (WLI). Methods Consecutive patients undergoing colonoscopy were randomized (1:1) after cecal intubation into right colon inspection at first pass by LCI or by WLI. At the hepatic flexure, the scope was reintroduced to the cecum under LCI and a second right colon inspection was performed under WLI in previously LCI-scoped patients (LCI–WLI group) and vice versa (WLI–LCI group). Lesions detected on first- and second-pass examinations were used to calculate detection and miss rates, respectively. The primary outcome was the right colon adenoma miss rate. Results Of the 600 patients enrolled, 142 had at least one adenoma in the right colon, with similar right colon adenoma detection rates (r-ADR) in the two groups (22.7 % in LCI–WLI and 24.7 % in WLI–LCI). At per-polyp analysis, double inspection of the right colon in the LCI–WLI and WLI–LCI groups resulted in an 11.8 % and 30.6 % adenoma miss rate, respectively (P < 0.001). No significant difference in miss rate was found for advanced adenomas or sessile serrated lesions. At per-patient analysis, at least one adenoma was identified in the second pass only (incremental ADR) in 2 of 300 patients (0.7 %) in the LCI – WLI group and in 13 of 300 patients (4.3 %) in the WLI – LCI group (P = 0.01). Conclusions LCI could reduce the miss rate of neoplastic lesions in the right colon.

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