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

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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Sa1642 - Duration of Retroflexion Significantly Influences Adenoma Detection Rate in the Right Colon: A Randomized Controlled Trial

Gastroenterology ◽

10.1016/s0016-5085(18)31466-5 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-339

Author(s):

Mir Fahad Faisal ◽

Badar Hasan ◽

Muhammad Shafiq ◽

Jamie Varghese ◽

Wendell K. Clarkston ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Detection Rate ◽

Controlled Trial ◽

Adenoma Detection Rate ◽

Right Colon ◽

Randomized Controlled ◽

Adenoma Detection ◽

The Right

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Impact of Second Forward-view Examination of the Right side of the Colon on Polyp and Adenoma Detection during Colonoscopy: A Randomized Controlled Trial

10.21203/rs.3.rs-141084/v1 ◽

2021 ◽

Author(s):

Keshu Shan ◽

Hongpeng Lu ◽

Zhixin Zhang ◽

Jiarong Xie ◽

Lu Xu ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Detection Rate ◽

Controlled Trial ◽

Lesion Detection ◽

Modest Improvement ◽

Randomized Controlled ◽

Adenoma Detection ◽

Significant Difference ◽

Advanced Lesion ◽

The Right

Abstract Objectives: Colorectal cancer in the right side of the colon is supposed to 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 adenoma detection rate (ADR) and 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 and a traditional colonoscopy (TC) group in which the colonoscopy was performed in a standard manner. The primary outcomes were the proximal PDR and ADR. The overall PDR and ADR, 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 proximal PDR and ADR in the SFE group were significantly higher than those in the TC group (PDR 17.8% vs. 9.7%, P =0.021; ADR 14.2% vs.7.2%, P =0.024). No significant difference was found for overall PDR/ADR, or advanced lesion detection rate between the two groups. Conclusions: This prospective study revealed that a second forward-view examination of the right side of the colon could result in a modest improvement in proximal ADR and PDR. This simple and time-effective technique might be recommended for routine colonoscopy. Trial registration: Clinical Trials.gov, NCT03619122. Registered on 7/8/2018.

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OC.02.3: Endocuff-Assisted Colonoscopy: A Useful Accessory to Improve Adenoma Detection Rate in Screening Colonoscopy? a Randomized Controlled Trial

Digestive and Liver Disease ◽

10.1016/s1590-8658(17)30306-7 ◽

2017 ◽

Vol 49 ◽

pp. e80-e81

Author(s):

S. Alicante ◽

F. De Grazia ◽

G. Manfredi ◽

G. Lupinacci ◽

C. Londoni ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Detection Rate ◽

Controlled Trial ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

Randomized Controlled ◽

Adenoma Detection

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Impact of preprocedure simethicone on adenoma detection rate during colonoscopy: a multicenter, endoscopist-blinded randomized controlled trial

Endoscopy ◽

10.1055/s-0043-119213 ◽

2017 ◽

Cited By ~ 5

Author(s):

Yu Bai ◽

Jun Fang ◽

Sheng-Bing Zhao ◽

Dong Wang ◽

Yan-Qing Li ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Bowel Preparation ◽

Detection Rate ◽

Controlled Trial ◽

Complete Removal ◽

Adenoma Detection Rate ◽

Randomized Controlled ◽

Adenoma Detection ◽

Bowel Cleansing ◽

Registration Number

Abstract Background and study aims Ideal bowel preparation for colonoscopy requires complete removal of fluid and foam from the colon. Polyethylene glycol (PEG) is widely used for bowel preparation, with antifoaming agents such as simethicone commonly used in combination with PEG. Data on the effect of simethicone on the adenoma detection rate (ADR) were limited. This study therefore aimed to investigate whether preprocedure simethicone could increase the ADR. Patients and methods This was a prospective, multicenter, endoscopist-blinded randomized controlled trial involving consecutive patients who underwent colonoscopy in six centers in China. Patients were randomly assigned to one of two groups: PEG plus simethicone or PEG alone. The primary outcome was ADR; secondary outcomes were quality of bowel preparation, measured by the Boston bowel preparation scale (BBPS) and bubble scores. Results 583 patients were included. More adenomas were detected in the PEG plus simethicone group than in the PEG alone group (ADR 21.0 % vs. 14.3 %, P = 0.04; advanced ADR 9.0 % vs. 7.0 %, P = 0.38). The mean number of adenomas detected was 2.20 ± 1.36 vs. 1.63 ± 0.89 (P = 0.02). Patients in the PEG plus simethicone group showed better bowel cleansing efficacy: BBPS ≥ 6 in 88.3 % vs. 75.2 % (P < 0.001) and bubble scores of 1.00 ± 1.26 vs. 3.98 ± 2.50 (P < 0.001). Abdominal bloating was reported less frequently in the PEG plus simethicone group (7.8 % vs. 19.7 %, P < 0.001) than in the PEG alone group. Conclusion Combined use of PEG and simethicone is associated with a significantly increased ADR in a Chinese population.Clinical trials registration number: NCT02540239

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