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

2015; Elsevier BV; Volume: 48; Issue: 2 Linguagem: Inglês

10.1016/j.dld.2015.11.024

1878-3562

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

Diverticular Disease and Complications

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.