Endoscopy 2020; 52(S 01): S42
DOI: 10.1055/s-0040-1704130
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 10:30 – 12:00 Innocent & guilty polyps Wicklow Meeting Room 3
© Georg Thieme Verlag KG Stuttgart · New York

INFLUENCE OF ADDITIONAL RETROGRADE INSPECTION VERSUS SECOND STANDARD FORWARD EXAMINATION ON THE DETECTION OF COLORECTAL ADENOMAS DURING COLONSCOPY: A BACK-TO-BACK RANDOMIZED CONTROLLED TRIAL

T Rath
1   Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Department of Gastroenterology, Erlangen, Germany
,
S Zopf
2   Klinikum Fürth, Department of Gastroenterology, Fürth, Germany
,
F Vitali
1   Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Department of Gastroenterology, Erlangen, Germany
,
E Klenske
1   Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Department of Gastroenterology, Erlangen, Germany
,
J Siebler
1   Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Department of Gastroenterology, Erlangen, Germany
,
MF Neurath
1   Ludwig Demling Endoscopy Center of Excellence, University Hospital Erlangen, Department of Gastroenterology, Erlangen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Adenoma detection rate (ADR) is inversely related to the incidence of interval colorectal cancers and serves as a benchmark criterion for quality assessment during screening or surveillance colonoscopies. Within this study, we analyzed whether additional retrograde inspection of the colon can increase ADR and the number of adenomas per patient.

    Methods Patients undergoing screening or surveillance colonoscopies were prospectively enrolled and randomized in a 1:1 fashion into the following arms: (i) RetroView (RV) Arm: colonoscopy was initially performed with standard forward view (SFV), followed by a second inspection of the whole colon in retroflexion; (ii) SFV Arm: colonoscopy was initially performed with standard forward view (SFV), followed by a second inspection of the whole colon again with SFV. Number of polyps and adenomas in each segment detected with SFV and RV as well as withdrawal times with SFV and RV were recorded.

    Results At the time of abstract submission, 160 patients were enrolled (78 patients RetroView Arm; 82 patients SFV Arm). Both, PDR and ADR were increased under second inspection in retroflexion in the RV Arm (PDR SFV: 38%, PDR 2nd RV: 49%; ADR SFV: 35%, ADR 2nd RV: 46%). Likewise, PDR and ADR were increased under second inspection in forward view in the SFV Arm (PDR SFV: 37%, PDR 2nd SFV: 51%; ADR SFV: 33%, ADR 2nd SFV: 51%). The mean number of adenomas found per patient was also increased upon second inspection either in retroflexion or in forward view. The majority of adenomas found upon second inspection were >5 mm in size with some of them exhibiting advanced or serrated histology.

    Conclusions A second inspection of the colon either in Retroflexion or in Forward view can the increase in ADR and mean number of adenomas per patients. Second inspection of the colon is therefore an easy approach to increase the ADR.


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