Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12504
Title: Right-sided adenoma detection with retroflexion versus forward-view colonoscopy.
Authors: Chandran, Sujievvan;Parker, Frank;Vaughan, Rhys B;Mitchell, Brent;Fanning, Scott;Brown, Gregor;Yu, Jenny;Efthymiou, Marios
Affiliation: Department of Gastroenterology, Austin Health, Melbourne, Victoria, Australia; Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.
Department of Anaesthetics, Austin Health, Melbourne, Victoria, Australia.
Department of Gastroenterology, Launceston General Hospital, Tasmania, Australia; Calvary Health Care, St. Vincent's Campus, Tasmania, Australia.
Department of Gastroenterology, Alfred Health, Victoria, Australia; Epworth HealthCare, Richmond, Victoria, Australia.
Department of Gastroenterology, Austin Health, Melbourne, Victoria, Australia.
Issue Date: 29-Oct-2014
Citation: Gastrointestinal Endoscopy 2014; 81(3): 608-13
Abstract: Colonoscopy and polypectomy can prevent up to 80% of colon cancer; however, a significant adenoma miss rate still exists, particularly in the right side of the colon.To assess whether retroflexion in the right side of the colon significantly improves the adenoma detection rate (ADR) over forward-view assessment.Multicenter prospective cohort study.Three tertiary care public and 2 private hospitals.A total of 1351 consecutive adult patients undergoing elective colonoscopy.Withdrawal from the cecum was performed in the forward view initially and identified polyps removed. Once the hepatic flexure was reached, the cecum was reintubated and the right side of the colon was assessed in the retroflexed view to the hepatic flexure.ADR in the retroflexed view when compared with forward-view examination of the right side of the colon.Retroflexion was successful in 95.9% of patients, with looping the predominant (69.6%) reason for failure. Forward-view assessment of the right side of the colon identified 642 polyps, of which 531 were adenomas yielding a polyp and ADR of 28.57% and 24.64%, respectively. Retroflexion identified a further 84 polyps of which 75 were adenomas, improving the polyp and ADR to 30.57% and 26.4%, respectively.Observational study.Right-sided retroflexion was successful in most of our cohort with a statistically significant but small increase in ADR. Right-sided retroflexion is safe when performed by experienced endoscopists with no adverse events observed in this cohort. (Australian New Zealand Clinical Trials Registry, ACTRN12613000424707.).
Internal ID Number: 25440687
URI: http://ahro.austin.org.au/austinjspui/handle/1/12504
DOI: 10.1016/j.gie.2014.08.039
URL: http://www.ncbi.nlm.nih.gov/pubmed/25440687
Type: Journal Article
Appears in Collections:Journal articles

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