Impact of Colonoscopy Insertion Techniques on Adenoma Detection

Background Low adenoma detection rate (ADR) predicts development of interval cancers, found mainly in the right (cecum-ascending) colon, where poor bowel preparation is an associated factor. Single-site studies reported increased detection of adenomas in the proximal colon segments by water exchange...

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Bibliographic Details
Published in:Digestive diseases and sciences 2016-07, Vol.61 (7), p.2068-2075
Main Authors: Cadoni, Sergio, Falt, Přemysl, Sanna, Stefano, Argiolas, Mariangela, Fanari, Viviana, Gallittu, Paolo, Liggi, Mauro, Mura, Donatella, Porcedda, Maria L., Smajstrla, Vit, Erriu, Matteo, Leung, Felix W.
Format: Article
Language:English
Subjects:
Adenoma
Adenoma - diagnosis
Adenoma - pathology
Aged
Biochemistry
Colon, Ascending - pathology
Colonoscopy
Colonoscopy - methods
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - pathology
Comparative analysis
Early Detection of Cancer
Female
Gastroenterology
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Methods
Middle Aged
Oncology
Original Article
Pneumoviridae
Transplant Surgery
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Summary:Background Low adenoma detection rate (ADR) predicts development of interval cancers, found mainly in the right (cecum-ascending) colon, where poor bowel preparation is an associated factor. Single-site studies reported increased detection of adenomas in the proximal colon segments by water exchange (WE). Data about colon cleansing revealed that WE had the greatest impact in the right colon. Aims To test the hypothesis that WE had the greatest impact on ADR in colon segments with the most favorable bowel cleanliness scores, namely the right colon. Methods We pooled right colon and overall ADR data of three similarly designed colonoscopy trials that compared WE, water immersion (WI) and insufflation of air or carbon dioxide (AICD) in a mixed gender European population. Results In this study, 1200 (704 males) subjects and were included. 288 were screening cases. Demographic and procedural data were comparable. Water exchange achieved significantly higher right colon
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-016-4053-1