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Colonoscopy technique increases polyp detection in far reaches of right colon
Date:10/18/2010

rger than 10 millimeters) and serrated lesions, particularly in men, older patients and those with polyps found on forward examination according to research conducted by Douglas K. Rex, M.D., FACG and colleagues at Indiana University Medical Center in Indianapolis, "Right Colon Retroflexion Increases Yield of Polyps in the Proximal Colon. Dr. Rex presented his findings at the 75th Annual Scientific Meeting of the American College of Gastroenterology. In retroflexion, the tip of the colonoscope is in a deflected position to better visualize the proximal side of the colon's anatomy.

"Colonoscopy has a significant miss rate for the smallest adenomas, but retroflexion in the right side of the colon could reduce the miss rate associated with lesions on the proximal sides of the folds and flexures in the colon," explained Dr. Rex. In the study, of a total of 1000 patients who underwent colonoscopy, retroflexion in the right side of the colon was successful in 945 patients. The colonoscopists in the Indiana University study identified 500 polyps in 287 patients on forward examination of the right colon, as the colonoscope passed through, and an additional 68 polyps in 58 patients on retroflexion of the scope. Importantly, 41 percent of the patients who had polyps identified on retroflexion had negative exams on forward examination.

The researchers analyzed predictors of successful retroflexion and polyp detection using logistic regression analysis. "The risk of identifying a polyp on retroflexion was three times more likely among those who had a polyp detected on forward view compared to those patients who were negative on forward examination," according to Dr. Rex. While the presence of a polyp on forward view predicted the detection of polyps in retroflexion in this study, the analysis revealed that older age and male gender were significant predictors of finding polyps on retroflexion after a negative forward exam.


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Contact: Jacqueline Gaulin
mediaonly@acg.gi.org
202-255-5541
American College of Gastroenterology
Source:Eurekalert

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