Yunho Jung1, Young-Eun Joo2, Hyun Gun Kim3, Seong Ran Jeon3, Jae Myung Cha4, Hyo-Joon Yang5, Jong Wook Kim6, Jun Lee7, Kyeong Ok Kim8, Hye Kyung Song9, Young Hwangbo10, Jeong Eun Shin11. 1. Department of Internal Medicine, Division of Gastroenterology, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea. 2. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea. 3. Department of Internal Medicine, Division of Gastroenterology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. 4. Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 5. Department of Internal Medicine and Gastrointestinal Cancer Center, Division of Gastroenterology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea. 7. Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea. 8. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Yeungnam University College of Medicine, Daegu, Republic of Korea. 9. Departments of Health Promotion Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea. 10. Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea. 11. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
Abstract
BACKGROUND AND AIMS: Appropriate colonoscopy withdrawal times for individual colonic segments are not well known. The relationship between withdrawal time and adenoma detection rate (ADR)/polyp detection rate (PDR) in individual colonic segments was examined in this study. METHODS: This was a prospective observational study involving 724 patients who underwent colonoscopy screening or surveillance colonoscopy from October 2015 to February 2017 at 10 university hospitals. RESULTS: In the right side of the colon, the ADR (33.2% vs 13.7%, P < .001), PDR, serrated polyp detection rate, and number of adenomas per colonoscopy (APC) were significantly higher when the colonoscopy withdrawal time was ≥2 minutes compared with <2 minutes. When the withdrawal time was ≥4 minutes in the proximal colon and ≥3 minutes in the left segment of the colon, the ADR, PDR, and APC were significantly higher compared with withdrawal times of <4 minutes and <3 minutes, respectively. Multivariate analyses showed that the ADR was significantly associated with withdrawal times of ≥2 minutes in the right side of the colon (odds ratio [OR], 2.98; 95% confidence interval [CI], 1.72-5.15; P < .001), ≥4 minutes in the proximal colon (OR, 4.48; 95% CI, 3.15-6.36; P < .001), and ≥3 minutes in the left segment of the colon (OR, 2.92; 95% CI, 1.74-4.91; P < .001). CONCLUSIONS: The PDR and ADR appeared to be significantly increased when the withdrawal time was ≥2 minutes in the right-sided colon segment, ≥4 minutes in the proximal colon, and ≥3 minutes in the left-sided colon segment compared with shorter withdrawal times.
BACKGROUND AND AIMS: Appropriate colonoscopy withdrawal times for individual colonic segments are not well known. The relationship between withdrawal time and adenoma detection rate (ADR)/polyp detection rate (PDR) in individual colonic segments was examined in this study. METHODS: This was a prospective observational study involving 724 patients who underwent colonoscopy screening or surveillance colonoscopy from October 2015 to February 2017 at 10 university hospitals. RESULTS: In the right side of the colon, the ADR (33.2% vs 13.7%, P < .001), PDR, serrated polyp detection rate, and number of adenomas per colonoscopy (APC) were significantly higher when the colonoscopy withdrawal time was ≥2 minutes compared with <2 minutes. When the withdrawal time was ≥4 minutes in the proximal colon and ≥3 minutes in the left segment of the colon, the ADR, PDR, and APC were significantly higher compared with withdrawal times of <4 minutes and <3 minutes, respectively. Multivariate analyses showed that the ADR was significantly associated with withdrawal times of ≥2 minutes in the right side of the colon (odds ratio [OR], 2.98; 95% confidence interval [CI], 1.72-5.15; P < .001), ≥4 minutes in the proximal colon (OR, 4.48; 95% CI, 3.15-6.36; P < .001), and ≥3 minutes in the left segment of the colon (OR, 2.92; 95% CI, 1.74-4.91; P < .001). CONCLUSIONS: The PDR and ADR appeared to be significantly increased when the withdrawal time was ≥2 minutes in the right-sided colon segment, ≥4 minutes in the proximal colon, and ≥3 minutes in the left-sided colon segment compared with shorter withdrawal times.
Authors: Martin Buerger; Philipp Kasper; Gabriel Allo; Johannes Gillessen; Christoph Schramm Journal: BMC Gastroenterol Date: 2019-11-15 Impact factor: 3.067