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Right colon retroflexion improves adenoma detection

16 Sep 2017
There are marked increases in the diagnosis of adenomas in the right colon with the use of colonoscopy with right-sided retroflexion compared with conventional colonoscopy, according to a recent study. In addition, the procedure has a high rate of manoeuvre success and small risk of adverse events.

Researchers performed a meta-analysis of studies on right colon retroflexion and its impact on adenoma detection compared with conventional colonoscopy by searching multiple databases including Embase, Medline and Web of Science. Pooled analyses of adenoma detection and retroflexion success were based on mixed-effects and random-effects models with heterogeneity analyses.

A total of eight studies, involving 3,660 participants, were included in the meta-analysis. The primary analysis comparing the two procedures to determine the per-adenoma miss rate in the right colon was 16.9 percent (95 percent CI, 12.5 to 22.5 percent).

Colonoscopy with right-sided retroflexion had a 91.9-percent (86 to 95 percent) overall rate of successful retroflexion and 0.03-percent rate of adverse events.

“Thus, re-examination of the right colon in retroflexed view should be strongly considered in future standard of care colonoscopy guidelines for quality improvement in colon cancer prevention,” according to researchers.

“Although colonoscopy with polypectomy can prevent up to 80 percent of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Previous studies addressing right colon retroflexion have revealed discordant evidence regarding the benefit of this manoeuvre on adenoma detection with concomitant concerns about safety and rates of manoeuvre success,” they added.

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Most Read Articles
3 days ago
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, Yesterday
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
6 days ago
Cognitive deficits in bipolar disorder are neurodevelopmental rather than neurodegenerative in nature, a recent study has reported. Furthermore, cognitive impairment in bipolar patients appears to be stable, in the majority at least.
3 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.