Longer observation time increases adenoma detection in the proximal colon - a prospective study.

Klare, Peter; Phlipsen, Henrik; Haller, Bernhard; Einwächter, Henrik; Weber, Andreas; Abdelhafez, Mohamed; Bajbouj, Monther; Brown, Hayley; Schmid, Roland M; von Delius, Stefan

doi:10.1055/s-0043-121072

Klinik und Poliklinik für Innere Medizin II, Gastroenterologie (Prof. Schmid)

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Title:: Longer observation time increases adenoma detection in the proximal colon - a prospective study.
Document type:: Journal Article; 12
Author(s):: Klare, Peter; Phlipsen, Henrik; Haller, Bernhard; Einwächter, Henrik; Weber, Andreas; Abdelhafez, Mohamed; Bajbouj, Monther; Brown, Hayley; Schmid, Roland M; von Delius, Stefan
Abstract:: Longer observation times are associated with increased adenoma detection rates (ADR) in the entire colon. However, adenomas in the proximal colon are at risk of being missed during colonoscopy. The aim of this study was to investigate the impact of observation time on detection of adenomatous polyps in the proximal colon.This was a prospective study at a university hospital in Germany. Colonoscopies were conducted using magnetic endoscope imaging (MEI) in order to determine the exact position of the scope. Exact observation times spent for the detection of polyps in the proximal and distal colon segments were assessed. The primary outcome was adenoma detection in the proximal colon. ROC curves were generated in order to test the correlation between observation time and adenoma detection. Logistic regression analysis was used to check for interfering factors. A total 480 procedures with 538 polyps were available for analysis. The overall adenoma detection rate was 38.5 %. ADR in the proximal colon was 28.0 %. There was a significant association between observation time in the proximal colon and the detection of proximal adenomas ( < 0.001). The impact of the time factor on ADR was stronger in the proximal compared to the distal colon ( = 0.030). A net period of 4 min 7 sec was found to be the minimum time span for sufficient adenoma detection in the proximal colon.Observation time is significant in terms of adenoma detection in the proximal colon. The impact of observation time on ADR is stronger in the proximal compared to the distal colon. In the proximal colon a minimum time span of 4 minutes should be spent in order to ensure adequate adenoma detection.
Journal title abbreviation:: Endosc Int Open
Year:: 2017
Journal volume:: 5
Journal issue:: 12
Pages contribution:: E1289-E1298
Language:: eng
Fulltext / DOI:: doi:10.1055/s-0043-121072
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/29218322
Print-ISSN:: 2364-3722
TUM Institution:: II. Medizinische Klinik und Poliklinik (Gastroenterologie); Institut für Medizinische Statistik und Epidemiologie
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