Adding Time for Inspection During Colonoscope Insertion Does Not Work
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Adding Time for Inspection During Colonoscope Insertion Does Not Work

Douglas K. Rex, MD, MASGE, reviewing Chandan S, et al. Gastrointest Endosc 2020 Jun 12.

There remain occasional advocates of dedicated time during colonoscope insertion to look for polyps as a way of increasing detection. In this analysis of 7 randomized controlled trials involving 3900 patients, the adenoma detection rate was 47.2% in the insertion-and-withdrawal cohort and 48.6% in a withdrawal-only cohort.

Douglas K. Rex, MD, FASGE

COMMENT

This analysis finds that, according to available literature, there is no benefit from dedicated time during insertion to look for polyps. On the other hand, we all know that when a polyp is seen on insertion, it’s much more efficient to remove it during insertion, as confirmed by another recent randomized controlled trial.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Chandan S, Mohan BP, Khan SR, et al. Adenoma and polyp detection rates during insertion versus withdrawal phase of colonoscopy: a systematic review and meta-analysis of randomized controlled trials. Gastrointest Endosc 2020 Jun 12. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2020.06.015)

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