Double Right-Sided Colon Examination Effective No Matter How You Do It
Douglas K. Rex, MD, MASGE, reviewing Kamal F, et al. Endosc Int Open 2022 Jul 11.
This study identified 5 randomized controlled trials that addressed the value of a second right-sided colon examination in the forward view versus no second examination. Overall, the right-sided colon adenoma detection rate (ADR) increased from 18% with no second examination in the forward view to 26% with the second examination. Advanced ADR in the right-sided colon increased from 2.5% to 3.7%, but the difference was not significant.
For studies that addressed whether a second examination should be performed in retroflexion versus a second forward-viewing examination, the additional pooled ADR was 8% with the second examination in retroflexion and 11% with a second forward-viewing examination. This difference did not reach significance.
COMMENTOne of the most effective maneuvers to increase ADR during colonoscopy is second examination. These data again confirm that there is no significant difference in detection gain between a second examination in the forward view versus retroflexion, and the numbers favor a second examination in the forward view.
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)
Kamal F, Khan MA, Lee-Smith WM, et al. Second exam of right colon improves adenoma detection rate: systematic review and meta-analysis of randomized controlled trials. Endosc Int Open 2022 Jul 11. (Epub ahead of print) (https://doi.org/10.1055/a-1896-4499)
