Evidence for Routine Double Right-Sided Colon Examination
Douglas K. Rex, MD, FASGE reviewing Kim SY, et al. J Gastroenterol Hepatol 2020 Apr 8.
Double right-sided colon examination during colonoscopy is often recommended, and randomized controlled trials have compared a second examination of the right-sided colon in the forward view to one in retroflexion. Two forward-view examinations have numerically outperformed a second examination in retroflexion, without a statistically significant difference.
In this trial, patients were randomized to one or two right-sided colon examinations in the forward view. The adenoma detection rate for right-sided colon examinations increased from 11.9% with one examination to 17.5% with two examinations (P=.04), and in the two-examinations arm, the number of neoplastic lesions detected increased by 38% with a second examination.
COMMENTThis study has been previously performed in one arm or another in many tandem studies, but it serves as a reminder of how much can be missed when only one right-sided colon examination is performed.
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)
Kim SY, Lee SJ, Chung JW, et al. Efficacy of repeat forward-view examination of the right-sided colon during colonoscopy: a prospective randomized controlled trial. J Gastroenterol Hepatol 2020 Apr 8. (Epub ahead of print) (https://doi.org/10.1111/jgh.15064)
