Endoscopy 2019; 51(04): S100-S101
DOI: 10.1055/s-0039-1681466
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: Colonic polyps: detection Club D
Georg Thieme Verlag KG Stuttgart · New York

SECOND FRONTAL VIEW VERSUS PROXIMAL RETROFLEXION IN RIGTH COLON IN COLO-RECTAL CANCER SCREENING: MULTICENTRE RANDOMIZED TRIAL

MH Núñez-Rodriguez
1   Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
,
P Diez-Redondo
1   Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
,
F Riu
2   Hospital del Mar, Digestive System Service, Barcelona, Spain
,
M Cimavilla
3   Gastroenterology, Hospital Rio Carrion, Palencia, Spain
,
A Loza
4   Hospital Santos Reyes, Aranda de Duero, Spain
,
L Hernandez Villalba
4   Hospital Santos Reyes, Aranda de Duero, Spain
,
M Pérez-Miranda
1   Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Colonoscopy, the gold standard for the detection of colorectal cancer, fails to detect 22 – 28% of polyps, resulting in interval cancer (IC). IC are more frequent in right colon. The aim of this study was to compare second view of right colon with proximal retroflexion to second forward viewing in the detection of colorectal neoplasm in colorectal cancer screening programme. (NCT03041532).

    Methods:

    Multicenter Prospective Randomized study of 691 patients referred from the colorectal screening program with a positive fecal occult blood test (FOBT) (October 2016 and October 2018). Patients were randomized to second view of right colon with proximal retroflexion (PRF) or standard forward-viewing colonoscopy (SFV).

    Results:

    691 patients were included, 43 were excluded due to inadequate preparation in the right colon and/or incomplete colonoscopy. 55.2% are males. The average total withdrawal time is 9.16 min (SD 4.5). The average time of assessment of the 1st pass is 2.04 min (DS: 1.3 min) and the second pass 1.61 min (DS 0.96).

    Proximal Retroflexion was succeed in 83%. At right colon 595 lesions was detected. First exploration detected 79,1% vs. 20,9% lesions at second view. Maneuver at second view did not produce a significantly: 18,3% (PRF) vs. 22,8% (SFV) p:0,18. Lesion size did not produce a significantly (1 ° exploration: 6,5 mm DS:6,6 vs. 2 ° exploration: 5 mm DS 2,7).

    Tab. 1:

    Polyp detection rate in right colon (PDR)

    GLOBAL

    1 ° view

    2 ° View

    Polyp Detection Rate (PDR)

    583/649 = 0.89

    461/649 = 0.71

    122/649 = 0.18

    Conclusions:

    Proximal retroflexion is a secure maneuver. A second view of right colon increases lesion rate detection (20%), regardless of method used.


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