Comparison of Right Colon Adenoma Miss Rates Between Water Exchange and Carbon Dioxide Insufflation

Cheng, Ching‐Yi; Kuo, Yen Lin; Hsieh, Yu Hsi; Tang, Jui Hsiang; Leung, Felix W.

doi:10.1097/mcg.0000000000001454

Cited by 10 publications

(11 citation statements)

References 35 publications

(113 reference statements)

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“…6 WE decreased the miss rate of right colon adenomas 6,7 and serrated polyps. 7 WE produced significantly higher ADR than WI. 8 Network meta-analyses showed WE colonoscopy had the highest ADR, 9 advanced ADR 9 and serrated adenoma/polyp detection rate 10 compared with cap-and Endocuff-assisted colonoscopy when gas insufflation was used as the common comparator.…”

Section: Discussionmentioning

confidence: 92%

“…Compared with gas insufflation WE significantly increased overall advanced ADR, 5 right colon ADR 6 and serrated lesions detection rate 6 . WE decreased the miss rate of right colon adenomas 6,7 and serrated polyps 7 . WE produced significantly higher ADR than WI 8 .…”

Section: Discussionmentioning

confidence: 94%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

“…In this context, it is important to explore how WE could benefit screening colonoscopy practice during pandemic recovery. In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights 5–13 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Endoscopy featured water-aided colonoscopy (WAC) as novel in the Innovation Forum in 2011. Gastrointestinal Endoscopy published a modified Delphi consensus review (MDCR) that supports WAC for clinical practice in 2021. We tested the hypothesis that experience was an important predictor of WAC use, either as water immersion (WI), water exchange (WE), or a combination of WI and WE. Methods: A questionnaire was sent by email to the MDCR authors with an in-depth knowledge of WAC. They responded and also invited colleagues and trainees without in-depth knowledge to respond. Logistic regression analysis was used with the reasons for WAC use treated as the primary outcome. Reports related to WAC post MDCR were identified. Results: Of 100 respondents, > 80% indicated willingness to adopt and modify practice to accommodate WAC. Higher adenoma detection rate (ADR) incentivized WE use. Procedure time slots ≤ 30 and > 30 min significantly predicted WI and WE use, respectively. Co-authors of the MDCR were significantly more likely to perform WAC (odds ratio [OR] = 7.5, P = 0.037). Unfamiliarity with (OR = 0.11, P = 0.02) and absence of good experience (OR = 0.019, P = 0.002) were associated with colonoscopists less likely to perform WAC. Reports related to WAC post MDCR revealed overall and right colon WE outcomes continued to improve. Network meta-analyses showed that WE was superior to Cap and Endocuff. On-demand sedation with WE shortened nursing recovery time. Conclusions: An important predictor of WAC use was experience. Superior outcomes continued to be reported with WE.* Kruskal-Wallis non-parametric test.CO 2 , carbon dioxide; WAC, water-aided colonoscopy; WE, water exchange colonoscopy; WI, water immersion colonoscopy.FW Leung et al.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 94%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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“…On the other hand, CADe works as a second observer and points out polyps that are exposed but not recognized due to human error [ 17 ]. A single-center study clearly demonstrated that even WE missed polyps in the right colon [ 44 ]. In other words, the individual strengths of WE and CADe complement the weakness of one another.…”

Section: Water Exchange and Its Potential Beneficial Effect On Reducing Fpsmentioning

confidence: 99%

Computer-Aided Detection False Positives in Colonoscopy

et al. 2021

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Randomized control trials and meta-analyses comparing colonoscopies with and without computer-aided detection (CADe) assistance showed significant increases in adenoma detection rates (ADRs) with CADe. A major limitation of CADe is its false positives (FPs), ranked 3rd in importance among 59 research questions in a modified Delphi consensus review. The definition of FPs varies. One commonly used definition defines an FP as an activation of the CADe system, irrespective of the number of frames or duration of time, not due to any polypoid or nonpolypoid lesions. Although only 0.07 to 0.2 FPs were observed per colonoscopy, video analysis studies using FPs as the primary outcome showed much higher numbers of 26 to 27 per colonoscopy. Most FPs were of short duration (91% < 0.5 s). A higher number of FPs was also associated with suboptimal bowel preparation. The appearance of FPs can lead to user fatigue. The polypectomy of FPs results in increased procedure time and added use of resources. Re-training the CADe algorithms is one way to reduce FPs but is not practical in the clinical setting during colonoscopy. Water exchange (WE) is an emerging method that the colonoscopist can use to provide salvage cleaning during insertion. We discuss the potential of WE for reducing FPs as well as the augmentation of ADRs through CADe.

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Comparing right colon adenoma detection rate during water exchange and air insufflation: a double-blind randomized controlled trial

et al. 2021

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Comparison of Right Colon Adenoma Miss Rates Between Water Exchange and Carbon Dioxide Insufflation

Abstract: Supplemental Digital Content is available in the text.

Cited by 10 publications

References 35 publications

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Computer-Aided Detection False Positives in Colonoscopy

Comparing right colon adenoma detection rate during water exchange and air insufflation: a double-blind randomized controlled trial

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