Detection of colonic polyps according to insertion/withdrawal phases of colonoscopy

Abstract

Most advanced neoplasia are detected during the insertion. Although withdrawal time has been shown to be important, the scope insertion phase related to polyp detection should be specifically addressed.

Results of screening in Lublin Province, Poland, for colorectal cancer and neoplastic polyps - the role of environmental factors

“…The ratio was somewhat higher than in other studies carried out in Poland -17.3% [12] but it was close to Italian studies [13]. CRC was detected in 1.29% of the examined subjects.…”

The water method significantly enhances proximal diminutive adenoma detection rate in unsedated patients

“…In contrast to recent reports on evaluation of enhancement of ADR in sedated patients by new technologies 16,18,23,34,35 , focus on the withdrawal phase 10,21,22,25,26 and time of day 24 of colonoscopy or timing of bowel preparation 31 and removal of polyps during insertion 36 , we have described possible enhancement of proximal diminutive ADR on withdrawal in unsedated patients by the water method. Previous reports of worldwide availability of unsedated colonoscopy focused discussions on cecal intubation, patient tolerance, absence of sedation side-effects and potential cost savings 37 .…”

Therapeutic and Diagnostic Approaches in Colonoscopy

“…The study also demonstrated that the missed adenoma rates were 2%, 13%, and 26% for polyp sizes of 10 mm <, 5-10 mm, and 1-5 mm respectively [41]. The reasons for missed polyps included the quality of bowel preparation, lesion characteristics (location, number, shape, and size), the endoscopist's experience, and the operator's insertion and withdrawal techniques [41][42][43][44]. Although many clinical studies, including randomized controlled trials (RCTs), have confirmed reduced missed rates in colonoscopy using NBI techniques [45][46][47][48][49][50][51][52], one recent meta-analysis revealed that there was no statistically significant difference in the rates of adenoma detection rate between NBI and WL [53], and a large-scale multicenter Japanese study did not show an improvement with NBI [54].…”