Difference in Adenoma Detection Rates according to Colonoscopic Withdrawal Times and the Level of Expertise

Kim, Young Doo; Bae, Woo Kyung; Choi, Yun Ho; Jwa, Yoon Jung; Jung, Sang Kyung; Lee, Bu Hyun; Paik, Woo Hyun; Kim, Jong Wook; Kim, Nam Hoon; Kim, Kyung-Ah; Lee, June Sung

doi:10.4166/kjg.2014.64.5.278

Cited by 9 publications

(3 citation statements)

References 23 publications

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“…3 A previous study showed that, despite a shorter inspection time, the ADR of experienced endoscopists was higher than that of beginners. 9 The main result of this study differs from that of recent studies showing comparable ADRs between the Endocuff and conventional cap. 5,6 The authors of this study did not determine why the Endocuff provided a superior ADR compared with the conventional cap in their study, the difference could be related to differing mechanisms between the conventional cap and the Endocuff.…”

contrasting

confidence: 97%

Accessories to Enhance Adenoma Detection Rates: Is the Endocuff Better than the Conventional Cap for Trainees?

Gweon

Kang

2020

Clin Endosc

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Colonoscopy can prevent colorectal cancer (CRC) by detecting and removing precancerous lesions including colorectal adenomas. 1 The adenoma detection rate (ADR), defined as the percentage of subjects with at least one adenoma detected during colonoscopy, is the most important quality indicator for colonoscopy as the ADR is inversely associated with the rate of post-colonoscopy CRC. 2 An inspection time of at least 6 minutes and adequate bowel cleansing are associated with higher ADR. 3 Devices such as a conventional cap, Endocuff, and Endoring, which are distally attached to the colonoscope, were developed to enhance the ADR. 4 Distal attachment devices can flatten colon folds, thereby enhancing the visualization of concealed areas. Clinical trials using the conventional cap produced mixed results and could not demonstrate a beneficial effect on ADR. The Endocuff (Arc Medical Design Ltd., Leeds, England) is a novel distal attachment device comprising several soft, flexible plastic arms. A meta-analysis demonstrated an increased ADR for the Endocuff compared to that of standard colonoscopy; i.e., colonoscopy without any distal attachment device. 4 Several studies comparing ADR between

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contrasting

confidence: 97%

Accessories to Enhance Adenoma Detection Rates: Is the Endocuff Better than the Conventional Cap for Trainees?

Gweon

Kang

2020

Clin Endosc

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“…For de Jonge et al., we could not extract the required data and were not able to verify the data as reported in the previous meta‐analysis 38 . Also, we considered the article by Kim 39 ineligible for inclusion, since the comparison in Kim's study did not elaborate whether the fellow performed colonoscopy alone or under supervision of attending physician/experts.…”

Section: Discussionmentioning

confidence: 99%

You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy

Sun,

Chen,

et al. 2023

J Evidence Based Medicine

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BackgroundParticipation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes.MethodsThis meta‐analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random‐effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias.ResultsSeventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR = 1.26, 95% CI = 1.14–1.40, p < 0.001; OR = 1.29, 95% CI = 1.02–1.63, p = 0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD = 0.12, 95% CI = 0.08–0.17, p < 0.001; MD = 0.15, 95% CI = 0.02–0.28, p = 0.020, respectively).ConclusionIn addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.

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“…However, it is invasive, reduces patient compliance, and has the potential for complications, such as bleeding and perforation. Colonoscopy being costlier than other screening tools and its variable adenoma detection rate, which depends on the skill of the operator, are also concerns when considering this technique as a primary screening tool [52]. At the time of the 2015 revision of the Korean CRC screening recommendations, whether colonoscopy should be adopted as a primary screening test tool was greatly debated.…”

Section: Screening Testsmentioning

confidence: 99%

Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version

Jung

Kim

2022

J Anus Rectum Colon

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Colorectal cancer (CRC) is the fourth most common malignancy in Korea and has been ranked as the third leading cause of cancer deaths in 2020. Although the incidence and mortality rates of CRC have decreased in recent years in Korea, it is still a significant public health burden. From the early 1990s until the mid-2000s, the 5-year relative survival of patients with CRC in Korea continuously increased. This finding appears to be a consequence of the successful introduction of a government-led screening program; the development of improved surgical techniques, anticancer drugs, and adjuvant treatment; and the advancement of medical resources and infrastructure along with economic growth. However, the improvement in survival has stagnated since the late 2000s. The recent coronavirus disease 2019 outbreak led to a reduction in hospital visits and screenings, which is expected to cause a stage shift to advanced disease stages and a worse prognosis for patients with CRC. Exploring modifiable environmental risk factors and appropriate screening test methods in Korea is necessary to overcome these challenges. Primary prevention through risk factor mediation and secondary prevention using suitable screening programs can help reduce the incidence and mortality rates of CRC.

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Difference in Adenoma Detection Rates according to Colonoscopic Withdrawal Times and the Level of Expertise

Abstract: ADRs were significantly lower when colonoscopy was performed by trainees, although withdrawal times were longer than those of staff. Our results demonstrated that the quality of colonoscopy, as measured by ADRs, may be improved by experienced examiners.

Cited by 9 publications

References 23 publications

Accessories to Enhance Adenoma Detection Rates: Is the Endocuff Better than the Conventional Cap for Trainees?

Accessories to Enhance Adenoma Detection Rates: Is the Endocuff Better than the Conventional Cap for Trainees?

You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy

Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version

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