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Efficacy of repeat forward‐view examination of the right‐sided colon during colonoscopy: A prospective randomized controlled trial
Author(s) -
Kim Su Young,
Lee Sang Jin,
Chung JunWon,
Kwon Kwang An,
Kim Kyoung Oh,
Kim Yoon Jae,
Kim Jung Ho,
Park Dong Kyun
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15064
Subject(s) - medicine , colonoscopy , randomized controlled trial , asymptomatic , colorectal cancer , adenoma , prospective cohort study , descending colon , distal colon , gastroenterology , surgery , rectum , cancer
Background and Aim Generally, colonoscopy is less effective for detecting colorectal adenomas in the right‐sided colon compared with the distal colon. Repeat forward‐view (RF) examination of the right‐sided colon has been suggested to increase the adenoma detection rate (ADR). However, studies investigating the efficacy of RF examination are lacking. Thus, the aim of this study was to determine whether RF examination in the right‐sided colon enhances right‐sided ADR. Methods We performed a prospective, randomized controlled trial, including asymptomatic subjects who underwent screening colonoscopy. Subjects were randomized to the RF group, in which the right‐sided colon was examined twice in the forward view, or to the standard forward‐view (SF) group, in which the right‐sided colon was examined once in the forward view. The primary outcome was the right‐sided ADR on RF examination of the right‐sided colon. Results A total of 640 subjects completed the study protocol (RF group, n = 320; SF group, n = 320). The right‐sided ADR in the RF group was significantly higher than that in the SF group (17.5% vs 11.9%, respectively; P = 0.044). In the RF group, an additional 31 adenomas were found, resulting in an increased detection rate of adenomas of 38.3% compared with the first forward view. The ADR of the whole colon was similar between the groups. Conclusions In our prospective randomized controlled trial, RF examination of the right‐sided colon, which can be easily performed in clinical practice, was associated with an increased rate of detection of right‐sided ADR.