A new study from researchers in Indiana reports that use of a retroflexion technique in the right side of the colon during colonoscopy is safe and results in the detection of additional adenomatous polyps in approximately four percent of patients. The results of study have been published in Gastrointestinal Endoscopy, the journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Cancer of the colon or rectum is also called colorectal cancer. In the United States, it is the fourth most common cancer in men and women. Caught early, it is often curable. It is more common in people over 50, and the risk increases with age. Symptoms can include blood in the stool, narrower stools, a change in bowel habits and general stomach discomfort. However, you may not have symptoms at first, so screening is important. Everyone who is 50 or older should be screened for colorectal cancer. Colonoscopy is one method that your doctor can use to screen for colorectal cancer (presented in the movies).

Several recent studies have shown that colonoscopy is less effective in preventing colorectal cancer in the proximal colon (right side of colon) compared with the distal colon (left side of colon). Several possible explanations for this difference include relatively poor bowel preparation and a higher prevalence of lesions, that have a subtle endoscopic appearance, including serrated lesions and flat or depressed lesions. Special measures can provide the effectiveness of colonoscopy in the proximal colon. Retroflexion technique during colonoscopy is commonly used to improve detection of polyps in the distal rectum (part of left colon). Retroflexion describes a technique where the colonoscope bends backwards to examine colon.

This study is the first assessment of using retroflexion technique in the proximal colon for the purpose of neoplasia detection. The team found that proximal colon retroflexion is safe and achievable in 95% of patients. It resulted in the detection of additional adenomatous polyps in approximately 4% of patients. Additionally, polyps detected by retroflexion were associated with older age, male sex, and the detection of polyps in the forward view during colonoscopy. Furthermore, of those with no polyp detected in the forward view 2,2% had and adematous polyp detected on retroflexion.

A total of 1000 patients underwent colonoscopy during 8-month period. Retroflexion was successful in 94,4% of patients. Colonoscopy in the forward view identified 634 proximal colon polyps and 497 adenomatous polyps. Retroflexion detected an additional 68 polyps and 54 adenomatous polyps.

The reasearchers noted limitations of the study, which included that it was an uncontrolled, single center study with only two endoscopists. Rather, the study is a description of the success rate, yield and safety of right colon retroflexion. The researchers stated that additional study by other examiners and in higher-risk populations may help determine whether right-sided colon anatomy is such that retroflexion occasionally identifies large lesions that are invisible on forward viewing. They also noted that this technique may, at least in the short time, have the potential for greater population-wide public health impact than more technologically complex advances.

Author: Piotr Łażewski-Banaszak

Source:
1. http://www.asge.org/
2. http://www.medicalnewstoday.com/releases/232342.php

More information: http://cancerhelp.cancerresearchuk.org/type/bowel-cancer/, http://www.nlm.nih.gov/medlineplus/colorectalcancer.html,http://www.cdc.gov/cancer/colorectal/


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“Colonoscopy – 3D Medical Animation”