Targeting Withdrawal Time to 6 Minutes can Increase Polyp Detection During Colonoscopy

Abstract 

Objective

To investigate whether increasing the withdrawal time of the endoscope to 6 minutes during colonoscopy can improve the polyp detection rate by an individual endoscopist.

Materials and Methods

We reviewed the procedural data from routine colonoscopies performed in the physical examination department at Buddhist Dalin Tzu Chi General Hospital by a single endoscopist. Two-hundred and sixty-six consecutive patients who underwent colonoscopy from July to December 2006 constituted the “before” group (group 1). A second group of 266 consecutive patients who underwent colonoscopies from July through December 2007 served as the “after” group (group 2). In group 2, the endoscopist attempted to prolong withdrawal of the colonoscope to 6 minutes. The rate of polyp detection was then compared between the two groups.

Results

The withdrawal time was 4.2±1.1 minutes in group 1 and 5.7±1.6 minutes in group 2, respectively (p<0.001). More patients in group 2 had at least one polyp than those in group 1 (55.4% vs. 42.4%, respectively; p = 0.004). More patients in group 2 also had at least one adenoma than patients in group 1 (33.9% vs. 23.7%, respectively; p=0.010). In addition, more adenomas were detected in group 2 than in group 1 (126 vs. 85, respectively; p = 0.038).

Conclusion

Using proper inspection techniques, increasing the amount of time spent using the colonoscope could significantly increase detection rates of polyps and adenomas.

Keywords:  Adenoma , Colonic polyps , Colonoscope , Colonoscopy

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