ArticleSurgical endoscopy2021
Success, safety, and usefulness of right colon retroflexion for the detection of additional colonic lesions not visualized with standard frontal view.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Optimizing detection and resection of colorectal polyps.Translational gastroenterology and hepatology · 2026Review
- Unlocking quality in endoscopic mucosal resection.World journal of gastrointestinal endoscopy · 2023Review
- Improving polyp detection at colonoscopy: Non-technological techniques.World journal of gastrointestinal endoscopy · 2023Review
- Second exam of right colon improves adenoma detection rate: Systematic review and meta-analysis of randomized controlled trials.Endoscopy international open · 2022Review
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMissed adenomas are the main concern for endoscopists. Right colon retroflexion (RCR) seems to increase the adenoma detection rate (ADR), but important variation in success and usefulness of this maneuver has been reported in the literature
aimsPrimary objective: to assess additional adenoma detection rate (AADR) detected during the RCR attempt. Secondary objectives: to assess success rates of RCR, variables associated with it, and safety of RCR.
methodsThis is a prospective, unicentric, non-randomized study. Consecutive colonoscopies done by six endoscopists (3 of them with < 3 years of experience and 3 with > 3 years) from March to May 2017 were included. Olympus colonoscopes were used (CF-H190, CF-H180) Demographic, clinical, and endoscopic variables were collected.
results463 colonoscopies were included. RCR success rate was 93.1% (431/463 colonoscopies). Forty additional lesions were visualized during RCR in 34/463 colonoscopies (7.3%). Additional adenomas were detected in 31/463 colonoscopies (6.7%; OR 0.07). HISTOLOGY: low-grade dysplasia adenomas in 29/40 (72.5%) lesions; 3/40 (7.5%), adenomas with high-grade dysplasia; and 7/40 (17.5%) sessile serrated lesions. Additional adenoma detection contributed to modify the colonoscopy surveillance interval in 25 patients (5.4% of the cohort). Variables associated with RCR success in multivariate analysis were no previous abdominal surgery, length of colonoscope insertion in cecum < 80 cm, and use of Olympus 190 series colonoscopes. No differences between endoscopists' experience were found. RCR was a safe maneuver, with no adverse events in our study.
conclusionsRCR is a feasible and safe maneuver that can increase ADR, so its routine inclusion in colonoscopy practice should be considered.
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