Detection of colonic polyps according to insertion/withdrawal phases of colonoscopy.
OBJECTIVE
Issues on colonoscopy quality are crucial to reduce the advanced neoplasia miss rate of colonoscopy. Recently, a >6-min withdrawal time has been recommended. However, the relative prevalence of polyp detected during insertion and withdrawal phases of colonoscopy is unknown. Therefore, we designed this prospective, endoscopic study.


METHODS
Three hundred and sixty-eight patients with 396 adenomas were selected from a consecutive colonoscopic series of 1,205 cases. Detection rates of adenomas, advanced adenomas, and cancer according to withdrawal and insertion phases of colonoscopy, also subgrouping polyps for size and location, were compared.


RESULTS
Thirty-two (74%) advanced adenomas and 21 (95%) cancers were detected during the insertion, being only 11 (26%) and one (5%) identified during withdrawal, respectively. This was mainly due to a higher detection of >10 mm polyps during insertion than during withdrawal (75% versus 25%).


CONCLUSIONS
Most advanced neoplasia are detected during the insertion. Although withdrawal time has been shown to be important, the scope insertion phase related to polyp detection should be specifically addressed.
Morini
Sergio
S
Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy. sergio.morini@gmail.com
Hassan
Cesare
C
Zullo
Angelo
A
Lorenzetti
Roberto
R
de Matthaeis
Marina
M
Stella
Francesca
F
Campo
Salvatore M A
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D006801:Humans; D008875:Middle Aged