Nimy John, MD, Anand Curuchi, MD. St.Vincent Hospital, Worcester,MA
Objectives: Retroflexion in the rectum at the end of a colonoscopy is a requirement for a complete endoscopic evaluation. Retroflexion helps to visualize and detect polyps which would be missed otherwise. Currently new endoscopes are available which can do retroflexion in the caecum.
Aim: Our study aims to compare the rate of polyp detection rate in Cecum and Ascending colon with and without retroflexion in cecum.
Methods: This is a single center, single operator, retrospective study. A total of two hundred patients were involved. A single center IRB waiver was obtained. Patients were divided into two groups based on the presence /absence of retroflexion in caecum during their colonoscopy. The data was obtained from 2017 records.
Group A (n = 100) had colonoscopy without retroflexion in caecum
Group B (n = 100) had colonoscopy with retroflexion in caecum
Inclusion criteria: Patients undergoing screening colonoscopy between the age of 40 and 85.
Results: Group A: Total of 100 patients were screened. A total of 95 polyps were detected in group A. Number of cecal polyps were 4 (4.2% of total polyp count). Number of ascending colon polyp were 18 (19% of total polyp). On analyzing the pathology 60% of the cecal polyps were tubular adenoma, 20% hyperplastic polyps 20% and 20% lymphoid aggregate. Number of ascending colon polyps were 18, of which 72% were tubular adenoma, 22% tubular adenoma and 6 % tubulovillous adenoma
Group B: Total of 100 patients were screened. A total of 80 polyps were detected. Number of cecal polyps detected were 5 (6.2% of total polyp count). Number of ascending of ascending colon polyps were 11 (13%). On analyzing pathology, 80% cecal polyps were tubular adenoma and 20% were sessile serrated. Out of the ascending colon polyps 27% were tubular adenoma, 27% sessile serrated,27% tubulovillous and 18 % hyperplastic polyp.
Side Events: Two mass lesions were noted in both group A and B. There was incomplete colonoscopy in group A and B.
Conclusion: This retrospective analysis reveals a small increase in polyp detection in the cecum with retroflexion, especially in detecting sessile polyps which have more malignant potential. However, a large multicenter analysis will be required to validate the above observation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88231
Program Number: P215
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster