| BackgroundsColorectal cancer(CRC)is one of the most common malignancies,including colon and rectal cancer.The CRC incidence varies greatly in the world,and the incidence is high in western countries.However,with the development of economic and the changes in national dietary habits in recent years,the CRC incidence and mortality have also increased in China.Colonoscopy is efficient for both diagnosis and screening of CRC which can reduce the colorectal cancer-related deaths by detecting and removing adenomas.Colorectal adenomas belong to neoplastic polyps,which are the main precancerous lesions of CRC.Although the removal of colorectal adenomas through colonoscopy can prevent the occurrence of CRC,there is still a significant number of adenomas missed due to the existence of colon folds,intestinal bendings and other factors.The polyps and adenomas are relatively flat in the right colonic compared with the left and less histopathological recognition in the past years,resulting in a higher miss rate.In order to improve the detection of colorectal polypsand adenomas,new techniques for increasing endoscopic visibility during colonoscopy are constantly evolving,which include the improvement of endoscopic vision,flattening the intestinal mucosa,and increasing endoscopic magnification.Colonoscopy retroflexion and second forward view examination are two methods.Therefore,the technique of improving the polyps and adenomas detection of right colon through colonoscopy has become a research hotspot.ObjectiveTo investigate the value of retroflexion view and second forward view on screening of the right-sided colon adenomas duing colonoscopy.Methods1080 patients were divided into retroflexion view(RV)group(n=552)and second forward view(FV)group(n=528)randomly.Colonoscopy were inserted to ileocecal region in both groups and performed routine forward view firstly and withdrawl to the hepatic flexure.Record the number of discovered polyps and send for histopathology which were conducted a biopsy.Then retroflexion view in RV group and second forward view in FV group were performed during the right colon to the hepatic flexure,record the number of discovered polyps and send for histopathology which were conducted a biopsy again.Calculate colonoscopy retroflexion success rate and the difficulty level of retroflexion in the right colon.Compare the differences in polyp and adenoma detection rates,improvement detection rates after retroflexion/ second forward view,the overall detection rates between two groups.And compare the influence of adenoma sizes on the right colon adnomas detection..ResultsThe colonoscopy retroflexion success rate was 94.02%.The retroflexionoperation was easy in 479 patients accounting for 92.29%,hard in 40 patients accounting for 7.71%.hemorrhage and perforation through colonoscopy.There was no statistically significant difference in the difficulty level of second withdrawal between the RV and FV groups(P> 0.05).The polyp and adenoma detection rate were 11.37% and 3.28%,improvement detection rate were 4.82% and 3.08%,the overall detection rate were 16.18% and 6.35% in RV group.Which were 10.28%,2.84%,4.17%,2.65%,14.39%,5.49% respectively in FV group.There were no statistically significant differences in the above-mentioned indexes between two groups(P>0.05).The overall polyp and adenoma detection rate exceeded the routine forward view in both groups(P < 0.05).There were no statistically significant differences between the routine forward view and the second withdrawal(retroflexion view/second forward view)in adenoma sizes in the two groups(P > 0.05).There were no statistically significant differences between retroflexion view and second forward view in adenoma sizes in the two groups(P>0.05).ConclusionRetroflexion can be performed safely in the right colon.It can improve the right-sided colon adenoma detection rate during colonoscopy,as well as the second forward view.Meanwhile,they are not affected by adenoma sizes. |
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