Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society | 2021
Retroflexed view for the re-examination of the right colon after forward view examination: a systematic review and meta-analysis.
Abstract
BACKGROUND\nThe effect of retroflexed view (RV) for the re-examination of the right colon after forward view (FV) examination has not been fully understood.\n\n\nMETHODS\nWe searched multiple databases including PubMed, Embase, and the Cochrane Library for prospective studies exploring the role of RV for re-examination of the right colon. A meta-analysis was performed on outcomes including lesion detection rates, lesion miss rates and withdrawal time.\n\n\nRESULTS\nFour randomized controlled trials aimed to compare the impact of the second withdrawal from the right colon in RV versus FV following a standard colonoscopy. Both the additional adenoma detection rate (AADR) and additional polyp detection rate (APDR) of the right colon were lower in the RV group compared with the FV group (RR 0.73 for AADR; RR 0.76 for APDR); similar results were noted in comparisons of the adenoma miss rate and polyp miss rate. Six prospective cohort studies aimed to describe the effect of RV examination of the right colon after one or two times of FV examination. Both the adenoma detection rate (ADR) and polyp detection rate (PDR) of the right colon were slightly higher in combined examinations with RV examination than single FV examination (RR 1.11 for ADR; RR 1.16 for PDR) or two FV examinations (RR 1.21 for ADR; RR 1.22 for PDR).\n\n\nCONCLUSIONS\nFV may detect more adenomas and polyps than RV during the second withdrawal from the right colon. RV may detect additional adenomas and polyps in the right colon after two FV examinations.