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Cecal retroflexion is infrequently performed in routine practice and the retroflexed view is of poor quality
BMC Gastroenterology ( IF 2.5 ) Pub Date : 2021-07-31 , DOI: 10.1186/s12876-021-01877-4
Rajesh N Keswani 1 , Charles J Kahi 2 , Mark Benson 3 , Andrew J Gawron 4 , Tonya R Kaltenbach 5 , Rena H Yadlapati 6 , Dyanna L Gregory 1 , Anna Duloy 7
Affiliation  

As right colon polyps are challenging to detect, a retroflexed view of right colon (RV) may be useful. However, cecal retroflexion (CR) without a RV to the hepatic flexure (HF) is inadequate. We aimed to determine the frequency of CR and quality of the RV in routine practice. This prospective observational study performed at an academic medical center assessed colonoscopy inspection technique of endoscopists who had performed ≥ 100 annual screening colonoscopies. We video recorded ≥ 28 screening/surveillance colonoscopies per endoscopist and randomly evaluated 7 videos per endoscopist. Six gastroenterologists blindly reviewed the videos to determine if CR was performed and HF withdrawal time (cecum to HF time, excluding ileal/polypectomy time). Reviewers assessed 119 colonoscopies performed by 17 endoscopists. The median HF withdrawal time was 3 min and 46 s. CR was performed in 31% of colonoscopies. CR frequency varied between endoscopists with 9 never performing CR and 2 performing CR in all colonoscopies. When performed, nearly half (43%) of RVs did not extend to the HF with median RV duration of 16 s (IQR 9–30 s). Three polyps were identified in the RV (polyp detection rate of 8.1%), all identified prior to a forward view. CR is performed infrequently in routine practice. When CR is performed, the RV is of low quality with a very short inspection duration and insufficient ascending colon examination. Further education is required to educate endoscopists in optimal technique to improve overall colonoscopy quality.

中文翻译:

盲肠后屈在常规实践中很少进行,后屈视图质量差

由于右结肠息肉难以检测,右结肠 (RV) 的后屈视图可能有用。然而,没有 RV 到肝曲 (HF) 的盲肠后屈 (CR) 是不够的。我们旨在确定常规实践中 CR 的频率和 RV 的质量。这项在学术医疗中心进行的前瞻性观察研究评估了每年进行 100 次以上结肠镜筛查的内镜医师的结肠镜检查技术。我们为每位内镜医师记录了≥28 次筛查/监视结肠镜检查,并随机评估每位内镜医师 7 次视频。六名胃肠病学家盲目地查看视频以确定是否进行了 CR 和 HF 停药时间(盲肠到 HF 时间,不包括回肠/息肉切除术时间)。评审员评估了 17 名内窥镜医师进行的 119 次结肠镜检查。HF 戒断时间中位数为 3 分 46 秒。31% 的结肠镜检查进行了 CR。CR 频率因内窥镜医师而异,在所有结肠镜检查中,9 名从未执行 CR,2 名执行 CR。执行时,近一半 (43%) 的 RV 没有扩展到 HF,中位 RV 持续时间为 16 秒(IQR 9-30 秒)。在 RV 中发现了三个息肉(息肉检出率为 8.1%),所有息肉都在前视图之前被识别。CR 在常规实践中很少进行。当进行 CR 时,RV 质量低,检查持续时间很短,升结肠检查不充分。需要进一步教育以教育内窥镜医师使用最佳技术以提高整体结肠镜检查质量。CR 频率因内窥镜医师而异,在所有结肠镜检查中,9 名从未执行 CR,2 名执行 CR。执行时,近一半 (43%) 的 RV 没有扩展到 HF,平均 RV 持续时间为 16 秒(IQR 9-30 秒)。在 RV 中发现了三个息肉(息肉检出率为 8.1%),所有息肉都在前视图之前被识别。CR 在常规实践中很少进行。当进行 CR 时,RV 质量低,检查持续时间很短,升结肠检查不充分。需要进一步教育以教育内窥镜医师使用最佳技术以提高整体结肠镜检查质量。CR 频率因内窥镜医师而异,在所有结肠镜检查中,9 名从未执行 CR,2 名执行 CR。执行时,近一半 (43%) 的 RV 没有扩展到 HF,平均 RV 持续时间为 16 秒(IQR 9-30 秒)。在 RV 中发现了三个息肉(息肉检出率为 8.1%),所有息肉都在前视图之前被识别。CR 在常规实践中很少进行。当进行 CR 时,RV 质量低,检查持续时间很短,升结肠检查不充分。需要进一步教育以教育内窥镜医师使用最佳技术以提高整体结肠镜检查质量。所有在前瞻前确定。CR 在常规实践中很少进行。当进行 CR 时,RV 质量低,检查持续时间很短,升结肠检查不充分。需要进一步教育以教育内窥镜医师使用最佳技术以提高整体结肠镜检查质量。所有在前瞻前确定。CR 在常规实践中很少进行。当进行 CR 时,RV 质量低,检查持续时间很短,升结肠检查不充分。需要进一步教育以教育内窥镜医师使用最佳技术以提高整体结肠镜检查质量。
更新日期:2021-08-01
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