Colonoscopic withdrawal time and adenoma detection in the right colon

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Abstract

Shorter colonoscopic withdrawal time (CWT) has been associated with lower adenoma detection rate (ADR), which can increase the risk of interval colorectal cancer (ICC) that commonly arises in the right colon (RC). Therefore, a better ADR in the RC could decrease the incidence of ICC. We analyzed the relationship between CWT and ADR in the RC and entire colon.

We retrospectively reviewed the patients who had undergone screening colonoscopy at Chungnam National University Hospital between March 2015 and February 2016. We enrolled 5370 patients in whom colonoscopies were performed by 7 gastroenterologists. We categorized patients into 4 groups in the RC and 6 groups in the entire colon by CWT. Multivariable analysis was used for detection of adenoma in the RC and entire colon.

In the RC, the odds ratio (OR) of CWT longer than 3 minutes was 3.70, compared to CWT of <2 minutes [3.06–4.85, 95% confidence interval (CI), P < .001]. In the entire colon, the OR of CWT between 9 to 10 minutes and longer than 10 minutes was 3.34 [2.61–4.27, 95% CI, P < .001] and 3.49 [2.80–4.33, 95% CI, P < .001] compared to CWT of <6 minutes.

Based on our result, we suggest that the optimum CWT in the RC should exceed 3 minutes, and considering the “ceiling effect,” the optimum CWT in the entire colon should exceed 9 minutes.

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