Right-sided Retroflexion With Standard Adult Versus Pediatric Colonoscopes

Medical College of Wisconsin

Overview

Screening colonoscopy has been shown to be less effective in preventing colorectal cancer in the proximal colon compared to the distal colon. Possible reasons for this include bowel preparation often being worse in the proximal colon as well as flat depressed lesions being more common in the proximal colon. Retroflexion is commonly regarded as standard practice in the rectum, but retroflexion in the proximal colon is not currently routinely performed due to concerns of perforation and possibly because of the increased time required. Proximal colon retroflexion has been shown to be safe and effective without any complications, but data regarding ability to retroflex with certain types of colonoscopes is limited. Endoscopists interchangeably use standard adult colonoscopes or pediatric colonoscopes. Studies have not been performed to comparatively evaluate the success rates of standard adult and pediatric colonoscopes and whether either type of instrument confers a greater polyp detection rate.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Conditions

Colonic Neoplasms

Interventions

Retroflexion with the adult colonoscope.PROCEDURE

Retroflexion with the pediatric colonoscope.PROCEDURE

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients over the age 18 undergoing screening or surveillance colonoscopy Exclusion Criteria: * Age less than 18 * Pregnant * History of ulcerative colitis or Crohn's disease * History of polyposis syndromes * History of colon resection * Colonoscopy being performed for diagnostic purposes (ie. bleeding, abdominal pain, alternating bowel habits)

Locations (1)

Froedtert Surgery Center

Milwaukee, Wisconsin, United States

Outcomes

Primary Outcomes

Percentage of cases in which right-sided retroflexion is successful with the adult and pediatric colonoscopes.

Time frame: After 50% and 100% of patient enrollment is complete.

Secondary Outcomes

Adenoma detection rate in forward and retroflexed views.

Time frame: After 50% and 100% of patient enrollment is complete.

Reasons for failure of retroflexion.

This will be assessed as a yes/no variable. In addition, the specific reasons that the endoscopist could not retroflex the colonoscope in the right colon will assessed, such as the colonoscope not being able to be advanced to the cecum, small diameter of the right colon, too much resistance encountered when attempting retroflexion that the endoscopist does not feel comfortable with, etc.

Time frame: After 50% and 100% of patient enrollment is complete.

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.