Double Right-Sided Colon Examination Effective No Matter How You Do It
Douglas K. Rex, MD, MASGE, reviewing Kamal F, et al. Endosc Int Open 2022 Jul 11.
This study identified 5 randomized controlled trials that addressed the value of a second right-sided colon examination in the forward view versus no second examination. Overall, the right-sided colon adenoma detection rate (ADR) increased from 18% with no second examination in the forward view to 26% with the second examination. Advanced ADR in the right-sided colon increased from 2.5% to 3.7%, but the difference was not significant.
For studies that addressed whether a second examination should be performed in retroflexion versus a second forward-viewing examination, the additional pooled ADR was 8% with the second examination in retroflexion and 11% with a second forward-viewing examination. This difference did not reach significance.
![d-rex](/wp-content/uploads/d-rex.jpg)
COMMENTOne of the most effective maneuvers to increase ADR during colonoscopy is second examination. These data again confirm that there is no significant difference in detection gain between a second examination in the forward view versus retroflexion, and the numbers favor a second examination in the forward view.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Kamal F, Khan MA, Lee-Smith WM, et al. Second exam of right colon improves adenoma detection rate: systematic review and meta-analysis of randomized controlled trials. Endosc Int Open 2022 Jul 11. (Epub ahead of print) (https://doi.org/10.1055/a-1896-4499)