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Surgical Endoscopy

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01-05-2021 | Colectomy

Withdrawal time of 8 minutes is associated with higher adenoma detection rates in surveillance colonoscopy after surgery for colorectal cancer

Authors: Da Hyun Jung, Ja In Lee, Cheal Wung Huh, Min Jae Kim, Young Hoon Youn, Yeong Hyeon Choi, Byung-Wook Kim

Published in: Surgical Endoscopy | Issue 5/2021

Abstract

Background & Aims

Although several studies have been conducted on the relation between withdrawal time (WT) and adenoma detection rate (ADR) in the intact colonKim, little is known about the optimal WT needed to increase ADR in the postoperative colon. We investigated the association between WT and ADR in surveillance colonoscopy after colorectal cancer (CRC) surgery.

Methods

We conducted a retrospective cohort study of CRC patients who underwent 1st surveillance colonoscopy after curative colectomy. We excluded patients with incomplete inspection of colon during preoperative colonoscopy, inadequate bowel preparation, and total colectomy or subtotal colectomy. The colonoscopies were performed by 8 board-certified colonoscopists. The receiver operating characteristic curve of the WT revealed an optimal cutoff value of 7.8 min for adenoma detection. We divided the colonoscopists into fast and slow colonoscopists using the 8-min WT as cutoff, and compared the ADR between the two groups.

Results

We analyzed a total of 1341 patients underwent first surveillance colonoscopy after CRC surgery. Mean WTs by 8 colonoscopists during colonoscopy with and without polypectomy were 18.9 ± 13.7 and 8.1 ± 5.6 min, respectively. ADR varied from 29.3 to 50.6% by individual colonoscopists. Slow colonoscopists showed significantly higher ADR than fast colonoscopists (49.1% vs 32.2%, P < 0.001). The mean WT during colonoscopy without polypectomy for each colonoscopist and the detection rate of all neoplasia were positively correlated (Rs = 0.874, P = 0.005).

Conclusion

Because patients who underwent colorectal surgery possess high risk of metachronous CRC and adenoma, sufficient WT (8–10 min) is mandatory, despite short length colon due to surgery.

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Title: Withdrawal time of 8 minutes is associated with higher adenoma detection rates in surveillance colonoscopy after surgery for colorectal cancer
Authors: Da Hyun Jung
Ja In Lee
Cheal Wung Huh
Min Jae Kim
Young Hoon Youn
Yeong Hyeon Choi
Byung-Wook Kim
Publication date: 01-05-2021
Publisher: Springer US
Keywords: Colectomy
Colectomy
Colonoscopy
Colorectal Cancer
Colorectal Cancer
Published in: Surgical Endoscopy / Issue 5/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07653-x

At a glance: The STEP trials

Springer Medicine

Withdrawal time of 8 minutes is associated with higher adenoma detection rates in surveillance colonoscopy after surgery for colorectal cancer

Abstract

Background & Aims

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background & Aims

Methods

Results

Conclusion

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