Rath T, Pfeifer L, Neufert C, Kremer A, Leppkes M, Hoffman A, Neurath MF, Zopf S. Retrograde inspection vs standard forward view for the detection of colorectal adenomas during colonoscopy: A back-to-back randomized clinical trial. World J Gastroenterol 2020; 26(16): 1962-1970 [PMID: 32390706 DOI: 10.3748/wjg.v26.i16.1962]
Corresponding Author of This Article
Timo Rath, MD, PhD, Full Professor, Department of Internal Medicine 1, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Friedrich-Alexander-University, Erlangen Nuernberg, Ulmenweg 18, Erlangen 91054, Germany. timo.rath@uk-erlangen.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Clinical Trial
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Rath T, Pfeifer L, Neufert C, Kremer A, Leppkes M, Hoffman A, Neurath MF, Zopf S. Retrograde inspection vs standard forward view for the detection of colorectal adenomas during colonoscopy: A back-to-back randomized clinical trial. World J Gastroenterol 2020; 26(16): 1962-1970 [PMID: 32390706 DOI: 10.3748/wjg.v26.i16.1962]
World J Gastroenterol. Apr 28, 2020; 26(16): 1962-1970 Published online Apr 28, 2020. doi: 10.3748/wjg.v26.i16.1962
Retrograde inspection vs standard forward view for the detection of colorectal adenomas during colonoscopy: A back-to-back randomized clinical trial
Timo Rath, Lukas Pfeifer, Clemens Neufert, Andreas Kremer, Moritz Leppkes, Arthur Hoffman, Markus F Neurath, Steffen Zopf
Timo Rath, Lukas Pfeifer, Clemens Neufert, Andreas Kremer, Moritz Leppkes, Markus F Neurath, Department of Internal Medicine 1, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Friedrich-Alexander-University, Erlangen Nuernberg, Erlangen 91054, Germany
Arthur Hoffman, Department of Internal Medicine, Division of Gastroenterology, Klinikum Aschaffenburg, Aschaffenburg 63739, Germany
Steffen Zopf, Department of Internal Medicine, Division of Gastroenterology, Klinikum Fürth, Fürth 90766, Germany
Author contributions: Rath T, Zopf S and Neurath MF were responsible for the study conception and design, data analysis; Hoffman A was involved in data interpretation and manuscript drafting; Rath T, Pfeifer L, Leppkes M, Neufert C, Zopf A, and Kremer A were involved in patient recruitment and performing of the colonoscopies; all authors reviewed and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Friedrich-Alexander University Erlangen.
Clinical trial registration statement: The study was registered at ClinicalTrials.gov under the following ID: NCT04107376.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no potential conflicting interests related to this paper.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Corresponding author: Timo Rath, MD, PhD, Full Professor, Department of Internal Medicine 1, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Friedrich-Alexander-University, Erlangen Nuernberg, Ulmenweg 18, Erlangen 91054, Germany. timo.rath@uk-erlangen.de
Received: February 3, 2020 Peer-review started: February 3, 2020 First decision: February 27, 2020 Revised: March 26, 2020 Accepted: April 17, 2020 Article in press: April 17, 2020 Published online: April 28, 2020 Processing time: 84 Days and 17.8 Hours
Core Tip
Core Tip: This is the first study to systematically assess the effect of an additional retrograde inspection of the whole colon on adenoma detection rate compared to a second inspection in standard forward view. Our results show that both, additional inspection of the entire colon in retroflexion as well as in forward view leads to an increased adenoma detection rate with no differences between retrograde and forward inspection. Further, the majority of adenomas additionally found during second inspection in retroflexion or in forward view were located in the transverse and left-sided colon and were > 5 mm in size. These results clearly suggest that increased adenoma detection is most likely a feature of the second inspection itself but not of the inspection mode.
