Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Polyp detection increases with longer colonoscopy withdrawal time

Serrated and adenomatous polyp detection increases with longer withdrawal time, reports this month's American Journal of Gastroenterology.

News image

Detection and removal of adenomas and clinically significant serrated polyps (CSSPs) is critical to the effectiveness of colonoscopy in preventing colorectal cancer.

Although longer withdrawal time has been found to increase polyp detection, this association and the use of withdrawal time as a quality indicator remains controversial.

Few studies have reported on withdrawal time and serrated polyp detection.

Using data from the New Hampshire Colonoscopy Registry, Dr Lynn Butterly and colleagues from New Hampshire, USA examined how an endoscopist's withdrawal time in normal colonoscopies affects adenoma and serrated polyp detection.

The researchers analyzed 7,996 colonoscopies performed in 7,972 patients between 2009 and 2011 by 42 endoscopists at 14 hospitals, ambulatory surgery centers, and community practices.

Adenomas were detected in 4% with a minimum withdrawal time of 9 minutes
American Journal of Gastroenterology

CSSPs were defined as sessile serrated polyps and hyperplastic polyps proximal to the sigmoid.

The research team calculated adenoma and CSSP detection rates on median endoscopist withdrawal time in normal exams.

Regression models were used to estimate the association of increased normal withdrawal time and polyp, adenoma, and CSSP detection.

The team found that polyp and adenoma detection rates were highest among endoscopists with 9 min median normal withdrawal time, and detection of CSSPs reached its highest levels at 8–9 min.

The researchers found that incident rate ratios for adenoma and CSSP detection increased with each minute of normal withdrawal time above 6 min, with maximum benefit at 9 min for adenomas, and CSSPs.

When the team used modeling to set the minimum withdrawal time at 9 min, adenomas and CSSPs were detected in 4%, and 2% more patients.

The increase in detection was most striking for the CSSPs, with nearly a 30% relative increase.

Dr Butterly's team concludes, "A withdrawal time of 9 min resulted in a statistically significant increase in adenoma, and serrated polyp detection."

"Colonoscopy quality may improve with a median normal withdrawal time benchmark of 9 min.

Am J Gastroenterol 2014; 109:417–426
18 March 2014

Go to top of page Email this page Email this page to a colleague

 02 August 2015

Advanced search
 31 July 2015 
Reducing surgical site infection after stoma reversal
 31 July 2015 
Risk of hepatocellular carcinoma in chronic HCV with diabetes
 31 July 2015 
Prognostic index for hep C-related cirrhosis
 30 July 2015 
Post-colonoscopy colorectal cancer rates
 30 July 2015 
Venous thromboembolism in colorectal surgery
 30 July 2015 
Saccharomyces boulardii for antibiotic-associated diarrhea
 29 July 2015 
Sitafloxacin-based triple therapy for H.pylori
 28 July 2015 
Lifestyle changes after colorectal cancer screening
 27 July 2015 
Fecal microbiota transplantation for severe C. difficile infection
 24 July 2015 
Causes of death in celiac disease
 23 July 2015 
Reduction in H. pylori prevalence
 22 July 2015 
Detection of esophageal eosinophilia and eosinophilic esophagitis
 21 July 2015 

Clinical outcomes for Barrett's esophagus neoplasia

 20 July 2015 
Certolizumab pegol for Crohn's disease
 17 July 2015 

Sexual dysfunction after rectal cancer treatment

 17 July 2015 
Genetic variation and gastric cancer
 17 July 2015 
Colitis associated with anti-CTLA-4 therapy
 16 July 2015 
Lynch syndrome screening by microsatellite instability
 16 July 2015 
Relapse of IBD after discontinuation of anti-TNF therapy
 16 July 2015 
Hormones and endometrial cancer in Lynch syndrome
 15 July 2015 
Aspergillus niger-derived enzymes
 15 July 2015 
Prophylactic omeprazole improves GI symptoms
 15 July 2015 
Risk prediction index for advanced colorectal cancer
 14 July 2015 
Combination therapies for chronic HCV
 14 July 2015 
Interferon- and ribavirin-free treatment regimen for HCV
 14 July 2015 
Cancer surveillance in ulcerative colitis
 13 July 2015 
Colon polyps in chronic inflammatory conditions of the colon
 13 July 2015 
Drugs and occult vs overt upper GI bleeds
 13 July 2015 
Anxiety and depression in functional GI disorders
 10 July 2015 
Daclatasvir in the treatment of chronic HCV
 10 July 2015 
Surveillance intervals to reduce colorectal cancer
 10 July 2015 
Stress and GI symptoms in IBD
 09 July 2015 
Opioid-induced esophageal dysfunction
 09 July 2015 
Predictive factors for metastasis in colorectal cancer
 09 July 2015 
Marker of response to medical therapy in Crohn's
 08 July 2015 

Nucleoside analogue therapy in HBeAg-negative chronic hepatitis B?

 08 July 2015 

Medical education in endoscopy training

 08 July 2015 
Chronic unexplained nausea and vomiting
 07 July 2015 
Anastomotic leak after elective surgery for colonic cancer
 07 July 2015 
Fecal transplantation for ulcerative colitis
 07 July 2015 
Obesity and risk of hepatocellular carcinoma
 06 July 2015 
Fecal microbiota transplantation
 06 July 2015 
Liver Failure–Sequential Organ Failure Scoring System
 06 July 2015 
Future colorectal surgery for metachronous cancers
 03 July 2015 
Tumors with mismatch-repair deficiency
 03 July 2015 
Aptitude of trainees in endoscopic ultrasonography
 03 July 2015 
Extracolonic pathologies in colorectal cancer
 02 July 2015 
Ulcerative colitis prognosis after thiopurines withdrawal
 02 July 2015 
Anastomotic leak and cancer cancer
 02 July 2015 
Health care use by IBD children
 01 July 2015 
Missed gastric cancers
 01 July 2015 
Oral mechanical bowel preparation
 01 July 2015 
Probiotics in IBD
 30 June 2015 
Split-dose preparations vs day-before bowel cleansing regimens
 30 June 2015 
Glucocorticoids and peptic ulcer bleeding
 30 June 2015 
NSAIDs and hearburn symptoms
 29 June 2015 
Prevention of pancreatitis after ERCP
 29 June 2015 
Advances in autoimmune pancreatitis
 29 June 2015 
Rescue therapy in ulcerative colitis
 26 June 2015 
Dietary fibre–microbiota interactions

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us