Polyp detection at colonoscopy

Endoscopist and technical factors

Douglas Rex

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The adenoma detection rate (ADR) has emerged as the most important quality measure in colonoscopy, as it predicts the risk of interval cancer after colonoscopy. Measuring and improving ADR is the central focus of the current quality movement in colonoscopy. High ADRs can be achieved by a colonoscopist with a thorough understanding of the wide range of endoscopic appearances of precancerous lesions in the colorectum, effective bowel preparation, and meticulous technique using high definition colonoscopes. The knowledgeable and effective examiner needs no adjunctive devices or techniques to achieve master level ADRs. However, measurement reveals that many colonoscopists have ADRs that are below recommended minimum thresholds or below master levels. These colonoscopists, and even master level performers, can choose from a variety of adjunctive tools to improve ADR. This review describes these tools according to whether they are non-device methods (e.g. double right colon examination, patient position change, water exchange), mucosal exposure devices (wide angle colonoscopy, fold flattening devices), and lesion highlighting techniques (e.g. chromoendoscopy, electronic chromoendoscopy).

Original languageEnglish (US)
JournalBest Practice and Research: Clinical Gastroenterology
DOIs
StateAccepted/In press - 2017

Fingerprint

Colonoscopy
Polyps
Adenoma
Equipment and Supplies
Colonoscopes
Colon
Water
Neoplasms

Keywords

  • Adenoma detection rate
  • Colon polyps
  • Colonoscopy
  • Colorectal cancer
  • Quality

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Polyp detection at colonoscopy : Endoscopist and technical factors. / Rex, Douglas.

In: Best Practice and Research: Clinical Gastroenterology, 2017.

Research output: Contribution to journalArticle

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