Impact of 9-Minute Withdrawal Time on the Adenoma Detection Rate: A Multicenter Randomized Controlled Trial
In: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, Jg. 20 (2020-08-10), Heft 2
Online
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Zugriff:
Although current quality indicators of colonoscopy recommend 6 minutes as the minimum standard for withdrawal time (WT), the impact of a WT longer than 6 minutes on neoplasia detection is unclear.A multicenter randomized controlled trial involving 1027 patients was conducted from January 2018 to July 2019. Participants were randomly divided into a 9-minute (n = 514) and 6-minute (n = 513) WT group, and a timer was used to adjust the withdrawal speed. The primary outcome was the adenoma detection rate (ADR).Intention-to-treat analysis showed a significantly higher ADR in the 9-minute versus 6-minute WT group (36.6% vs. 27.1%, P = .001). Prolonging WT from 6 to 9 minutes significantly increased ADR of the proximal colon (21.4% vs. 11.9%, P.001) as well as of the less experienced colonoscopists (36.8% vs. 23.5%, P = .001). Improvements were also observed in the polyp detection rate (58.0% vs. 47.8%, P.001), and mean number of polyps and adenomas detected per colonoscopy (1.1 vs. 0.9, P = .002; 0.5 vs. 0.4, P = .008, respectively). The higher ADRs in 9-minute WT were also confirmed by the per-protocol (PP) analysis and subgroup analyses, with an increased rate of sessile serrated lesion detection in the 9-minute WT by PP analysis (4.0% vs. 1.3%, P = .04). Multivariate logistic regression demonstrated that the 9-minute WT was independently associated with increased ADR (P = .005).Prolonging WT from 6 to 9 minutes significantly improved ADR, especially in the proximal colon and for less experienced colonoscopists. A 9-minute WT benchmark should be considered as one of the quality indicators of colonoscopy. ClinicalTrials.gov (identifier, NCT03399045).
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Impact of 9-Minute Withdrawal Time on the Adenoma Detection Rate: A Multicenter Randomized Controlled Trial
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Autor/in / Beteiligte Person: | Bai, Yu ; Yan, Caiwen ; Meng, Qianqian ; Gong, Aixia ; Ma, Yingcai ; Zheng, Jinghua ; Wang, Yiping ; Zhao, Sheng-Bing ; Wang, Shaofeng ; Yang, Fan ; Yao, Jun ; Wang, Rundong ; Wang, Shu-Ling ; Tang, Shan ; Zhu, Yangbei ; Zhu, Xian ; Pan, Peng ; Zhao, Xiao-Jun ; Bo, Lumin ; Ma, Rui-Jun ; Yang, Xia ; Li, Zhao-Shen ; Chang, Xin ; Sheng, Jianqiu ; Chen, Weigang ; Wang, Rong ; Xia, Tian ; Wang, Yali ; Shen, Jianwei ; Yang, Youlin |
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Zeitschrift: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, Jg. 20 (2020-08-10), Heft 2 |
Veröffentlichung: | 2020 |
Medientyp: | unknown |
ISSN: | 1542-7714 (print) |
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