Acuña PR, López JAF, Mondragón VME, Reyes DÁ, Acuña MA, Nuño ÁJE

Language: Spanish
References: 25
Page: 193-198
PDF size: 138.19 Kb.

ABSTRACT

Objective: To analyze the usefulness and safety of the retrograde-viewing maneuver in the cecum and colon performed in a series of 20 patients.
Setting: Third level health care center.
Type of study: Prospective, comparative, cross-sectional, and observational.
Statistical analysis: Percentages.
Patients and method: Twenty patients with indication for colonoscopy. Assessed variables were: feasibility of the maneuver. Complications and comparison of injuries localized with conventional endoscopy and by means of the retrograde-viewing device.
Results: Average age was 53 years (33 to 72 years), 12 women and 8 men. The retrograde viewing maneuver was feasible in 16 of the colonoscopies (80%). The most frequent complication observed was slight erosion of the mucosa due to the friction caused by the tip of the endoscope in the cecum in four patients (20%), which did not need any treatment. There was no perforation or bleeding in any case. The retrograde-viewing maneuver provided an additional endoscopic diagnosis in three patients (15%), being these small polyps and a diverticulum in the cecum.
Conclusions: Retrograde-viewing in the cecum was useful and safe, as it allowed to diagnose 15% more lesions than those observed before performing the maneuver; without presenting complications.

REFERENCES

1. Johnson DA, Gurney MS, Volpe RJ, Jones DM, VanNess MM, Chobanian SJ, et al. A prospective study of the prevalence of colonic neoplasms in asymptomatic patients with an age related risk. Am J Gastroenterol 1990; 85: 969-974.

2. Niv Y, Hazazi R, Levy Z, Frazier G. Screening colonoscopy for colorectal cancer in asymptomatic people: a meta-analysis. Dig Dis Sci 2008; 53: 3049-3054.

3. Greisinger A, Hawley ST, Bettencourt JL, Perz CA, Vernon SW. Primary care patients understanding of colorectal cancer screening. Cancer Detect Prev 2006; 30: 67-74.

4. Jones RM, Devers KJ, Kuzel AJ, Woolf SH. Patient-reported barriers to colorectal cancer screening: a mixed-methods analysis. Am J Prev Med 2010; 38: 508-516.

5. Rex DK, Petrini JL, Baron TH, Chak A, Cohen J, Deal SE, et al. Quality indicators for colonoscopy. Am J Gastroenterol 2006; 101: 873-885.

6. Barclay RL, Vicari JJ, Doughty AS, Johanson JE, Greenlaw. Colonoscopic withdrawal times and adenoma detection rate during screening colonoscopy. N Eng J Med 2006; 355: 2533-2541.

7. Pickhardt PJ, Nugent PA, Myslievic PA, Choi JR, Schindler WR. Location of adenomas missed by optical colonoscopy. Ann Intern Med 2004; 141: 352-359.

8. Rex DK. Maximizing detection of adenomas and cancers during colonoscopy. Am J Gastroenterol 2006; 101: 2866-2877.

9. Bressier B, Paszat LF, Vinden C, Li C, He J, Rabeneck L. Colonoscopic miss rates for right-sided colon cancer: a population based analysis. Gastroenterology 2004; 127: 452-456.

10. Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L. Association of colonoscopic and death from colorectal cancer. Ann Intern Med 2009; 150: 1-8.

11. Wayne JD, Heigh RI, Fleischer DE, Leighton JA, Gurudu S, Aldrich LB, et al. A retrograde-viewing device improves detection of adenomas in the colon: a prospective efficacy evaluation (with videos). Gastrointest Endosc 2010; 71: 55l-556.

12. Triadafilopoulos G, Li J. A pilot study to assess the safety and efficacy of the third eye retrograde auxilliary imaging system during colonoscopy. Endoscopy 2008; 40: 478-482.

13. Barthel JS. Adenoma detection and retroscopy. Gastrointest Endosc 2010: 71: 557-559.

14. De Marco DC, Odstrcil E, Lara LF, Bass DF, Herdman C, Kinney T, et al. Impact of experience with a retrograde-viewing device on adenoma detection rates and withdrawal times during colonoscopy: The Third Eye Retroscope study group. Gastrointest Endosc 2010: 71: 542-550.

15. Triadafilopoulos G, Watts HD, Higgins J, Van Dam J. A novel retrograde-viewing auxilliary imaging device Third Eye Retroscope) improves the detection of simulated polyps in anatomic models of the colon. Gastroinest Endosc 2007; 65: 139-144.

16. Nelson DB, McQuaid KR, Bond JH, Lieberman DA, Weiss DG, Johnston TK. Procedural success and complications of large-scale screening colonoscopy. Gastrointest Endosc 2002; 55: 307-314.

17. Crispin A, Birkner B, Munte A, Nusko G, Mansmann U. Process quality and incidence of acute complications in a series of more than 230,000 colonoscopies. Endoscopy 2009; 41: 1018-1025.

18. Thomas Gibson S, Rogers P, Cooper S, Man R, Rutter MD, Suzuki N, et al. Judgment of the quality of bowel preparation at screening flexible sigmoidoscopy is associated with variability in adenoma detection rates. Endoscopy 2006; 38: 456-460.

19. Rex DK. Colonoscopic withdrawal technique is associated with adenoma miss rates. Gastrointest Endosc 2000; 51: 33-36.

20. Obstein KL, Patil VD, Jayender J, San José Estépar R, Spofford IS, Lengyel BI, et al. Evaluation of colonoscopic technical skill levels by use of an objective kinematic-based system. Gastrointest Endosc 2011; 73: 315-321.

21. Spier BJ, Benson M, Pfau PR, Nelligan G, Lucey MR, Gaumnitz EA. Colonoscopy training in gastroenterology fellowships: determining competence. Gastrointest Endosc 2010; 71: 319-324.

22. Singh H, Singh G. Inequities in colonoscopy: variation in performance and outcomes of colonoscopy. Gastrointest Endosc 2009; 69: 1296-98.

23. Chen LA, Santos S, Jandorf L, Christie J, Castillo A, Winkel G, et al. A program to enchance completion of screening colonoscopy among urban minorities. Clin Gastroenterol Hepatol 2008; 6: 443-450.

24. Chen SC, Rex DK. Endoscopist can be more powerfull than age and gender in predicting adenoma detection at colonoscopy. Am J Gastroenterol 2006; 101: 856-861.

25. Robertson DJ, Greensberg ER, Beach M, Sandler RS, Ahnen D, Haile RW, et al. Colorectal cancer in patients under close colonoscopic surveillance. Gastroenterology 2005; 129: 34-41.