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Rectal retroflexion - An essential part of lower gastrointestinal endoscopic examination

Lookup NU author(s): Dr Jonathan Hanson, Clive Griffith, Jagnohan Varma, Dr Stefan Plusa


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PURPOSE: Retroflexion of the endoscope during rectal examination may increase diagnostic yield but is not routinely performed because of concerns about safety and a lack of appreciation of its importance. The purpose of this study was to examine the yield, safety, and tolerance of endoscopic rectal retroflexion. METHODS: Prospective cohorts of subjects undergoing unsedated screening flexible sigmoidoscopy were examined with and without routine retroflexion. Pain scores were recorded. RESULTS: A total of 526 subjects (mean age 60 (range, 55-66) years) underwent flexible sigmoidoscopy in the first period when the endoscope was not routinely retroflexed. Of these, 480 (mean age 60 (range, 55-66) years) were subsequently examined with routine retroflexion. Retroflexion was impossible in 17 subjects (3.5 percent) because of discomfort. In the second group, 12 subjects (2.5 percent) had polyps in the lower rectum seen only on retroflexion. Of these, eight had metaplastic and four had adenomatous polyps (3 tubular < 5 nim, I tubulovillous 15 mm). There was no difference in mean pain scores between the groups (no retroflexion = 2.13, retroflexion = 2.18). CONCLUSION: With an adenoma pick-up rate of 8 to 12 percent for screening flexible sigmoidoscopy, retroflexion increases adenoma detection by approximately 1 percent without adverse effects an should be an integral part of flexible sigmoidoscopy.

Publication metadata

Author(s): Hanson JM, Atkin WS, Cunliffe WJ, Browell DA, Griffith CDM, Varma JS, Plusa SM

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Annual Meeting of the Association of Great Britain and Ireland

Year of Conference: 2001

Pages: 1706-1708

ISSN: 0012-3706

Publisher: Lippincott Williams & Wilkins


DOI: 10.1007/BF02234394

Library holdings: Search Newcastle University Library for this item

Series Title: Diseases of the Colon and Rectum

ISBN: 15300358