The Korean Society of Gastroenterology & SIDDS 2028 : Slide Session ; S-LG-01 : Lower GI Tract ; Effect of Dynamic Position Change in Colonic Adenoma Detection during Colonoscope Withdrawal: A Randomized Controlled Trial = The Korean Society of Gastroenterology & SIDDS 2028 : Slide Session ; S-LG-01 : Lower GI Tract ; Effect of Dynamic Position Change in Colonic Adenoma Detection during Colonoscope Withdrawal: A Randomized Controlled Trial

다국어 초록 (Multilingual Abstract)

Background:Adequate luminal distention is essential to maximize adenoma detection during colonoscope withdrawal. There was a few single operator studies reporting dynamic position change improves luminal distension and has the potential to improve adenoma detection rate. We designed a randomized, controlled multicenter trial to verify the effect of dynamic position change in colonic adenoma detection. Methods:This study conducted at the six hospitals of the Catholic University of Korea. Patients aged 45 to 80 years who underwent colonoscopy for the fi rst time were included. In the position change group, position changes during colonoscope withdrawal were as follows: cecum, ascending colon, and hepatic fi exure: left lateral position; transverse colon: supine position; splenic fi exure, descending colon, sigmoid colon and rectum: right lateral position. In control group, examination was performed entirely in left lateral position during colonoscope withdrawl. The primary outcome measure was adenoma detection rate in the two groups, defi ned as the proportion of patients with =1 adenoma. Results: A total 1034 patients were randomized to position change group (517 patients) and control group (517 patients). Adenoma detection rate was higher in the position change group compared with left lateral alone (42.4% vs 33.0%, P=0.002). Most of the apparent improvement in adenoma detection appeared to occur through supine positioning for examination of the transverse colon (15.1% and 8.6% in the position change group and control group, respectively, P=0.001). Position change colonoscope also detected a higher number of adenomas per subject (0.90 vs 0.67, P = 0.038). Conclusions: Dynamic position change during colonoscope withdrawal increased adenoma detection rate.