Extending Withdrawal Time Can Improve Adenoma Detection Rate

When endoscopists knew procedures were being monitored, colonoscopy withdrawal time and adenoma detection rates increased significantly.

Colonoscopy withdrawal time correlates extremely well with adenoma detection rate (ADR) and with cancer prevention in retrospective studies. When applied prospectively as a single quality monitor, however, it has demonstrated limited impact. Presumably, longer withdrawal times must be accompanied by improved examination technique.

In a Swiss university hospital, investigators monitored seven experienced gastroenterologists for colonoscopy withdrawal time, initially without their knowledge. After monitoring 355 procedures surreptitiously, the researchers then notified the endoscopists of ongoing monitoring, and an additional 203 colonoscopies were openly timed.

In the first phase, median withdrawal time was 4.5 minutes without intervention (e.…

Reviewing Author

Douglas K. Rex, MD

Disclosures

Consultant/Advisory BoardOlympus Corporation America; Boston Scientific

Speaker’s BureauOlympus

Grant/Research SupportMedtronic; Boston Scientific; Colonary Solutions; Paion Medical; Medivators; Braintree Laboratories

Editorial BoardsWorld Journal of Gastroenterology; The Journal of Clinical Gastroenterology; Techniques in Gastrointestinal Endoscopy; Gastroenterology & Hepatology; Expert Review of Gastroenterology & Hepatology; Medscape Gastroenterology; World Journal of Gastrointestinal Pharmacology and Therapeutics; Annals of Gastroenterology & Hepatology; World Journal of Gastrointestinal Oncology; Comparative Effectiveness Research; Journal of Anesthesia & Clinical Research; Gastroenterology; World Journal of Gastrointestinal Pathophysiology; Gastroenterology Research and Practice; GI & Hepatology News; Gastroenterology Report; Clinical Epidemiology Reviews; JSM Gastroenterology and Hepatology; GI Journal Watch; Austin Journal of Gastroenterology; World Journal of Gastrointestinal Pharmacology & Therapeutics

Leadership Positions in Professional SocietiesAmerican Society for Gastrointestinal Endoscopy (Treasurer); US Multi-Society Task Force (AGA, ACG, ASGE) (Chair)