Efficacy of Second Forward-View Colonoscopy to Improve Adenoma Detection of Right-Side Colon: Systematic Review and Meta-Analysis
Background/Aims: The second forward view (SFV) has been considered an effective method to improve the adenoma detection rate (ADR) in the right-side colon. On the other hand, there is insufficient evidence on how much the ADR is improved compared to standard one forward view (OFV) colonoscopy. A sys...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jin Publishing & Printing Co.
2024-12-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.kjg.or.kr/journal/view.html?uid=6068&vmd=Full |
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| Summary: | Background/Aims: The second forward view (SFV) has been considered an effective method to improve the adenoma detection rate (ADR) in the right-side colon. On the other hand, there is insufficient evidence on how much the ADR is improved compared to standard one forward view (OFV) colonoscopy. A systematic review and meta-analysis were performed to determine the efficacy of improvement in the ADR by SFV colonoscopy.
Methods: This study conducted a systematic literature search in Medline, Embase, and Cochrane Library until Sep 2024. Two independent investigators (HJK, JWL) conducted a database search, and studies regarding the SFV or retroflexion were selected. The primary outcomes were the ADR of the right-side colon, polyp detection rate, and withdrawal time. Statistical analyses were performed using STATA 18.0 Special edition.
Results: Ten studies with 5,886 patients were included in this review. The pooled ADR of SFV colonoscopy for the right colon was significantly higher than that of the OFV, with a risk ratio (RR) of 1.25 (95% CI, 1.13–1.38 I2=0.0%). This result was statistically significant in three non-randomized trials (RR 1.19, 95% CI 1.06–1.34, I2=0.0%) with low heterogeneity. The right-sided polyp detection rate (RR 1.19, 95% CI 1.06–1.34, I2=61.6%) and the ADR of the whole colon (RR 1.10, 95% CI 1.01–1.20, I2=0.0%) were also significantly higher than those of OFV colonoscopy.
Conclusions: SFV colonoscopy is an effective method to improve the ADR of the right colon. |
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| ISSN: | 1598-9992 2233-6869 |