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Methods to Improve the Adenoma Detection Rate

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Colon Polypectomy

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Abstract

Colonoscopy, the gold standard for large bowel examination and colorectal cancer screening and surveillance, is still imperfect; adenomas as well as cancers can be missed, thus increasing the risk of interval cancer. Adequate bowel preparation and meticulous inspection of the mucosa during scope withdrawal are of paramount importance for efficient colon examination. Moreover, techniques like a second examination of the right colon either with direct or with retroflexed view and water-assisted colonoscopy promise better quality of the examination. Beyond these procedural issues, new endoscopic modalities including wide-angle view endoscopes and add-on devices have been developed in an effort to improve colonoscopy’s diagnostic yield by either expanding the field of scope view up to 330° or by providing retrograde view of the lumen or by flattering the haustral folds during withdrawal. In this chapter we discuss how these advances affect colonoscopy performance by improving its main quality indicator, namely, adenoma detection rate, which has been clearly associated with examination’s outcomes.

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  1. Hepatogastroenterology Unit, Second Department of Internal Medicine—Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University, Attikon University General Hospital, 1 Rimini Street, 124 62, Athens, Greece

    Vasilios Papadopoulos & Konstantinos Triantafyllou

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  1. Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy

    Antonio Facciorusso

  2. Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy

    Nicola Muscatiello

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Papadopoulos, V., Triantafyllou, K. (2018). Methods to Improve the Adenoma Detection Rate. In: Facciorusso, A., Muscatiello, N. (eds) Colon Polypectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-59457-6_2

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