Colorectal polypectomy during insertion and withdrawal or only during withdrawal? A randomized controlled trial

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Prevention

Background:

• Colorectal polyp removal is standard during colonoscope withdrawal.
• Polyps found during insertion may be missed upon withdrawal.

Purpose of the Study:

• To compare polyp detection and removal rates between dual-stage (insertion and withdrawal) and single-stage (withdrawal only) polypectomy.
• To assess the impact on colonoscopy duration.

Main Methods:

• Patients randomized into two groups: Group A (polypectomy during insertion and withdrawal) and Group B (polypectomy during withdrawal only).
• Focus on polyps ≤ 10 mm.
• Outcome measures included colonoscopy duration, polyp miss rates, technical ease, patient discomfort, and complications.

Main Results:

• No significant difference in colonoscopy duration between groups (30.8 min vs. 28.5 min).
• A 7.3% polyp miss rate observed in the withdrawal-only group (13 polyps missed).
• Similar patient tolerance and complication rates between groups.

Conclusions:

• Polypectomy during withdrawal only results in a significant miss rate for colorectal polyps ≤ 10 mm.
• Recommends dual-stage polypectomy (insertion and withdrawal) to improve detection and removal rates.