Routine ileal intubation in colonoscopy does not increase the polyp detection rate: a retrospective study

Area of Science:

• Gastroenterology
• Colorectal Cancer Screening
• Endoscopy

Background:

• Colonoscopy is crucial for colorectal cancer prevention and screening.
• The necessity and clinical benefit of terminal ileal (TI) intubation during colonoscopy, particularly regarding polyp detection rate (PDR), are not well-established.

Purpose of the Study:

• To evaluate the clinical utility of terminal ileal intubation during colonoscopy.
• To determine if TI intubation impacts polyp detection rate (PDR) and identify factors associated with PDR.

Main Methods:

• Retrospective analysis of 1675 patients undergoing colonoscopy with cecal intubation.
• Data collected included TI intubation status, time for TI intubation, and positive findings.
• Univariate and multivariate analyses were used to identify predictors of PDR.

Main Results:

• The overall PDR was 27%.
• Factors independently predicting higher PDR included age >50, male sex, presence of symptoms, and non-TI intubation.
• A decreasing trend in PDR was observed with increasing depth of TI intubation (non-TI, 0-5 cm TI, >5 cm TI).

Conclusions:

• Terminal ileal intubation is valuable for diagnosing specific small bowel diseases in select patients.
• Routine TI intubation in all colonoscopies is not recommended due to minimal positive findings, increased procedure time, and potential PDR reduction.