TY - JOUR
T1 - Retroflexion in the colon
T2 - A useful and safe technique in the evaluation and resection of sessile polyps during colonoscopy
AU - Pishvaian, Aline Charabaty
AU - Al-Kawas, Firas H.
PY - 2006/7/1
Y1 - 2006/7/1
N2 - OBJECTIVE: Endoscopic polypectomy has become the standard management approach for colon polyps. Three factors can make endoscopic resection of colonic polyps difficult: size, configuration, and location. We describe the use of retroflexion in the colon as a useful and routine technique using a standard colonoscope for the resection of difficult sessile polyps. METHODS: Fifteen patients in whom the retroflexion technique was used for polyp removal were prospectively identified. Each polyp was visualized and resected using both a forward and retroflexed view. RESULTS: Nine women and six men were identified between the ages of 49 and 81 years. The 15 polyps were located in the cecum (3), ascending colon (3), hepatic flexure (3), splenic flexure (2), descending colon (2), and sigmoid colon (2). All the polyps were sessile and their largest diameter ranged from 20 mm to 50 mm. Retroflexion combined with forward viewing allowed for a better assessment of the size and extent of all the polyps compared with forward viewing alone. All polyps, except two, were completely resected during the first session, using both the prograde and retroflexion approaches. No complications from retroflexion of the colonoscope, including perforation or bleeding, occurred. CONCLUSION: Retroflexion complements the conventional prograde inspection of sessile polyps that are only partially visualized on prograde view alone. Retroflexion allows a complete assessment of the lesions' size and extent and aid in their complete removal.
AB - OBJECTIVE: Endoscopic polypectomy has become the standard management approach for colon polyps. Three factors can make endoscopic resection of colonic polyps difficult: size, configuration, and location. We describe the use of retroflexion in the colon as a useful and routine technique using a standard colonoscope for the resection of difficult sessile polyps. METHODS: Fifteen patients in whom the retroflexion technique was used for polyp removal were prospectively identified. Each polyp was visualized and resected using both a forward and retroflexed view. RESULTS: Nine women and six men were identified between the ages of 49 and 81 years. The 15 polyps were located in the cecum (3), ascending colon (3), hepatic flexure (3), splenic flexure (2), descending colon (2), and sigmoid colon (2). All the polyps were sessile and their largest diameter ranged from 20 mm to 50 mm. Retroflexion combined with forward viewing allowed for a better assessment of the size and extent of all the polyps compared with forward viewing alone. All polyps, except two, were completely resected during the first session, using both the prograde and retroflexion approaches. No complications from retroflexion of the colonoscope, including perforation or bleeding, occurred. CONCLUSION: Retroflexion complements the conventional prograde inspection of sessile polyps that are only partially visualized on prograde view alone. Retroflexion allows a complete assessment of the lesions' size and extent and aid in their complete removal.
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U2 - 10.1111/j.1572-0241.2006.00606.x
DO - 10.1111/j.1572-0241.2006.00606.x
M3 - Article
C2 - 16863549
AN - SCOPUS:33745571524
VL - 101
SP - 1479
EP - 1483
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 7
ER -