{"title":"第二次前视结肠镜检查提高右侧结肠腺瘤检出率的疗效：系统回顾和荟萃分析。","authors":"Hyun Jung Kim, Hyuk Yoon, Jung Won Lee","doi":"10.4166/kjg.2024.117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 I<sup>2</sup>=0.0%). This result was statistically significant in three non-randomized trials (RR 1.19, 95% CI 1.06-1.34, I<sup>2</sup>=0.0%) with low heterogeneity. The right-sided polyp detection rate (RR 1.19, 95% CI 1.06-1.34, I<sup>2</sup>=61.6%) and the ADR of the whole colon (RR 1.10, 95% CI 1.01-1.20, I<sup>2</sup>=0.0%) were also significantly higher than those of OFV colonoscopy.</p><p><strong>Conclusions: </strong>SFV colonoscopy is an effective method to improve the ADR of the right colon.</p>","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":"84 6","pages":"265-273"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Efficacy of Second Forward-View Colonoscopy to Improve Adenoma Detection of Right-Side Colon: Systematic Review and Meta-Analysis].\",\"authors\":\"Hyun Jung Kim, Hyuk Yoon, Jung Won Lee\",\"doi\":\"10.4166/kjg.2024.117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 I<sup>2</sup>=0.0%). This result was statistically significant in three non-randomized trials (RR 1.19, 95% CI 1.06-1.34, I<sup>2</sup>=0.0%) with low heterogeneity. The right-sided polyp detection rate (RR 1.19, 95% CI 1.06-1.34, I<sup>2</sup>=61.6%) and the ADR of the whole colon (RR 1.10, 95% CI 1.01-1.20, I<sup>2</sup>=0.0%) were also significantly higher than those of OFV colonoscopy.</p><p><strong>Conclusions: </strong>SFV colonoscopy is an effective method to improve the ADR of the right colon.</p>\",\"PeriodicalId\":94245,\"journal\":{\"name\":\"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi\",\"volume\":\"84 6\",\"pages\":\"265-273\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4166/kjg.2024.117\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4166/kjg.2024.117","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景/目的：第二前视（SFV）被认为是提高右侧结肠腺瘤检出率（ADR）的有效方法。另一方面，与标准单前视（OFV）结肠镜检查相比，没有足够的证据表明ADR改善了多少。进行了系统回顾和荟萃分析，以确定SFV结肠镜检查改善不良反应的效果。方法：本研究在Medline、Embase、Cochrane图书馆进行系统文献检索，检索时间截止到2024年9月。两名独立研究者（HJK， JWL）进行了数据库检索，选择了关于SFV或反屈的研究。主要观察结果为右侧结肠不良反应、息肉检出率和停药时间。采用STATA 18.0特别版进行统计分析。结果：本综述纳入了10项研究，共5886例患者。右结肠SFV结肠镜的总不良反应明显高于OFV，风险比（RR）为1.25 （95% CI, 1.13 ~ 1.38 I2=0.0%）。该结果在三个非随机试验中具有统计学意义（RR 1.19, 95% CI 1.06-1.34, I2=0.0%），异质性较低。右侧息肉检出率（RR 1.19, 95% CI 1.06 ~ 1.34, I2=61.6%）和全结肠不良反应（RR 1.10, 95% CI 1.01 ~ 1.20, I2=0.0%）均显著高于OFV结肠镜检查。结论：SFV结肠镜检查是改善右结肠不良反应的有效方法。
[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 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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