Polypectomy During Both Insertion and Withdrawal Phase Versus During Withdrawal Phase Only: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

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  • Author(s): Dai Q;Dai Q; Tu S; Tu S; Chen S; Chen S; Zheng B; Zheng B; Wan Z; Wan Z; Chen B; Chen B
  • Source:
    Journal of laparoendoscopic & advanced surgical techniques. Part A [J Laparoendosc Adv Surg Tech A] 2021 Jun; Vol. 31 (6), pp. 621-626. Date of Electronic Publication: 2020 Aug 21.
  • Publication Type:
    Comparative Study; Journal Article; Meta-Analysis; Systematic Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9706293 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-9034 (Electronic) Linking ISSN: 10926429 NLM ISO Abbreviation: J Laparoendosc Adv Surg Tech A Subsets: MEDLINE
    • Publication Information:
      Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1997-
    • Subject Terms:
      Adenoma/*diagnostic imaging ; Adenoma/*surgery ; Colonic Polyps/*surgery ; Colonoscopy/*methods ; Colorectal Neoplasms/*diagnostic imaging ; Colorectal Neoplasms/*surgery; Adenoma/pathology ; Colonic Polyps/diagnostic imaging ; Humans ; Operative Time ; Randomized Controlled Trials as Topic
    • Abstract:
      Background: This study aimed to compare polypectomy during both insertion and withdrawal phase versus during withdrawal phase only. Method: We performed literature searching in PubMed and Ovid for randomized clinical trials (RCTs) that compared polypectomy during both insertion and withdrawal phase versus during withdrawal phase only on April 3, 2020. The primary outcome was adenoma detection rate (ADR). Results: Five RCTs published between 2012 and 2020 with a total of 2694 individuals were included in this meta-analysis. No significant difference was observed between the two groups for ADR ( P  = .99, odds ratio = 1.00, 95% confidence interval [CI] 0.84-1.19, I 2  = 0%), or average number of adenomas per individuals ( P  = .53, weighted mean difference [WMD] = 0.04, 95% CI -0.09 to 0.17, I 2  = 30%). Besides, polypectomy during both insertion and withdrawal group showed significantly longer time for insertion phase ( P  = .01, WMD = 2.16, 95% CI 0.47-3.84, I 2  = 95%), and shorter time for withdrawal phase ( P  = .010, WMD = -2.32, 95% CI -4.09 to -0.56, I 2  = 94%), although the total procedure time was not significantly different between the two groups. Conclusion: No obvious advantages were observed for polypectomy during both insertion and withdrawal phase. We are looking forward to the long-term outcomes of these studies. More studies are warranted in the future for further exploration, especially the detection rate of small lesions.
    • Contributed Indexing:
      Keywords: adenoma detection rate; insertion phase; meta-analysis; polypectomy; withdrawal phase
    • Publication Date:
      Date Created: 20200825 Date Completed: 20210714 Latest Revision: 20210714
    • Publication Date:
      20240105
    • Accession Number:
      10.1089/lap.2020.0538
    • Accession Number:
      32833585