XXXX : an essential part of lower gastrointestinal endoscopic examination.

@entity1127 @entity3455 @entity6523 @entity158 @entity652
PURPOSE: Retroflexion of the endoscope during rectal examination may increase diagnostic yield but is not routinely performed because of concerns about safety and a lack of appreciation of its importance. The purpose of this study was to examine the yield, safety, and tolerance of endoscopic @entity3455 . METHODS: Prospective cohorts of subjects undergoing unsedated screening flexible sigmoidoscopy were examined with and without routine retroflexion. @entity158 scores were recorded. RESULTS: A total of 526 subjects (mean age 60 (range, 55-66) years) underwent flexible sigmoidoscopy in the first period when the endoscope was not routinely retroflexed. Of these, 480 (mean age 60 (range, 55-66) years) were subsequently examined with routine retroflexion. Retroflexion was impossible in 17 subjects (3.5 percent) because of discomfort. In the second group, 12 subjects (2.5 percent) had @entity1127 in the lower rectum seen only on retroflexion. Of these, eight had metaplastic and four had @entity6523 (3 tubular <5 mm, 1 tubulovillous 15 mm). There was no difference in mean @entity158 scores between the groups (no retroflexion = 2.13, retroflexion = 2.18). CONCLUSION: With an @entity652 pick-up rate of 8 to 12 percent for screening flexible sigmoidoscopy, retroflexion increases @entity652 detection by approximately 1 percent without adverse effects and should be an integral part of flexible sigmoidoscopy.
