Published online Nov 26, 2014. doi: 10.13105/wjma.v2.i4.162
Revised: September 20, 2014
Accepted: October 14, 2014
Published online: November 26, 2014
Processing time: 184 Days and 0.2 Hours
AIM: To determine the diagnostic yield of the “third eye retroscope”, on adenoma detection rate during screening colonoscopy.
METHODS: The “third eye retroscope” when used with standard colonoscopy provides an additional retrograde view to visualize lesions on the proximal aspects of folds and flexures. We searched MEDLINE (PubMed and Ovid), SCOPUS (including MEDLINE and EMBASE databases), Cochrane Database of Systemic Reviews, Google Scholar, and CINAHL Plus databases to identify studies that evaluated diagnostic yield of “third eye retroscope” during screening colonoscopy. DerSimonian Laird random effects model was used to generate the overall effect for each outcome. We evaluated statistical heterogeneity among the studies by using the Cochran Q statistic and quantified by I2 statistics.
RESULTS: Four distinct studies with a total of 920 patients, mean age 59.83 (95%CI: 56.77-62.83) years, were included in the review. The additional adenoma detection rate (AADR) defined as the number of additional adenomas identified due to “third eye retroscope” device in comparison to standard colonoscopy alone was 19.9% (95%CI: 7.3-43.9). AADR for right and left colon were 13.9% (95%CI: 9.4-20) and 10.7 (95%CI: 1.9-42), respectively. AADR for polyps ≥ 6 mm and ≥ 10 mm were 24.6% (95%CI: 16.6-34.9) and 24.2% (95%CI: 12.9-40.8), respectively. The additional polyp detection rate defined as the number of additional polyps identified due to “third eye retroscope” device in comparison to standard colonoscopy alone was 19.8% (95%CI: 7.9-41.8). There were no complications reported with use of “third eye retroscope” device.
CONCLUSION: The “third eye retroscope” device when used with standard colonoscopy is safe and detects 19.9% additional adenomas, compared to standard colonoscopy alone.
Core tip: Missed lesions remain one of the main causes for development of interval colorectal cancer after screening colonoscopy. The third eye retroscope (TER) provides an additional retrograde view to visualize lesions on the proximal aspects of folds. In this meta-analysis of four studies including 920 patients undergoing screening colonoscopy, we observed that the additional adenoma detection rate, defined as the number of additional adenomas identified due to TER device in comparison to standard colonoscopy alone, was 19.9% (95%CI: 7.3-43.9). We found that TER device was safe and identified significant more numbers of adenoma which would have been missed by standard colonoscopy alone.