A comparison of 9‐min colonoscopy withdrawal time and 6‐min colonoscopy withdrawal time: A systematic review and meta‐analysis
Abhishek Bhurwal, Puru Rattan, Avik Sarkar, Anish V. Patel, Shahid Haroon, Mihajlo Gjeorgjievski, Vikas Bansal, Hemant Mutneja
Abstract
Abstract Introduction The optimal colonoscopy withdrawal time is still a controversial topic. While several studies demonstrate that longer withdrawal time improves adenoma detection rate, others have contradicted these findings. Methods Three independent reviewers performed a comprehensive review of all original articles published from inception to January 2021 and included studies reporting comparison of the two cohorts—(i) ≥ 6 but less than 9 min of colonoscopy withdrawal time (CWT) and (ii) ≥ 9 min of CWT. The outcome measures were the following: (i) adenoma detection rate (ADR), (ii) advanced ADR, and (iii) sessile serrated adenoma detection rate (SDR). The meta‐analysis was performed, and the statistics were two‐tailed. Results A total of seven studies met the inclusion criteria after a thorough search of the literature was completed. The analysis revealed that ≥ 9 min of CWT had significantly higher odds of adenoma detection as compared with 6–9 min of CWT (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.30–1.82; I 2 = 93.7). Additionally, a significantly higher odds of sessile serrated adenoma detection (OR 1.68, 95% CI 1.28–2.22; I 2 = 0) and a trend towards higher odds of advanced adenoma detection (OR 1.38, 95% CI 0.98–1.95, I 2 = 90) were seen with CWT of at least 9 min when compared with 6–9 min of CWT. Conclusion This systematic review and meta‐analysis analysis provides further evidence that at least 9 min of CWT cohort had significantly higher ADR and SDR as compared with the at least 6 min but less than 9 min of cohort.