Why and how Improve Your Adenoma Detection Rate?

摘要

There is a direct relationship between adenoma detection rate (ADR) and mortality by interval colorectal cancer. The most relevant means to improve its ADR are presented herein. These means are numerous, nonexclusive, and efficient. The first step is to regularly assess and be aware of its own ADR. Amongst others, the easiest and immediately available ways to improve its ADR are to optimize patients' bowel preparation, to use a water-pump and to lavage during insertion, to allow oneself a sufficient withdrawal time, and to get his assistants involved during mucosal inspection. The place of caecal and rectal retrofle-xions seems to be limited. Last generation, high-definition endoscopes and the use of dedicated caps to see behind colo-nic folds improve ADR. Although dye-spraying improves ADR, this technique is hardly applicable to all patients in clinical practice (and only recommended for patients at veiy high risk). Improvements are expected in virtual chromoen-doscopy, in terms of ADR.