Published online Nov 16, 2022. doi: 10.4253/wjge.v14.i11.694
Peer-review started: September 5, 2022
First decision: October 12, 2022
Revised: October 20, 2022
Accepted: November 6, 2022
Article in press: November 6, 2022
Published online: November 16, 2022
Colonic looping is a common obstacle during routine colonoscopy.
Looping is associated with a redundant colon, older age, female sex, and cecal intubation time. However, the clinical significance of looping is not fully understood.
We aimed to clarify the effect of looping on colorectal premalignant polyp detection.
We extracted data from the clinic’s endoscopy database on patient age, sex, endoscopist-assessed looping, colonoscopy duration, endoscopist experience, and premalignant polyp detection. The effects of looping on premalignant polyp detection were assessed using logistic regression analyses.
The detection rates of adenomas, high-risk adenomas, and clinically significant serrated polyps (CSSPs) increased with the severity of looping (all P < 0.001). The number of adenomas increased with looping severity (P < 0.001). Multivariate analyses found that detection of adenoma, high-risk adenoma, and CSSP was associated with severe looping (P < 0.001, P < 0.001, and P = 0.007, respectively) regardless of age, sex, and the time required for colonoscope insertion and withdrawal, and endoscopist experience.
Looping severity was independently associated with high detection rates of premalignant polyps.
Looping may predict the risk of metachronous colorectal cancer; however, further investigation is needed.