Keswani, Rajesh N.Kahi, Charles J.Benson, MarkGawron, Andrew J.Kaltenbach, Tonya R.Yadlapati, Rena H.Gregory, Dyanna L.Duloy, Anna2024-04-022024-04-022021-07-31Keswani RN, Kahi CJ, Benson M, et al. Cecal retroflexion is infrequently performed in routine practice and the retroflexed view is of poor quality. BMC Gastroenterol. 2021;21(1):307. Published 2021 Jul 31. doi:10.1186/s12876-021-01877-4https://hdl.handle.net/1805/39695Background: As right colon polyps are challenging to detect, a retroflexed view of right colon (RV) may be useful. However, cecal retroflexion (CR) without a RV to the hepatic flexure (HF) is inadequate. We aimed to determine the frequency of CR and quality of the RV in routine practice. Methods: This prospective observational study performed at an academic medical center assessed colonoscopy inspection technique of endoscopists who had performed ≥ 100 annual screening colonoscopies. We video recorded ≥ 28 screening/surveillance colonoscopies per endoscopist and randomly evaluated 7 videos per endoscopist. Six gastroenterologists blindly reviewed the videos to determine if CR was performed and HF withdrawal time (cecum to HF time, excluding ileal/polypectomy time). Results: Reviewers assessed 119 colonoscopies performed by 17 endoscopists. The median HF withdrawal time was 3 min and 46 s. CR was performed in 31% of colonoscopies. CR frequency varied between endoscopists with 9 never performing CR and 2 performing CR in all colonoscopies. When performed, nearly half (43%) of RVs did not extend to the HF with median RV duration of 16 s (IQR 9-30 s). Three polyps were identified in the RV (polyp detection rate of 8.1%), all identified prior to a forward view. Conclusions: CR is performed infrequently in routine practice. When CR is performed, the RV is of low quality with a very short inspection duration and insufficient ascending colon examination. Further education is required to educate endoscopists in optimal technique to improve overall colonoscopy quality.en-USAttribution 4.0 InternationalRetroflexionQualityRight colonArticle