P1611 - Comparing the Clinical Outcomes of 6-Minute and 9-Minute Minimal Withdrawal Time During Colonoscopy: A Retrospective Study

Dalton A. Norwood, MD¹, Tatiana Torres Herman, MD², Rachel Taylor, MD², Udita Gupta, MD², Priya Nethala, MD³, Johnson Dane, MD², Douglas Morgan, MD, MPH², Fayez Sarkis, MD^2
1UAB Minority Health and Health Equity Research Center, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; ²University of Alabama at Birmingham, Birmingham, AL; ³University of Alabama at Birmingham Hospital, Birmingham, AL

Introduction: Minimal withdrawal time is a critical factor in the efficacy of colonoscopy, and longer withdrawal times may improve detection rates and reduce the incidence of interval cancers. However, the optimal duration of minimal withdrawal time remains controversial. This study aims to compare the clinical outcomes of patients who underwent colonoscopy with a 6-minute minimal withdrawal time versus those with a 9-minute minimal withdrawal time at a single tertiary-care referral center.

Methods: This retrospective observational study analyzed the database of patients who underwent colonoscopy at a single tertiary referral center between a 2017 and end 2022. The study population included patients who underwent colonoscopy adequately prepped screening colonoscopies. Patients were categorized based on their withdrawal time to be either a minimum of 6-minute or minimum of 9-minute minimal withdrawal time. Data was collected on patient demographics, colonoscopy findings, adenoma detection rate (ADR), sessile serrated detection rate, and colorectal cancer (CRC) detection rates for both groups. Univariate and multivariate logistic regression analyses were performed to compare the 2 groups.

Results: This study included 9152 consecutive patients, 54.4% males, median age 56 (IQR 50-64). 3239 and 5913 patients were classified into the 6 minutes and 9 minutes group respectively. The results of the logistic regression model comparing the two groups times showed that patients who underwent colonoscopy with a 9-minute minimal withdrawal time had a significantly higher polyp detection rate (69.1 vs 37.4%, OR 2.66, 95% CI 2.32-3.05, p< 0.001), adenoma detection rate (ADR) (53.2 vs 27.7%, OR 1.43, 95% CI 1.24-1.65, p< 0.001), and serrated polyp rate (8.4 vs 1.9%, OR 2.97, 95% CI 2.25-3.92, p< 0.001) compared to those with a 6-minute minimal withdrawal time. There was also a higher colorectal cancer detection (CRC) rate in the 9-minute withdrawal group, (0.1% vs 0.4%, OR 4.24, 95% CI 1.24-14.46, p=0.021). (Table)

Discussion: The results of this study provide evidence that a 9-minute minimal withdrawal time during colonoscopy is associated with improved outcomes in terms of higher detection rates of polyps, adenomas, serrated polyps, and colorectal carcinoma compared to a 6-minute minimal withdrawal time. This finding suggests that a longer withdrawal time may lead to better colonoscopy outcomes and may help improve the efficacy of colonoscopy screening and surveillance.


Disclosures:


Dalton A. Norwood, MD¹, Tatiana Torres Herman, MD², Rachel Taylor, MD², Udita Gupta, MD², Priya Nethala, MD³, Johnson Dane, MD², Douglas Morgan, MD, MPH², Fayez Sarkis, MD². P1611 - Comparing the Clinical Outcomes of 6-Minute and 9-Minute Minimal Withdrawal Time During Colonoscopy: A Retrospective Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.