2.4. Trial interventions
polyps, NRS, pain
COMPLICATIONS
For patients assigned to the control group, after cecal intubation, the colonoscopist performed 2 forward examinations from the cecum to the hepatic flexure during withdrawal, recording the examination distance (cecum insertion distance and hepatic flexure insertion distance), examination time (total examination time, cecum insertion time, first withdrawal time from cecum to hepatic flexure, second withdrawal time from cecum to hepatic flexure, total withdrawal time), polyps detection (location and size of polyps found from cecum to hepatic flexure for the first and second time), numerical rating scale for pain (NRS), and any complications.For patients assigned to the trial group, after cecal intubation, the colonoscopist first performed a forward examination from the cecum to the hepatic flexure during withdrawal, then reentered the cecum and performed a reverse observation using colonoscopic retroflexion, before continuing to withdraw the colonoscope to the hepatic flexure with the forward examination and recorded the same information as the control group.The examination speed of cecal retroflexion observed was performed according to the routine examination, with the specific examination time determined based on the lesion conditions, and no mandatory requirement. If colonoscopic retroflexion was difficult or unsuccessful after 15 minutes, the attempt should be stopped, and the colonoscopy should be continued, with the sample being exited from the group and not included in the study. Furthermore, no special requirements were applied for other auxiliary techniques (such as abdominal compression and body position change) except for cecal retroflexion observed.