Influence of Sedated Endoscopy on Colorectal Adenoma Detection Rate: A Multicenter Study

Background and objectives: Studies on the effect of sedated endoscopy on adenoma detection rate (ADR) and advanced adenoma detection rate (AADR) remain scarce. The present study aims to determine whether sedation can help improve ADR and AADR. Methods: Colonoscopies conducted in four endoscopy centers from January 2012 to July 2019 were included to create a propensity score-matched cohort, and compare the endoscopic factors. Results: The colonoscopies of 216,400 cases were included. The ADR (32.24% vs. 31.63%, p < 0.05), AADR (5.59% vs. 5.39%, p < 0.05), and polyp (20.61% vs. 20.21%, p < 0.05) increased in the sedated endoscopy group, especially for flat adenomas (44.80% vs. 43.95%, p < 0.05) and adenomas of 0–5 mm (66.99% vs. 66.24%, p < 0.05). However, there was no significant difference, in terms of lesion site. Furthermore, the number of biopsies per colonoscopy was significantly higher in the sedated group (0.79 ± 0.93 vs. 0.56 ± 0.80, p < 0.001). Moreover, there was a significant increase in electronic (0.92% vs. 0.83%, p < 0.05) and chemical staining (0.57% vs. 0.45%, p < 0.001) in the sedated group. Conclusions: The ADR, AADR and polyp detection rate increased for sedated colonoscopy, especially for flat adenomas and adenomas of 0–5 mm. In addition, the frequency of staining, image enhancement techniques, and number of biopsies per colonoscopy increased in sedated colonoscopy.