Comparing the Adenoma Detection Rate With Air Insufflation, Water Immersion and Water Exchange

Dalin Tzu Chi General Hospital

Status: Completed

Conditions: Adenoma

Treatments: Procedure: Water exchange; Procedure: water immersion; Procedure: Air insufflation

Study type: Interventional

Funder types: Other

Identifiers

NCT01894191

DalinTCGH-hsieh-03

Details and patient eligibility

About

Interval (missed) cancers and lower than expected mortality reduction of proximal colon cancers in the United States and elsewhere after screening colonoscopy drew attention to quality indicators. Missed adenomas which are more likely to be in the proximal colon may be contributing factors. An independent predictor of the risk of interval cancers is adenoma detection rate. In pilot observations, the investigators showed that water exchange enhanced adenoma detection in the right colon (cecum to hepatic flexure). This prospective, randomized controlled trial will compare water exchange with water immersion and traditional air insufflation in patients undergoing colonoscopy. The investigators test the hypothesis that compared with air insufflation and water immersion, water exchange produces a significantly higher adenoma detection rate in the right colon.

Full description

All of the procedures will be recorded and stored as digital files.

Enrollment: 651 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing colonoscopy performed by the participating endoscopists

Exclusion criteria

• obstructive lesions of the colon known before colonoscopy
• massive ascites
• past history of partial colectomy
• refusal to provide written informed consent

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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651 participants in 3 patient groups

air insufflation

Active Comparator group

Description:

Air insufflation will be used throughout whole procedure of colonoscopy

Treatment:

Procedure: Air insufflation

water immersion

Active Comparator group

Description:

Water will be infused during the insertion phase and removed during withdrawal phase of colonoscopy.

Treatment:

Procedure: water immersion

water exchange

Active Comparator group

Description:

Water will be infused and removed during insertion phase of colonoscopy

Treatment:

Procedure: Water exchange