Left-colon WEC May Reduce Insertion Time Compared With Whole-colon WEC.

Air Force Military Medical University of People's Liberation Army

Status: Completed

Conditions: Polyp; Pain

Treatments: Other: Water exchange colonoscopy; Other: Air colonoscopy

Study type: Interventional

Funder types: Other

Identifiers

NCT01735266

20121108-5

Details and patient eligibility

About

In most of situation, left colon (especially SD junction) is considered the most difficult part of colonoscopy, where endoscopist may encounter difficulty for scope insertion and patients may feel pain or uncomfortable. It is suggested more than half of the whole time for scope insertion should be used in left colon. Many methods, such as water immersion, abdominal palpation, have been used to facilitate insertion in left colon.

Colonoscopy with whole-colon water exchange method has been shown to be useful for reducing medication used, pain experienced during colonoscopy, increasing the success rate of cecum intubation and adenoma detection rate in sedated and unsedated patients undergoing screening colonoscopy. Exchange of water during scope insertion minimizes loop formation and prevents lengthening and distension of the colon during colonoscopy. This will facilitate the colonoscopy in average or difficult colonoscopy. However, it is not known whether the benefits of water exchange method of colonoscopy was mainly due to its effect on the left colon.

We hypothesized that left-colon water exchange colonoscopy (LWE) may have the similar effect regarding the maximal pain score and mean pain score in unsedated patients compared with whole-colon water exchange colonoscopy (WWE). At the mean time, LWE may reduce the insertion time compared with WWE. Here we performed a prospective, randomized controlled study to investigate the efficacies of whole-colon water exchange, left-colon water exchange and air methods of colonoscopy on pain score and insertion time in unsedated outpatients.

Enrollment: 300 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Outpatients with unsedated colonoscopy

Exclusion criteria

• history of colon resection
• severe colonic stricture or obstructing tumor
• hemodynamic instability
• current pregnancy
• inability to provide informed consent

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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300 participants in 3 patient groups

Air colonoscopy

Active Comparator group

Description:

Air was insufflated during whole procedure of colonoscope insertion.

Treatment:

Other: Air colonoscopy

Whole-colon water exchange colonoscopy

Experimental group

Description:

The air pump was turned off before colonoscopy. During the whole procedure of the scope insertion, residual air in lumen was suctioned and 37°C (maintained with a water bath) water was infused with a peristaltic pump to obtain lumen visualization. Air was insufflated until cecum was reached or appendix opening was seen.

Treatment:

Other: Water exchange colonoscopy

left-colon water exchange colonoscopy

Experimental group

Description:

In the left side of colon (including descending colon, sigmoid colon and rectum), water was infused instead of air to obtain lumen visualization as described above in whole-colon water exchange colonoscopy group.

Treatment:

Other: Water exchange colonoscopy