The Effects of the Water-exchanged Colonoscopy on Adenoma Detection Rate

Air Force Military Medical University of People's Liberation Army

Status: Completed

Conditions: Pain; Adenoma

Treatments: Other: Water colonoscopy

Study type: Interventional

Funder types: Other

Identifiers

NCT02135601

20140408-7

Details and patient eligibility

About

Water exchange method has been shown to reduce medication requirement and pain experienced during colonoscopy. It may increase the adenoma detection rate (ADR). Water exchange provides salvage cleansing and the refractive index of water (n equals about 1.3) is larger than that of air, which creates optical distortion that likely contributes to objects appearing larger underwater, making smaller lesions easier to visualize and it may help draw attention to those smaller lesions during withdraw. These principles facilitate to the higher adenoma detection rate.

There is a large number of literature on the adenoma detection rate during water exchange colonoscopy, but most studies have been conducted in only one centre, simple-size, and under sedation patients, the influence of adenoma detection rate under unsedation patients was unclear.

The aim of this study is to compare the ADR of colonoscopy by using the water exchange method versus the conventional air method in unsedation patients in multiple centers in China.

Enrollment: 3,303 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• age 18-80 patients with intact colon and rectum

Exclusion criteria

• prior finding of severe colorectal stricture;
• solid fetus contained in the last stool before colonoscopy
• no bowel preparation or cleansed by enema/lavage
• without the requirement of reaching cecum
• known colorectal polyps or polyposis syndrome without complete removal previously
• pregnant women
• hemodynamically unstable
• patients who cannot give informed consent

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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3,303 participants in 2 patient groups

Air colonoscopy

No Intervention group

Description:

Colonoscopy will be performed without medications and with judicious air insufflation during colonoscope insertion.

Water colonoscopy

Other group

Description:

Colonoscopy will be performed without medications and aided by water infusion in-lieu of air insufflation during insertion of the colonoscope.

Treatment:

Other: Water colonoscopy