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Cap‐assisted water immersion for minimal sedation colonoscopy: Prospective, randomized, single‐center trial
Author(s) -
Falt Přemysl,
Šmajstrla Vít,
Fojtík Petr,
Liberda Martin,
Kliment Martin,
Tvrdík Josef,
Urban Ondřej
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2012.01402.x
Subject(s) - colonoscopy , medicine , sedation , intubation , insertion time , anesthesia , clinical endpoint , randomized controlled trial , endoscopy , surgery , colorectal cancer , airway , cancer
Background and Aim Water immersion insertion is able to reduce discomfort and need for sedation during colonoscopy. A cap attached to the colonoscope tip may improve insertion during air insufflation colonoscopy. According to several reports, both techniques alone may result in higher detection of neoplastic lesions. Our study was designed to evaluate the efficacy of cap‐assisted water immersion compared to water immersion colonoscopy in minimally sedated patients. Methods A total of 208 consecutive outpatients were randomized to either cap‐assisted water immersion ( C ap W ater) or water immersion colonoscopy ( W ater). The primary endpoint was cecal intubation time. Results Cecal intubation time was 6.9 ± 2.9 min in C ap W ater and 7.4 ± 4.2 min in the W ater arm ( P = 0.73). Success rate of minimal sedation colonoscopy was equal in both groups (92.9%, P = 1.00). From the endoscopist's point of view, there were non‐significant trends towards lower discomfort ( P = 0.06), less need for abdominal compression ( P = 0.06) and lower difficulty score ( P = 0.05) during C ap W ater colonoscopy. Adenoma detection rate was similar in both arms (44% in C ap W ater vs 45% in the W ater group, P = 0.88). There were no complications recorded in the present study. Conclusions In comparison with water immersion without cap, cap‐assisted water immersion colonoscopy was not able to shorten the cecal intubation time. However, it has the possibility of reducing patient discomfort and difficulty of colonoscope insertion. Potential impact on improved detection of neoplastic lesions has to be evaluated by further studies.