Adenoma Miss Rate With Water Exchange vs Carbon Dioxide Colonoscopy

Evergreen General Hospital, Taiwan176 enrolled

Overview

This was an observational study comparing consecutive group of WE and CO2 insufflation in terms of right and proximal colon AMR by tandem colonoscopy.

This was a prospective observational study to assess how WE colonoscopy would fit into clinical and research practices. We first observed whether optimal WE colonoscopy decreased the AMR in the right and proximal colon in a tandem approach. If WE did lower the AMR as compared with data in the literature, a randomized RCT deserves to be studied. For the calculation of sample size in the upcoming RCT, the AMR in the CO2 group would be collected. The differences of the AMRs in the right and proximal colon determined by tandem colonoscopy using WE or CO2 insufflation would then be compared.

Study Type

OBSERVATIONAL

Enrollment

176

Conditions

Colonic Adenoma Water Exchange Colonoscopy

Interventions

Water exchange colonoscopyPROCEDURE

During back-to-back colonoscopy, the first examination was completed with water exchange during insertion and CO2 insufflation during withdrawal. The second examination was completed with CO2 insufflation during both the insertion and withdrawal.

CO2 insufflation colonoscopyPROCEDURE

During back-to-back colonoscopy, the first examination was completed with CO2 insufflation during both the insertion and withdrawal. The second examination was also completed with CO2 insufflation during both the insertion and withdrawal.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Consecutive patients aged 20 years or older undergoing colonoscopy for screening and surveillance indications were considered for enrollment. Exclusion Criteria: * familial adenomatous polyposis and hereditary non-polyposis CRC syndrome, personal history of inflammatory bowel disease, previous colonic resection, inability to achieve cecal intubation, obstructive lesions of the colon, poor colon preparation, inability to completely remove a polyp, gastrointestinal bleeding, allergy to fentanyl or midazolam, American Society of Anesthesiology classification of physical status grade 3 or higher, mental retardation, pregnancy, and refusal to provide a written informed consent.

Locations (1)

Evergreen General Hospital

Taoyuan District, Taiwan

Outcomes

Primary Outcomes

Percentage of Overall Detected Adenomas Missed During the First Right-Colon Colonoscopy

Right-colon (cecum, A-colon, hepatic flexure) adenomas detected on the second-pass examination were used for the calculation of adenoma miss. Adenoma miss rate was calculated as the number of adenomas missed in the first colonoscopy divided by the total number of adenomas detected during both the first and second colonoscopies.

Time frame: During procedure, approximately 1.5 hours

Percentage of Overall Detected Adenomas Missed During the First Proximal-Colon Colonoscopy

Proximal-colon (cecum, A-colon, hepatic flexure, T-colon) adenomas detected on the second-pass examination were used for the calculation of adenoma miss. Adenoma miss rate was calculated as the number of adenomas missed in the first colonoscopy divided by the total number of adenomas detected during both the first and second colonoscopies.

Time frame: During procedure, approximately 1.5 hours

Data from ClinicalTrials.gov

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