Adenoma
Conditions
Keywords
adenoma detection rate, colonoscopy, water exchange
Brief summary
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.
Detailed description
All of the procedures will be recorded and stored as digital files.
Interventions
PROCEDUREAir insufflation
Insufflation during colonoscopy including insertion phase
PROCEDUREwater immersion
Water will infused during insertion phase and removed during withdrawal phase of colonoscopy
PROCEDUREWater exchange
Water will infused and removed during insertion phase of colonoscopy
Sponsors
Sepulveda Ambulatory Care Center, VAGLAHS
Dalin Tzu Chi General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| adenoma detection rate | one week |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| adenoma detection rate in proximal colon | one week | the proportion of patients with the presence of adenoma in the proximal colon |
Other
| Measure | Time frame | Description |
|---|---|---|
| post-procedure discomfort and 30 days complication rate | 30 days | telephone follow up for post-procedure discomfort and 30 days complication rate |
Countries
Taiwan, United States
Outcome results
None listed