Comparing the ADR With Air Insufflation, Water Immersion and Water Exchange During Two-endoscopist Colonoscopy

A Randomized, Controlled Trial Comparing the Adenoma Detection Rate With Air Insufflation, Water Immersion and Water Exchange During Two-endoscopist Colonoscopy

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02737514

Enrollment

371

Registered

2016-04-14

Start date

2015-12-31

Completion date

2020-02-29

Last updated

2020-05-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Adenoma

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

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

DIAGNOSTIC

Masking

DOUBLE (Subject, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

20 Years to 80 Years

Healthy volunteers

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 in the right colon	one week

Secondary

Measure	Time frame	Description
overall adenoma detection rate	one week	—
post-procedure discomfort	1 day after colonoscopy	pain or distention on a 0 to 10 VAS scale
30 days complication rate	30 days	incidence of bleeding, perforation and unexpected admission

Countries

Taiwan, United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 14, 2026