Colon Polyp
Conditions
Keywords
COLONOSCOPY, ENDOSCOPY
Brief summary
The colonoscopy procedure involves insertion of a thin, flexible tube with a tiny camera inside (colonoscope) passed inside the bowel. To allow passage of the colonoscope and adequate visualisation of the lining of the bowel wall a range of techniques can be used. During colonoscopy, you can distend the colon with water, CO2 and air. Air is no longer recommended for gas insufflation during colonoscopy as it causes pain and excess bowel distention. So the options are water and/or CO2 but it is not entirely clear which combination is the best and at what point during the colonoscopy. In practice, a hybrid technique where both CO2 and water are used during the colonoscopy in used. Here, water is exclusively used to help navigate the sigmoid colon with air pockets suctioned and turbid water exchanged with clean water. From splenic flexure to caecum a mixture of water and CO2 is used. The aim of this study is to assess procedure comfort and efficiency of two different colonoscopy insertion techniques: water-alone insertion of the colonoscope (gas insufflation not allowed on insertion; water exchange technique) versus water-CO2 hybrid insertion (water used predominately to splenic flexure with water/CO2 used to caecum; modified water immersion technique).
Interventions
OTHERColonoscopy insertion technique used during procedure
Each arm is using a different colonoscopy insertion technique: either water-alone colonoscopy or water-CO2 colonoscopy.
Sponsors
London North West Healthcare NHS Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Aged 18 years or older * Capacity to consent
Exclusion criteria
* Pregnancy * Previous bowel surgery * Unable to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Insertion time | During procedure | Time taken to insert the colonoscope |
| Total procedure time | During procedure | Time taken to insert and withdraw the colonoscope |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Loop formation | During procedure | Scopeguide appearance will be used to evaluate number of loops formed |
| Adenoma detection rate | 1 week after procedure with results of histology | A measure of the number of adenomas detected during colonoscopy |
| Caecal intubation rate | During procedure | The proportion of procedures where the caecum is reached |
| Number of ancilliary procedures | During procedure | The number of patient repositions and abdominal pressure episodes required during the procedure |
| Serrated polyp detection rate | 1 week after procedure with results of histology | A measure of the number of serrated polyps detected during colonoscopy |
| Patient discomfort scores | Immediately after procedure | Patients will subjectively assess discomfort scores following the procedure using a Visual Analogue Scale (VAS) which ranges from 0 to 10 where a higher score means a worse outcome. |
Countries
United Kingdom
Outcome results
None listed