Colonoscopy
Conditions
Keywords
COLONOSCOPY, WATER, microbiological safety, organization, ecological impacT, plastic waste
Brief summary
A joint opinion of the SFED and the SF2H recommends to orient our colonoscopy practices towards the use of bacteriologically controlled water in reusable bottles for colonic irrigation. To date, no study exists to validate the proposed set-up. Our main objective is therefore to evaluate the microbiological safety of the use of bacteriologically controlled water, in particular the absence of retro contamination of the water in the wash bottle by the faecal flora of the patient undergoing colonoscopy, in order to be able to generalise this practice
Detailed description
Colonoscopy is the reference examination for colon exploration. Since 2021, international recommendations recommend the practice of water-exchange which consists in performing colonoscopies by irrigating the colon with water, continuously and without insufflation. This technique facilitates the progression of the colonoscope, reduces pain and the risk of perforation for the patient, and improves the detection and resection of polyps. However, it requires a large volume of water, about 1L per patient. We currently use sterile water in single-use bottles. In order to propose a way to limit the production of waste in endoscopy, the SFED and the SF2H have published an opinion proposing to orient our practice towards the use of EBM packaged in reusable bottles. To date, no study has validated the set-up proposed in this advice. We therefore propose to ensure the microbiological safety of the use of EBM during water-assisted colonoscopies before generalizing this practice. A microbiological sample of 200 ml of EBM contained in the wash bottle at the end of each colonoscopy will be collected for bacteriological analysis. In addition, the use of reusable bottles requires the implementation of a maintenance and reconditioning circuit, and therefore a reorganization within the technical platform, the feasibility and acceptability of which must be evaluated by the professionals. Finally, we will also evaluate the carbon footprint of the sterilization circuit and compare the weight of waste related to the current practice, sterile water versus the use of EBM. This study would be the pilot phase for a larger study on the ecological and medico-economic impact of the use of bacteriologically controlled water in endoscopy
Interventions
PROCEDUREColonoscopy with Bacteriological Controlled Water
Patient with coloscopy which used Bacteriological Controlled Water : Collection of 250 ml of bacteriologically controlled water from the wash bottle at the end of each water-assisted colonoscopy to test for enterobacteria and fecal streptococci
Sponsors
University Hospital, Bordeaux
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients with a colonoscopy indication whose examination is scheduled in room 4, on a Monday and Tuesday shift (8:30 a.m. - 1:30 p.m.) * Male or female of legal age at the time the colonoscopy is ordered * Patient willing to participate in the study * Person affiliated with or benefiting from a social security plan
Exclusion criteria
* Pregnant woman * Patient of legal age under guardianship or protected person * Patient requiring indigo-carmine chromoendoscopy * Patient requiring an emergency colonoscopy * Patient not affiliated to the social security system
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of back contamination | inclusion visit | Rate of back contamination after colonoscopy using the EBM procedure. The absence of retro-contamination is defined as the absence of fecal flora (enterobacteria and fecal streptococci) in the wash bottle during the bacteriological analysis of the EBM microbiological samples taken after each colonoscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Workload | Inclusion visit | Estimation of the workload in minutes, per person involved and for each phase of the reusable vial circuit |
| Satisfaction and acceptability healthcare professionals | Inclusion visit | Evaluation of satisfaction and acceptability among healthcare professionals using the French version of the System Usability Scale (FSUS). |
| Acceptability patient | Inclusion visit | Assessment of patient acceptability of Bacteriologically Controlled Water use by counting the total number of patients offered the study to obtain 40 consents |
| Infectious episode | DAY 1 VISIT AND DAY 7 VISIT | Monitoring the occurrence of an infectious episode (D+1 and D+7) characterized by the occurrence of a fever episode higher than 38.5°C. |
Countries
France
Contacts
Primary ContactArthur BERGER
Backup ContactCaroline ESCLAIR
Outcome results
None listed