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Water-only Versus Water-CO2 (Hybrid) Colonoscopy Insertion Technique

Not Applicable
Completed
Conditions
Colon Polyp
Registration Number
NCT04710706
Lead Sponsor
London North West Healthcare NHS Trust
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).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
246
Inclusion Criteria
  • Aged 18 years or older
  • Capacity to consent
Exclusion Criteria
  • Pregnancy
  • Previous bowel surgery
  • Unable to consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Insertion timeDuring procedure

Time taken to insert the colonoscope

Total procedure timeDuring procedure

Time taken to insert and withdraw the colonoscope

Secondary Outcome Measures
NameTimeMethod
Caecal intubation rateDuring procedure

The proportion of procedures where the caecum is reached

Patient discomfort scoresImmediately 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.

Loop formationDuring procedure

Scopeguide appearance will be used to evaluate number of loops formed

Adenoma detection rate1 week after procedure with results of histology

A measure of the number of adenomas detected during colonoscopy

Serrated polyp detection rate1 week after procedure with results of histology

A measure of the number of serrated polyps detected during colonoscopy

Number of ancilliary proceduresDuring procedure

The number of patient repositions and abdominal pressure episodes required during the procedure

Trial Locations

Locations (1)

St Mark's Hospital

🇬🇧

Harrow, United Kingdom

St Mark's Hospital
🇬🇧Harrow, United Kingdom

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