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

Not Applicable
Completed
Conditions
Adenoma
Registration Number
NCT02737514
Lead Sponsor
Dalin Tzu Chi General Hospital
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
371
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
adenoma detection rate in the right colonone week
Secondary Outcome Measures
NameTimeMethod
post-procedure discomfort1 day after colonoscopy

pain or distention on a 0 to 10 VAS scale

overall adenoma detection rateone week
30 days complication rate30 days

incidence of bleeding, perforation and unexpected admission

Trial Locations

Locations (2)

Sepulveda Ambulatory Care Center, Veterans Affairs Greater

🇺🇸

North Hills, California, United States

Dalin Tzu Chi General Hospital

🇨🇳

Chia-Yi, Taiwan

Sepulveda Ambulatory Care Center, Veterans Affairs Greater
🇺🇸North Hills, California, United States

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