A prospective randomized study of the use of an ultrathin colonoscope versus a pediatric colonoscope in sedation-optional colonoscopy

Sato, Koichiro; Ito, Sayo; Kitagawa, Tomoyuki; Hirahata, Koichi; Hihara, Daisuke; Tominaga, Kenji; Yasuda, Ichiro; Maetani, Iruru

doi:10.1007/s00464-017-5581-2

Cited by 11 publications

(9 citation statements)

References 36 publications

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“…Various modifications and improvements in endoscopes and related equipment, such as variable-stiffness colonoscopies 1,2) , ultrathin colonoscopies [10][11][12] , passive bending endoscopes 13) , and double balloon enteroscopes 14) , have been developed to facilitate colonoscope insertion. Specifically, endoscopes with adjustable stiffness capabilities are widely used.…”

Section: Discussionmentioning

confidence: 99%

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Kikuchi

Kimura

Nomura

et al. 2019

J Anus Rectum Colon

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Objectives: The variable-stiffness colonoscope is reportedly useful for making colonoscope insertion easier. However, this function is not associated with all colonoscopes. We developed a variable-stiffness stylet that can be inserted into the endoscope instrumentation channel to change the rigidity of the endoscope. Methods: We developed a stylet with adjustable stiffness and investigated its utility in colonoscope insertion using an ex-vivo model. Four endoscopists performed 24 colonoscope insertions, alternating between using the stylet (Stylet method) and the conventional method. We assessed insertion rate, rate of applying abdominal compression, and insertion time between the two groups. Results: In all procedures, the endoscope was inserted up to the cecum. There were significantly fewer external abdominal compressions with the Stylet method (1/12, 8.3%) compared to the conventional method (6/12, 50%). The insertion time was shorter with the Stylet method (140.9 ± 53.7 s) compared to the conventional method (181.3 ± 64.9 s). Conclusions: Using the variable-stiffness stylet, currently under development, resulted in significantly fewer external abdominal compressions and tended to have shorter insertion time.

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Section: Discussionmentioning

confidence: 99%

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Kikuchi

Kimura

Nomura

et al. 2019

J Anus Rectum Colon

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“…In our study, there was no significant difference in the ADR between the PEG group and PEG-Asc group. An ADR >20% satisfies the benchmark for screening colonoscopy in the current literature [ 22 ]. Since the ADR has been shown to be an important measure of the ability of colonoscopy to decrease the future incidence and mortality from CRC [ 21 ], the finding of the similarity of ADR between the 2 groups is certainly reassuring.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Acceptability of 1 Liter of Polyethylene Glycol with Ascorbic Acid vs. 2 Liters of Polyethylene Glycol Plus Mosapride and Sennoside for Colonoscopy Preparation

et al. 2018

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BackgroundBowel preparation is an important factor for an optimal outcome of colonoscopy. Recently, polyethylene glycol (PEG) solution has been in common use for bowel cleansing for colonoscopy, but some patients are intolerant of PEG because of taste or volume. A low-volume PEG administered with ascorbic acid solution (PEG-Asc) was designed to improve tolerability, but the administration of this method is more complex than that with PEG alone. This study aimed to compare bowel cleansing efficacy, safety, and tolerability of 1 L PEG-Asc with a 2 L PEG preparation with use of sennosides and mosapride.Material/MethodsThis was a prospective, single-center, non-inferiority trial that included 112 patients (PEG-Asc group, 68; PEG group, 44). The primary endpoint was the efficacy of colon cleansing assessed by endoscopists using a validated 4-point scale according to the Aronchick scale and was verified by a blinded investigator. Acceptability, tolerability, and adenoma detection rate (ADR) of these 2 regimens were secondary endpoints.ResultsWe found no statistically significant differences between the groups in colon-cleansing efficacy or in the adenoma detection rate (ADR). Moreover, overall, patients significantly favored PEG-Asc over PEG, reflecting better acceptance of PEG-Asc. Additionally, more patients favored PEG-Asc over PEG for a hypothetical future colonoscopy.ConclusionsThe alternate 1 L PEG-Asc regimen and standard 2 L PEG regimen were clinically equivalent with respect to cleansing efficacy, safety, and ADR, and more patients favored PEG-Asc than PEG. This alternate regimen may improve patient compliance and acceptance of surveillance colonoscopy.

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“…The ultrathin colonoscope (UTC) is not only very slim (outer diameter 9.2 mm) but also has novel functional technology, featuring responsive insertion technology with passive‐bending and high‐force transmission. The pain‐relieving effects of UTC have been demonstrated in randomized controlled trials 7,8,10–12 . Its usefulness in patients with Crohn's disease complicated by colonic stenosis has also been reported 13 .…”

Section: Introductionmentioning

confidence: 97%

“…The pain-relieving effects of UTC have been demonstrated in randomized controlled trials. 7,8,[10][11][12] Its usefulness in patients with Crohn's disease complicated by colonic stenosis has also been reported. 13 However, there has been no large cohort study to evaluate the usefulness of ultrathin colonoscopy in stenotic CRC patients.…”

Section: Introductionmentioning

confidence: 99%

Ultrathin colonoscopy can improve complete preoperative colonoscopy for stenotic colorectal cancer: Prospective observational study

Ito

Imai

Kishida

et al. 2020

Digestive Endoscopy

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Objectives: Preoperative colonoscopy is often incomplete for stenotic colorectal cancers (CRC). This prospective observational study aimed to evaluate the ability of an ultrathin colonoscope (UTC) to inspect the whole colon by passing through the stenotic CRC.Methods: All patients who underwent preoperative colonoscopy for stenotic CRCs at Shizuoka Cancer Center were examined for eligibility. If a standard colonoscope (PCF-H290ZI) could not pass because of a stenosis, the patients were recruited. All of the eligible patients were prospectively enrolled when informed consent could be obtained, and complete colonoscopy was attempted again using an UTC (PCF-PQ260L). Patients with stent placement and those requiring right hemicolectomy were not recruited. Primary endpoints were pass-through and cecal intubation rates. The detected synchronous neoplasias (adenomas and cancers) and their pathological findings after resection were evaluated.Results: A total of 100 patients were enrolled between September 2017 and February 2019. The mean age was 65.6 AE 10.8 years, and 59% were male. The pass-through and cecal intubation rates were 67% (67/100) and 58% (58/100), respectively. Synchronous lesions located proximal to the stenoses were detected in 65.5% (38/58) of the complete colonoscopies, with a total of 86 lesions, including 18 advanced neoplasias with three invasive cancers. Conclusion:When standard colonoscopy cannot pass through stenotic CRC, ultrathin colonoscopy can be considered as an option to inspect the whole colon proximal to the stenosis because treatment strategy can potentially be changed by detecting synchronous neoplasias proximal to the stenosis before surgery. (UMIN000028505)

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A prospective randomized study of the use of an ultrathin colonoscope versus a pediatric colonoscope in sedation-optional colonoscopy

Abstract: Compared with a pediatric colonoscope, the UTC was associated with reduced overall and maximum pain during colonoscopy, with no difference in ADR.

Cited by 11 publications

References 36 publications

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Efficacy and Acceptability of 1 Liter of Polyethylene Glycol with Ascorbic Acid vs. 2 Liters of Polyethylene Glycol Plus Mosapride and Sennoside for Colonoscopy Preparation

Ultrathin colonoscopy can improve complete preoperative colonoscopy for stenotic colorectal cancer: Prospective observational study

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