Carbon dioxide insufflation during colonoscopy can significantly decrease post‐interventional abdominal discomfort in deeply sedated patients: A prospective, randomized, double‐blinded, controlled trial

“…Twenty‐three studies focused on the analysis regarding cecal intubation time. According to our analysis, we did not get any significant results on cecal intubation time.…”

Section: Resultsmentioning

confidence: 99%

Bayesian network meta‐analysis: Efficacy of air insufflation, CO₂ insufflation, water exchange, and water immersion in colonoscopy

Zhang

Sun

et al. 2018

Digestive Endoscopy

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“…CO 2 is absorbed from the bowel more rapidly than air, resulting in a reduction in post‐endoscopic gas volume. Many studies have shown that CO 2 insufflation reduces abdominal pain and distention during and post colonoscopy . Several studies have also demonstrated that CO 2 insufflation is safe and has no significant adverse events .…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent study with moderate sedation found that there was no difference in patient discomfort and satisfaction regarding the procedure sequence . Because carbon dioxide (CO 2 ) is absorbed across the intestines more rapidly than air, CO 2 insufflation has commonly been used in colonoscopies to decrease abdominal discomfort during and e after the procedure . The gas insufflation during EGD‐related difficult colonoscopy intubation might be minimized by applying CO 2 insufflation.…”

Section: Introductionmentioning

confidence: 99%

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

Chen

Cheng

Liu

et al. 2018

J of Gastro and Hepatol

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“…However, few studies have objectively evaluated the level of residual bowel gas following this procedure. Chen et al (39), observed that CO 2 insufflation significantly reduced the volume of residual bowel gas compared with air insufflation following colonoscopy by using abdominal radiography. To the best of our knowledge, the present study is the first to objectively evaluate the degree of bowel distention following colorectal ESD using CT examination.…”

Section: Discussionmentioning

confidence: 99%

Carbon dioxide insufflation reduces residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection

et al. 2018

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Abstract. Quantitative examinations evaluating the effects of CO 2 insufflation on residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection (ESD) are lacking. The present study aimed to assess whether CO 2 insufflation could decrease the amount of residual gas in the gastrointestinal tract following ESD in patients with colorectal neoplasms. Computed tomography (CT) was used to objectively examine whether CO 2 insufflation during colorectal ESD reduced residual gas levels in the gastrointestinal tract following ESD. A total of 83 patients who underwent colorectal ESD between January and December 2009 at Gifu University Hospital (Gifu, Japan) were enrolled. Following exclusion of 17 patients with chronic pulmonary dysfunction, 66 patients were randomized into a CO 2 insufflation group (n=34) and an air insufflation group (n=32). The level of residual gas and the presence of transmural and free-air leaks following ESD were evaluated in both groups using CT. Transcutaneous CO 2 tension (PtcCO 2 ) and ESD-related complications were also compared between the groups. CT measurements of the major and minor axes of the cecal lumen, and of the terminal ileum diameter, indicated the level of residual gas following ESD to be significantly reduced in the CO 2 insufflation group compared with the air insufflation group (P<0.001). Neither the incidences of ESD-related complications, including post-procedure hemorrhage and air leak, nor the abnormalities in vital signs differed between the groups. No significant between-group differences were identified in the baseline and peak PtcCO 2 levels during ESD or in the median PtcCO 2 following ESD. In conclusion, CO 2 insufflation during colorectal ESD was effective in reducing residual gas in the gastrointestinal tract following ESD. IntroductionColorectal cancer is among the most prevalent malignancies worldwide, and therefore effective and minimally invasive procedures are required to reduce the incidence rate of this malignancy (1,2). More recently, utilization of colorectal endoscopic submucosal dissection (ESD) as a minimally invasive treatment for en bloc resection of large superficial neoplasms has become a favored method (3). However, the risk of complication is higher than in gastric ESD as the wall of the colon is thin and operability is limited. In addition, colorectal ESD generally requires a long procedure time due to its technical difficulty (4,5). Therefore, a high level of gas enters the colonic lumen. This is associated with aggravation of subjective symptoms, such as abdominal pain, discomfort and distention, and an increased risk of severe problems, including pneumoderma, pneumothorax, abdominal compartment syndrome and air embolism (6)(7)(8)(9)(10)(11)(12)(13)(14).The safety and efficacy of CO 2 insufflation during ESD for lesions of the esophagus and stomach have been demonstrated in several randomized controlled trials (15-21). A pilot study also reported that CO 2 insufflation was safe and effective during colorectal ES...

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Carbon dioxide insufflation during colonoscopy can significantly decrease post‐interventional abdominal discomfort in deeply sedated patients: A prospective, randomized, double‐blinded, controlled trial

Abstract: Compared with air, CO2 insufflation during colonoscopy reduced postcolonoscopy abdominal discomfort and improved patients' satisfaction. It was safe to use CO2 insufflation in deeply sedated colonoscopy.

Cited by 21 publications

References 18 publications

Bayesian network meta‐analysis: Efficacy of air insufflation, CO₂ insufflation, water exchange, and water immersion in colonoscopy

Bayesian network meta‐analysis: Efficacy of air insufflation, CO₂ insufflation, water exchange, and water immersion in colonoscopy

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

Carbon dioxide insufflation reduces residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection

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Carbon dioxide insufflation during colonoscopy can significantly decrease post‐interventional abdominal discomfort in deeply sedated patients: A prospective, randomized, double‐blinded, controlled trial

Abstract: Compared with air, CO2 insufflation during colonoscopy reduced postcolonoscopy abdominal discomfort and improved patients' satisfaction. It was safe to use CO2 insufflation in deeply sedated colonoscopy.

Cited by 21 publications

References 18 publications

Bayesian network meta‐analysis: Efficacy of air insufflation, CO2 insufflation, water exchange, and water immersion in colonoscopy

Bayesian network meta‐analysis: Efficacy of air insufflation, CO2 insufflation, water exchange, and water immersion in colonoscopy

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

Carbon dioxide insufflation reduces residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection

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Bayesian network meta‐analysis: Efficacy of air insufflation, CO₂ insufflation, water exchange, and water immersion in colonoscopy

Bayesian network meta‐analysis: Efficacy of air insufflation, CO₂ insufflation, water exchange, and water immersion in colonoscopy