Minimal water exchange colonoscopy

Yeh, Jen‐Hao; Chien, Hsi‐Yuan

doi:10.1016/j.vgie.2018.11.001

Cited by 3 publications

(9 citation statements)

References 4 publications

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“…which theoretically retains the advantages of water exchange colonoscopy and is more convenient because of the elimination of an additional irrigation pump and optimization of the procedure for insertion. Moreover, for acute angles or segments with multiple diverticula, MWE may be safer than WE [14]. However, few studies have compared the two methods, and there are no data on whether MWE is comparable with LWE colonoscopy.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…There were few studies investigating the operation of minimal water exchange colonoscopy. To standardize the performance of the MWE colonoscopy proposed by Jen-Hao Yeh [14], we watched the video tutorial carefully and practiced repeatedly to ensure that the endoscopist mastered the skill.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…All patients were in the left decubitus position at the beginning of colonoscopy. The insertion method used for the MWE group was according to the literature by Jen-Hao Yeh et al [14]. First, we suctioned the lumen and infused water at a constant pressure on the air-water valve button of the endoscope with a forefinger at the rectum to open the lumen.…”

Section: Study Proceduresmentioning

confidence: 99%

“…All patients were in the left decubitus position at the beginning of colonoscopy. The insertion method used for the MWE group was according to the literature by Yeh and Chien [14] (▶ Fig. 1, ▶ Video 1).…”

Section: Study Proceduresmentioning

confidence: 99%

“…Yeh and Chien recently developed a new technique, minimal water exchange (MWE), which only infuses water into the left colon at constant pressure through the air-water valve provided by the colonoscope [14], which theoretically retains the advantages of water exchange colonoscopy and is more convenient because of the elimination of an additional irrigation pump and optimization of the procedure for insertion. Moreover, for acute angles or segments with multiple diverticula, MWE may be safer than water exchange [14]. However, few studies have compared the two methods, and there are no data demonstrating whether MWE is comparable to LWE colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

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Minimal water exchange by the air–water valve versus left colon water exchange in unsedated colonoscopy: a randomized controlled trial

et al. 2022

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Background and Objective: Water exchange colonoscopy is the least painful method for unsedated colonoscopies. Simplified left water exchange (LWE) reduced the cecal intubation time, but it was difficult to avoid the use of an additional pump. Minimal water exchange (MWE) is an improved novel method that eliminates the need for pumps, but it is not clear whether MWE has the same efficiency as LWE. Methods: This was a prospective, randomized controlled, non-inferiority trial conducted in a tertiary hospital. Enrolled patients were randomized 1:1 to the LWE group and MWE group. The primary outcome was recalled insertion pain measured by a 4-point verbal rating scale, and the secondary outcomes mainly included adenoma detection rate (ADR), cecal intubation time, the volume of water used, and the willingness to undergo unsedated colonoscopy. Results: A total of 226 patients were included (LWE, n = 113 and MWE, n = 113). The MWE showed non-inferior moderate/severe pain rates compared with the LWE (10.6% vs. 9.7%), with a difference of 0.9% (99% confidence interval [CI], [-9.5, 11.3]; threshold, 15%). ADR, cecal intubation time and willingness were not significantly different between the two groups, but the mean water used (volume) in the MWE was significantly less than in the other (163.7 ml vs. 407.2 ml, 99% CI [-298.28, -188.69]). Conclusion: Compared to LWE, MWE demonstrated a non-inferior outcome for insertion pain, and comparable cecal intubation time and ADR, but reduced the volume of water used and eliminated the need for a water pump.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Minimal water exchange by the air–water valve versus left colon water exchange in unsedated colonoscopy: a randomized controlled trial

et al. 2022

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Minimal water exchange with gel immersion: A safe and useful method to secure the visual field during balloon enteroscopy‐assisted endoscopic retrograde cholangiography

Yokoyama

Miwata

Yano

et al. 2022

J Hepato Biliary Pancreat

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Advancements in endoscopic management of small-bowel polyps in Peutz–Jeghers syndrome and familial adenomatous polyposis

Funayama,

Shinozaki,

Yano

et al. 2023

Therap Adv Gastroenterol

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Before the development of double-balloon enteroscopy (DBE), the standard management of small-bowel polyposis was surgical resection. This is an invasive procedure that could lead to short bowel syndrome. In the 21st century, several new enteroscopy techniques were distributed worldwide, including DBE, single-balloon enteroscopy, spiral enteroscopy, and motorized spiral enteroscopy. These devices enable the diagnoses and endoscopic interventions in the entire small bowel, even in patients with a history of laparotomy. In patients with Peutz–Jeghers syndrome (PJS), endoscopic ischemic polypectomy with clips or a detachable snare is the preferred method for managing pedunculated polyps because it is less likely to cause adverse events than conventional polypectomy. Although polyps in patients with PJS always recur, repeat endoscopic resection can reduce the total number and mean size of polyps in the long-term clinical course. Endoscopic reduction of small-bowel intussusception caused by PJS polyps can be successfully performed using DBE without surgery. A transparent hood is useful for securing a visual field during the treatment of small-bowel polyps, and minimal water exchange method is recommended to facilitate deep insertion. Familial adenomatous polyposis (FAP) is a genetic disorder that increases the risk of developing colorectal cancer. Because jejunal and ileal polyps in patients with FAP have the potential to develop into cancer via the adenoma–carcinoma sequence, periodical surveillance, and endoscopic resection are needed for them, not only polyps in the duodenum. In cases of multiple small-bowel polyps in patients with FAP, cold snare polypectomy without retrieval is an acceptable treatment option for polyps that are 10 mm or smaller in size. Additional good pieces of evidence are necessary to confirm these findings because this narrative review mostly includes retrospective observational studies from single center, case reports, and expert reviews.

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Minimal water exchange colonoscopy

Cited by 3 publications

References 4 publications

Minimal water exchange by the air–water valve versus left colon water exchange in unsedated colonoscopy: a randomized controlled trial

Minimal water exchange by the air–water valve versus left colon water exchange in unsedated colonoscopy: a randomized controlled trial

Minimal water exchange with gel immersion: A safe and useful method to secure the visual field during balloon enteroscopy‐assisted endoscopic retrograde cholangiography

Advancements in endoscopic management of small-bowel polyps in Peutz–Jeghers syndrome and familial adenomatous polyposis

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