Inspection on instrument insertion during colonoscopy: A randomized controlled trial

David G. Hewett, Douglas K. Rex

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. Objective: To investigate the impact of additional inspection during instrument insertion on adenoma detection in sedated patients undergoing routine screening or surveillance colonoscopy. Design: Randomized, controlled trial. Setting: University hospital and associated ambulatory surgery center. Patients: Patients undergoing elective screening or surveillance colonoscopy. Intervention: Patients were randomized to undergo colonoscopy with 3 minutes of dedicated inspection time during insertion plus 6 minutes during withdrawal versus 9 minutes of inspection on instrument withdrawal. Main Outcome Measurements: The primary outcome measure was the adenoma detection rate (proportion of patients with adenomas) between patients in whom inspection for adenomas was performed partly on instrument insertion compared with patients for whom inspection was performed entirely on withdrawal. Results: There was no difference in the proportion of patients with 1 or more adenomas between the inspection on insertion group (52%) and the inspection on withdrawal group (58%). There were no significant differences in total procedure time, time taken to remove polyps, sedation doses, or after-procedure pain between groups. Limitations: Single-center study with two endoscopists. Conclusion: Inspection during colonoscope insertion offered no additional benefit compared with an equivalent period of inspection performed entirely during withdrawal. These results do not support an additional role for routine inspection during colonoscope insertion. (Clinical trial registration number: NCT01035775.)

Original languageEnglish (US)
Pages (from-to)381-387
Number of pages7
JournalGastrointestinal endoscopy
Volume76
Issue number2
DOIs
StatePublished - Aug 1 2012

Fingerprint

Colonoscopy
Randomized Controlled Trials
Adenoma
Colonoscopes
Polyps
Ambulatory Surgical Procedures
Outcome Assessment (Health Care)
Clinical Trials
Pain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Inspection on instrument insertion during colonoscopy : A randomized controlled trial. / Hewett, David G.; Rex, Douglas K.

In: Gastrointestinal endoscopy, Vol. 76, No. 2, 01.08.2012, p. 381-387.

Research output: Contribution to journalArticle

Hewett, David G. ; Rex, Douglas K. / Inspection on instrument insertion during colonoscopy : A randomized controlled trial. In: Gastrointestinal endoscopy. 2012 ; Vol. 76, No. 2. pp. 381-387.
@article{f7dc3396f916409dbafec8771791136e,
title = "Inspection on instrument insertion during colonoscopy: A randomized controlled trial",
abstract = "Background: Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. Objective: To investigate the impact of additional inspection during instrument insertion on adenoma detection in sedated patients undergoing routine screening or surveillance colonoscopy. Design: Randomized, controlled trial. Setting: University hospital and associated ambulatory surgery center. Patients: Patients undergoing elective screening or surveillance colonoscopy. Intervention: Patients were randomized to undergo colonoscopy with 3 minutes of dedicated inspection time during insertion plus 6 minutes during withdrawal versus 9 minutes of inspection on instrument withdrawal. Main Outcome Measurements: The primary outcome measure was the adenoma detection rate (proportion of patients with adenomas) between patients in whom inspection for adenomas was performed partly on instrument insertion compared with patients for whom inspection was performed entirely on withdrawal. Results: There was no difference in the proportion of patients with 1 or more adenomas between the inspection on insertion group (52{\%}) and the inspection on withdrawal group (58{\%}). There were no significant differences in total procedure time, time taken to remove polyps, sedation doses, or after-procedure pain between groups. Limitations: Single-center study with two endoscopists. Conclusion: Inspection during colonoscope insertion offered no additional benefit compared with an equivalent period of inspection performed entirely during withdrawal. These results do not support an additional role for routine inspection during colonoscope insertion. (Clinical trial registration number: NCT01035775.)",
author = "Hewett, {David G.} and Rex, {Douglas K.}",
year = "2012",
month = "8",
day = "1",
doi = "10.1016/j.gie.2012.04.454",
language = "English (US)",
volume = "76",
pages = "381--387",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Inspection on instrument insertion during colonoscopy

T2 - A randomized controlled trial

AU - Hewett, David G.

AU - Rex, Douglas K.

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Background: Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. Objective: To investigate the impact of additional inspection during instrument insertion on adenoma detection in sedated patients undergoing routine screening or surveillance colonoscopy. Design: Randomized, controlled trial. Setting: University hospital and associated ambulatory surgery center. Patients: Patients undergoing elective screening or surveillance colonoscopy. Intervention: Patients were randomized to undergo colonoscopy with 3 minutes of dedicated inspection time during insertion plus 6 minutes during withdrawal versus 9 minutes of inspection on instrument withdrawal. Main Outcome Measurements: The primary outcome measure was the adenoma detection rate (proportion of patients with adenomas) between patients in whom inspection for adenomas was performed partly on instrument insertion compared with patients for whom inspection was performed entirely on withdrawal. Results: There was no difference in the proportion of patients with 1 or more adenomas between the inspection on insertion group (52%) and the inspection on withdrawal group (58%). There were no significant differences in total procedure time, time taken to remove polyps, sedation doses, or after-procedure pain between groups. Limitations: Single-center study with two endoscopists. Conclusion: Inspection during colonoscope insertion offered no additional benefit compared with an equivalent period of inspection performed entirely during withdrawal. These results do not support an additional role for routine inspection during colonoscope insertion. (Clinical trial registration number: NCT01035775.)

AB - Background: Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. Objective: To investigate the impact of additional inspection during instrument insertion on adenoma detection in sedated patients undergoing routine screening or surveillance colonoscopy. Design: Randomized, controlled trial. Setting: University hospital and associated ambulatory surgery center. Patients: Patients undergoing elective screening or surveillance colonoscopy. Intervention: Patients were randomized to undergo colonoscopy with 3 minutes of dedicated inspection time during insertion plus 6 minutes during withdrawal versus 9 minutes of inspection on instrument withdrawal. Main Outcome Measurements: The primary outcome measure was the adenoma detection rate (proportion of patients with adenomas) between patients in whom inspection for adenomas was performed partly on instrument insertion compared with patients for whom inspection was performed entirely on withdrawal. Results: There was no difference in the proportion of patients with 1 or more adenomas between the inspection on insertion group (52%) and the inspection on withdrawal group (58%). There were no significant differences in total procedure time, time taken to remove polyps, sedation doses, or after-procedure pain between groups. Limitations: Single-center study with two endoscopists. Conclusion: Inspection during colonoscope insertion offered no additional benefit compared with an equivalent period of inspection performed entirely during withdrawal. These results do not support an additional role for routine inspection during colonoscope insertion. (Clinical trial registration number: NCT01035775.)

UR - http://www.scopus.com/inward/record.url?scp=84864141572&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864141572&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2012.04.454

DO - 10.1016/j.gie.2012.04.454

M3 - Article

C2 - 22817789

AN - SCOPUS:84864141572

VL - 76

SP - 381

EP - 387

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 2

ER -