A randomized controlled trial comparing right and left lateral decubitus starting position on outcomes in colonoscopy

Greene, Alison; Borgoankar, Mark; Hodgkinson, Kathy; Garland, Chantae; Bacque, Lisa; Pace, David

doi:10.1007/s00464-020-07661-x

Cited by 3 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mocanu et al [ 33 ] reported no significant difference in pain scores (RL 3.92 vs. LL 3.94, P=0.05). Greene et al [ 15 ] also reported no significant difference in pain scores (RL 3.20 vs. LL 2.55, P=0.078), though this study used the Nurse-Assessed Patient Comfort Score. None of the studies reported any adverse outcomes following RL or LL starting body positions.…”

Section: Resultsmentioning

confidence: 92%

“…From an initial total of 558 studies, 535 records were screened after deduplication and 16 full-length articles were assessed. Five studies were included in the final meta-analysis [ 15 , 30 - 33 ]. Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Additional details of study characteristics with patient demographics are summarized in Table 1 . Four studies [ 15 , 30 - 32 ] were published as full manuscript publications while 1 study [ 33 ] was published in abstract format. Each study was from a geographically different location: the United Kingdom [ 30 ], Mexico [ 31 ], Canada [ 15 ], Indonesia [ 32 ], and Portugal [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [ 15 , 30 - 32 ] were published as full manuscript publications while 1 study [ 33 ] was published in abstract format. Each study was from a geographically different location: the United Kingdom [ 30 ], Mexico [ 31 ], Canada [ 15 ], Indonesia [ 32 ], and Portugal [ 33 ]. A detailed assessment of study quality is given in .…”

Section: Resultsmentioning

confidence: 99%

“…RL has been most studied compared to other starting positions. Recently, Greene et al randomized 94 patients to RL and 91 patients to LL starting positions for colonoscopy [ 15 ]. It was proposed that air would preferentially fill the left colon with an RL starting position, thus increasing luminal distention and improving navigation through the large bowel.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of left versus right lateral starting position on colonoscopy: a systematic review and meta-analysis of randomized controlled trials

Ramai

Singh

Brooks

et al. 2021

aog

View full text Add to dashboard Cite

Background Modifying patient position during colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distention and improve navigation through the large bowel. The left lateral (LL) decubitus starting position is commonly used during colonoscopy. However, reports indicate that other starting positions may offer additional benefit. We aimed to determine if the right lateral (RL) starting position compared to the standard LL starting position could improve outcomes in colonoscopy. Methods We searched PubMed, Medline, and EMBASE through June 2020 to identify studies comparing RL and LL starting positions during colonoscopy. The primary outcomes included mean cecal insertion time and cecal intubation rate, and adverse events were assessed by pooling data using a random-effects model expressed in terms of odds ratio (OR), mean difference, and 95% confidence interval (CI). Results We identified 5 randomized controlled trials, including 809 participants, that compared LL vs. RL colonoscopy. The pooled OR for cecal intubation rate was 1.3 (95%CI 0.8-2.3; P=0.3). The mean difference in mean cecal insertion time was 0.08 (95%CI -0.09 to 0.26; P=0.4). Heterogeneity between studies was low ( I 2 =0%). No complications were reported in either arm of the study. Pain scores assessed using a visual analog scale were comparable among both arms of the study. Conclusion The RL starting position for colonoscopy was comparable to the LL and offered no additional benefit in terms of cecal intubation time, intubation rate, or patient discomfort.

show abstract

Section: Resultsmentioning

confidence: 92%