DDW "Cutting Edge" Colonoscopy Techniques 2011 State-of-the-Art Lecture: Warm water infusion/CO2 insufflation for colonoscopy

Leung, Felix W.; Leung, Joseph; Mann, Surinder K; Friedland, Shai; Ramirez, Francisco C.; Ólafsson, Snorri

doi:10.4161/jig.1.2.16830

Cited by 15 publications

(15 citation statements)

References 28 publications

(26 reference statements)

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“…Great attention was also paid to the adenoma detection rate, because, in our previous study, it was unexpectedly lower in colonoscopies performed with WWi, although this difference was not statistically significant for advanced adenomas. this finding was not confirmed by several us studies, [11][12][13][14] conversely suggesting that a higher adenoma detection rate might be observed in WWi patients. the present study did not show any significant difference concerning either the prevalence of polyps or adenomas across the 3 groups, but conclusive data are still needed to allow a final comparison of the benefits of WWi and Co 2 .…”

Section: Discussioncontrasting

confidence: 77%

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Carbon Dioxide Insufflation or Warm-Water Infusion Versus Standard Air Insufflation for Unsedated Colonoscopy

Amato

Radaelli

Paggi

et al. 2013

Diseases of the Colon &Amp; Rectum

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Carbon dioxide insufflation was associated with a decrease in the proportion of patients requesting on-demand sedation, improved patient tolerance, and decreased colonoscopy-related pain in comparison with air insufflation. The findings regarding warm-water irrigation confirmed the previously reported advantages, so that warm-water irrigation and carbon dioxide insufflation could represent competitive strategies for colonoscopy in unsedated patients.

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Section: Discussioncontrasting

confidence: 77%

“…18,19 the combination of warm water in the insertion phase and Co 2 in the withdrawal of the examination seems to be the most fascinating item to be investigated in the future to further improve the acceptance and tolerability of colonoscopy. 12 …”

Section: Discussionmentioning

confidence: 97%

Carbon Dioxide Insufflation or Warm-Water Infusion Versus Standard Air Insufflation for Unsedated Colonoscopy

Amato

Radaelli

Paggi

et al. 2013

Diseases of the Colon &Amp; Rectum

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“…[39][40][41][42][43] Water immersion entails distention of the colon by infused water, which is removed predominantly during withdrawal. On the other hand, the explicit goal of developing a less painful method 5,14 for use in scheduled, unsedated patients [44][45][46][47] necessitated the exclusion of air during insertion.…”

Section: Discussionmentioning

confidence: 99%

Water-aided colonoscopy: a systematic review

Leung

Amato

Ell

et al. 2012

Gastrointestinal Endoscopy

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121

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“…The use of the water technique was first reported by Falchuk and Griffin [9]. Warm water infusion in lieu of air insufflation for aiding colonoscope insertion has been evaluated systematically by Leung et al [4,5]. Beneficial effects of the water method on patient comfort and safety have been well documented in sedated [10], minimally sedated [8], on-demand sedated [11], and unsedated patients [12,13], predominantly in male veterans, and in patients examined by both experienced and trainee endoscopists [8].…”

Section: Discussionmentioning

confidence: 99%

“…Water infusion in lieu of air insufflation during instrument insertion has been documented to decrease intraprocedural discomfort. The main reason is the reduced lengthening and angulation of the colon and thus diminished looping of the instrument, particularly in the sigmoid colon [4,5]. Carbon dioxide (CO 2 ) insufflation instead of air during colonoscopy leads to a rapid absorption of gas from the lumen and thus decreases abdominal distention and associated discomfort [6].…”

Section: Introductionmentioning

confidence: 99%

Combination of water immersion and carbon dioxide insufflation for minimal sedation colonoscopy

Falt¹,

Liberda²,

Smajstrla³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Objective Water immersion insertion and carbon dioxide (CO 2 ) insufflation, as alternative colonoscopic techniques, are able to reduce patient discomfort during and after the procedure. We assessed whether the combination of water immersion and CO 2 insufflation is superior in efficacy and patient comfort to other colonoscopic techniques.Methods In a prospective, randomized study, a total of 420 patients were randomized to either water immersion insertion and CO 2 insufflation during withdrawal (water/ CO 2 ), water insertion and air insufflation during withdrawal (water/air), CO 2 insufflation during both insertion and withdrawal (CO 2 /CO 2 ), or air insufflation during both insertion and withdrawal (air/air). The main outcome was the success of minimal sedation colonoscopy, which was defined as reaching the cecum without switching to another insertion method and without additional sedation beyond the initial 2 mg of midazolam. Patient comfort during and after the procedure was assessed.Results A total of 404 patients were analyzed. The success rate of minimal sedation colonoscopy in the water insertion arm (water/CO 2 and water/air) was 97% compared with 83.3% in the gas insertion arm (CO 2 /CO 2 and air/air; P < 0.0001). Intraprocedural pain and bloating were significantly lower in the water/CO 2 group than in all other groups. Patient discomfort in the water/CO 2 group during 24 h after the procedure was comparable with that in the CO 2 /CO 2 group and significantly lower than that in the air groups (water/air and air/air). No complications were recorded during the study. ConclusionThe combination of water immersion and CO 2 insufflation appears to be an effective and safe method for minimal sedation colonoscopy. Overall patient discomfort was significantly reduced compared with that in other techniques. Eur J Gastroenterol Hepatol 24:971-977 c

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DDW "Cutting Edge" Colonoscopy Techniques 2011 State-of-the-Art Lecture: Warm water infusion/CO2 insufflation for colonoscopy

Cited by 15 publications

References 28 publications

Carbon Dioxide Insufflation or Warm-Water Infusion Versus Standard Air Insufflation for Unsedated Colonoscopy

Carbon Dioxide Insufflation or Warm-Water Infusion Versus Standard Air Insufflation for Unsedated Colonoscopy

Water-aided colonoscopy: a systematic review

Combination of water immersion and carbon dioxide insufflation for minimal sedation colonoscopy

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