Does a Fitted Abdominal Corset Makes Colonoscopy More Tolerable?

Toros, Ahmet Burak; Ersöz, Feyzullah; Ozcan, Ozhan

doi:10.1111/j.1443-1661.2011.01207.x

Cited by 16 publications

(23 citation statements)

References 15 publications

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“…In a more recent Turkish study, 216 patients undergoing colonoscopy were randomized to receive either an “abdominal corset” or a conventional procedure. 23 The investigators reported reduced CIT in the intervention arm (7.9 minutes vs. 11.4 minutes, p=0.001) as well as decreased frequency of ancillary maneuvers. Additionally, patient pain scores were significantly reduced in the corset arm.…”

Section: Discussionmentioning

confidence: 93%

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Use of an Abdominal Compression Device in Colonoscopy: A Randomized, Sham-Controlled Trial

Crockett

Cirri

Kelapure

et al. 2016

Clinical Gastroenterology and Hepatology

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Background & Aims Looping is a common problem during colonoscopy that prolongs procedure time. We aimed to determine the efficacy and safety of ColoWrap, an external abdominal compression device, with respect to insertion time and other procedural outcomes. Methods We performed a prospective study of outpatients undergoing elective colonoscopy (40–80 years old; mean age, 60.5 years) at endoscopy facilities in the University of North Carolina Hospitals, from April 2013 through March 2014. Subjects were randomly assigned to groups that received either ColoWrap (n=175) or a sham device (control, n=175) during colonoscopy. Colonoscopists and staff were blinded to the application. The primary outcome was cecal intubation time (CIT). Secondary outcomes included use of manual pressure and position change. Results The mean CIT was similar for the control and ColoWrap groups (6.69 min vs 6.67 min; P=.98). There were no statistical differences between groups in the frequency of manual pressure (45% for controls vs 37% for ColoWrap group, P=.13) or position changes (4% for controls vs 2% for ColoWrap group, P=.36) between groups. Among patients with body mass index of 30–40 (n=78), CIT was significantly lower for patients who underwent ColoWrap (4.69 min) than controls (6.10 min) (P=.03). Adverse events were similar between groups. Conclusions In patients undergoing elective colonoscopy, application of an external abdominal compression device did not improve CIT or affect the frequency of ancillary maneuvers. It appears to benefit patients with body mass indices of 30–40, but further studies are needed. ColoWrap appears to be safe and could reduce looping in a subgroup of patients undergoing colonoscopy. ClinicalTrials.gov no: NCT02025504

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Section: Discussionmentioning

confidence: 93%

“…23, 24 In a randomized, unblinded Japanese study of 212 patients, the use of an “abdominal bandage” was found to reduce patient-reported pain at a statistically significant level (p=0.03). 24 There was, however, no significant difference in cecal intubation rate between groups.…”

Section: Discussionmentioning

confidence: 99%

Use of an Abdominal Compression Device in Colonoscopy: A Randomized, Sham-Controlled Trial

Crockett

Cirri

Kelapure

et al. 2016

Clinical Gastroenterology and Hepatology

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“…Extra difficulty is added when changing the position of a sedated obese patient. A recent study in which abdominal compression obtained with a fitted corset facilitates colonoscopy reported that extra abdominal compression and a change of position was used less frequently in the study subjects accompanied by less procedural pain [21]. In contrast, no definite data are available on the effect of a change from standard left lateral decubitus to prone position in facilitating colonoscopy in obese patients.…”

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confidence: 88%

Colonoscopy in Obese Patients: Time to Change Position

Lucendo

2013

Dig Dis Sci

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Improvements in the diagnostic and therapeutic potential of digestive endoscopy over the past few decades have notably increased the number of procedures performed, to the point that endoscopy is now almost considered to be routine. Changes in the epidemiology of colorectal cancer (CRC), which now represents the second leading cause of cancer-related death in America [1] and Europe [2], have also contributed to an increase in colonoscopies, since this procedure is considered the most accurate and effective method for early detection and prevention of CRC and premalignant precursor lesions. Colonoscopic removal of adenomatous polyps was proven to prevent approximately 80 % of CRCs [3,4], and to lower the overall death rate from the disease [5]. In this context, several studies have reported that CRC screening is clinically useful [6] and cost-effective [7] in the average-risk population, significantly reducing mortality [8].Obesity is a well-accepted risk factor for CRC [9,10]; excessive body mass index (BMI) and physical inactivity are interrelated risk factors reported to account for between a fourth and a third of CRCs [11]. BMI is associated with an increased risk of incident CRC in men of all ages and in women between the ages 50-66 [12]. Indeed, excessive BMI is a modifiable risk factor associated with increased risk of adenoma and advanced adenoma recurrence [13]; unfortunately, weight loss has no effect on this risk of recurrence.In this context, and taking into account that obesity has reached epidemic proportions in America [14] and Europe [15], colonoscopy in obese patients represents a challenging issue for endoscopists, with much research focusing on the special features of colonoscopy in this population. For example, while a higher waist circumference has not been associated with a difficult cecal intubation [16][17][18], obesity constitutes an independent predictor of inadequate bowel preparation for colonoscopy [19], although these results were not reproduced when using a sodium picosulphatebased bowel preparation [20]. Furthermore, some endoscopic techniques and maneuvers normally required during the examination, including patient repositioning and the application of abdominal pressure, are more difficult to perform on obese patients. Extra difficulty is added when changing the position of a sedated obese patient. A recent study in which abdominal compression obtained with a fitted corset facilitates colonoscopy reported that extra abdominal compression and a change of position was used less frequently in the study subjects accompanied by less procedural pain [21]. In contrast, no definite data are available on the effect of a change from standard left lateral decubitus to prone position in facilitating colonoscopy in obese patients.This number of Digestive Diseases and Sciences includes a prospective randomized trial by Uddin and colleagues [22] which reports for the first time that starting sedated colonoscopy in prone position for male obese subjects (BMI [ 30 kg/ m 2 ) significantly shortens ...

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“…V jiné práci bandáž na úspěšnost totálních koloskopií vliv neměla, zato snížila bolestivost vyšetření [11]. V poslední studii bandáž zlepšila jak toleranci vyšetření, tak intubační časy a vyšetření vyžadovalo méně manipulací s pacientem [12].…”

Section: Randomizace Výpočet Velikosti Souboru a Statistická Hodnoceníunclassified

Does abdominal compression improve the success rate of and tolerance to colonoscopy?

Kojecký¹,

Havlíčková²,

Gabrielová³

et al. 2019

Gastroent Hepatol

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Souhrn: Úvod: Úspěšnost a tolerance koloskopie souvisí s minimalizací střevní distenze endoskopem. Jedním ze způsobů, jak ji lze zmenšit, je komprese břišní stěny pásem. Cílem práce bylo zhodnotit přínos stažení stěny pásem na průběh koloskopie. Metody: Prospektivní, randomizovaná studie. Porovnávána byla doba do dosažení céka, tolerance a obtížnost vyšetření mezi pacienty s bandáží břicha pásem a bez něj. Výsledky: Mezi oběma skupinami nebylo rozdílu jak v délce koloskopie (375 ± 185 vs. 338 ± 200 s; p = NS), tak v toleranci vyšetření. Při použití pásu sestra, častěji než lékař, hodnotila vyšetření jako méně obtížné (p = 0,026). Délka vyšetření inverzně koreluje s body mass indexem (r = -0,27; 95% CI -0,45 až -0,06; p = 0,011). Závěr: Stažení břišní stěny kýlním pásem nezrychluje koloskopii ani nezlepšuje její toleranci. Rychlejšího dosažení céka lze očekávat u osob s nadváhou. Klíčová slova: koloskopie -abdominální bandáž -technikaSummary: Introduction: Intestinal distension during colonoscopy affects the success rate of and tolerance to this procedure. Abdominal banding can shorten the duration of the colonoscopy. This study aimed to evaluate the effect of abdominal banding during colonoscopy. Methods: This was a prospective randomized study. The duration of and tolerance to colonoscopy were compared between patients with and without abdominal banding. Results: The duration of colonoscopy (375 ± 185 sec vs. 338 ± 200 sec, p = NS) and tolerance to this procedure did not differ between patients with and without abdominal banding. Nurses reported that colonoscopy was less difficult in patients with abdominal banding than in those without (p = 0.026). The duration of colonoscopy was inversely correlated with body mass index (r = -0.27, 95% CI -0.45 to -0.06, p = 0.011). Conclusion: Abdominal banding does not affect the duration of or tolerance to colonoscopy. Cecal intubation is usually faster in overweight patients.

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Does a Fitted Abdominal Corset Makes Colonoscopy More Tolerable?

Abstract: Our data confirm the usefulness of the abdominal corset in decreasing the degree of patient pain and it makes colonoscopy easier and quicker with less manipulation, so we propose using a fitted abdominal corset during routine colonoscopic procedures.

Cited by 16 publications

References 15 publications

Use of an Abdominal Compression Device in Colonoscopy: A Randomized, Sham-Controlled Trial

Use of an Abdominal Compression Device in Colonoscopy: A Randomized, Sham-Controlled Trial

Colonoscopy in Obese Patients: Time to Change Position

Does abdominal compression improve the success rate of and tolerance to colonoscopy?

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