Evaluation of discomfort during colonoscopy with conventional and ultrathin colonoscopes in ulcerative colitis patients

Ogawa, Tomohiro; Ohda, Yoshio; Nagase, Kazuko; Kono, Tomoaki; Tozawa, Katsuyuki; Tomita, Toshihiko; Iimuro, Masaki; Hida, Nobuyuki; Oshima, Tadayuki; Fukui, Hirokazu; Hori, Keiichi; Watari, Jiro; Nakamura, Shirô; Miwa, Hiroto

doi:10.1111/den.12323

Cited by 16 publications

(13 citation statements)

References 31 publications

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“…Various modifications and improvements in endoscopes and related equipment, such as variable-stiffness colonoscopies 1,2) , ultrathin colonoscopies [10][11][12] , passive bending endoscopes 13) , and double balloon enteroscopes 14) , have been developed to facilitate colonoscope insertion. Specifically, endoscopes with adjustable stiffness capabilities are widely used.…”

Section: Discussionmentioning

confidence: 99%

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Kikuchi

Kimura

Nomura

et al. 2019

J Anus Rectum Colon

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Objectives: The variable-stiffness colonoscope is reportedly useful for making colonoscope insertion easier. However, this function is not associated with all colonoscopes. We developed a variable-stiffness stylet that can be inserted into the endoscope instrumentation channel to change the rigidity of the endoscope. Methods: We developed a stylet with adjustable stiffness and investigated its utility in colonoscope insertion using an ex-vivo model. Four endoscopists performed 24 colonoscope insertions, alternating between using the stylet (Stylet method) and the conventional method. We assessed insertion rate, rate of applying abdominal compression, and insertion time between the two groups. Results: In all procedures, the endoscope was inserted up to the cecum. There were significantly fewer external abdominal compressions with the Stylet method (1/12, 8.3%) compared to the conventional method (6/12, 50%). The insertion time was shorter with the Stylet method (140.9 ± 53.7 s) compared to the conventional method (181.3 ± 64.9 s). Conclusions: Using the variable-stiffness stylet, currently under development, resulted in significantly fewer external abdominal compressions and tended to have shorter insertion time.

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Section: Discussionmentioning

confidence: 99%

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Kikuchi

Kimura

Nomura

et al. 2019

J Anus Rectum Colon

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“…Table summarizes the randomized clinical trials of small‐caliber endoscopes for colonoscopy . In six of 10 trials, small‐caliber instruments facilitated colonoscopy with significantly less pain.…”

Section: Discussionmentioning

confidence: 99%

“…Use of small‐caliber instruments can facilitate difficult colonoscopy, specifically for negotiating the fixed, angulated or narrowed sigmoid colon. Currently available small‐caliber instruments include a gastroscope, a pediatric colonoscope (PDC) and an ultrathin colonoscope (UTC), which are all thinner and more flexible than standard adult colonoscopes, with a shorter bending section. PDC are 1 mm thinner than standard adult colonoscopes, are often selected for female colonoscopy because the female colon is often angulated and can be fixed from previous gynecological surgery .…”

Section: Introductionmentioning

confidence: 99%

“…Gastroscopes are a further 2–3‐mm thinner than PDC, and can also be used for angulated colons when a PDC is not successful or available. Indeed, these small‐caliber instruments improve completion rates and reduce discomfort during colonoscopy . UTC are also available to accomplish total colonoscopy in the very difficult sigmoid colon.…”

Section: Introductionmentioning

confidence: 99%

“…UTC are also available to accomplish total colonoscopy in the very difficult sigmoid colon. These instruments are 9 mm in diameter, and have been shown to improve cecal intubation and reduce patient discomfort . Recently, a new ultrathin colonoscope that is 2 mm thinner than conventional UTC (7.0 mm diameter, standard length, EC‐530XP; Fujifilm Corp., Tokyo, Japan) has become available in Japan.…”

Section: Introductionmentioning

confidence: 99%

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Ultrathin versus pediatric instruments for colonoscopy in older female patients: A randomized trial

Nemoto

Utano

Endo

et al. 2016

Digestive Endoscopy

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Background and Aim: Small-caliber endoscopes such as gastroscopes or pediatric colonoscopes are occasionally required to negotiate fixed or angulated colons. However, the use of a new ultrathin instrument (diameter 7.0 mm) narrower than other conventional colonoscopes has not been evaluated. The aim of the present study was to compare the use compare the use of an ultrathin colonoscope (UTC) with a pediatric colonoscope (PDC) for colonoscopy in older female patients.Methods: A prospective, randomized, controlled trial was conducted in a single academic endoscopy unit. A total of 77 female patients aged ≥70 years undergoing unsedated colonoscopy were randomized to colonoscopy with a UTC (n = 39) or PDC (n = 38). Primary outcome measurement was the degree of pain using a numerical rating scale, and secondary outcomes were cecal intubation rate, ileal intubation rate, time to cecum and adenoma detection rate.Results: There was a significant difference in reported pain using the numerical rating scale (median, UTC 1 vs PDC 4, P < 0.0001). Cecal intubation rates were 97.4% in UTC and 92.1% in PDC (P = 0.36), and ileal intubation rates were 82.0% and 89.4% (P = 0.76), respectively. However, median times to cecum were significantly longer using UTC compared with PDC (15.2 min vs 11.1 min, P = 0.022). Adenoma detection rates were 30.7% in UTC and 26.3% in PDC (P = 0.80).Conclusions: Colonoscopy using UTC was almost equivalent to that of PDC in older female patients, with significantly less pain compared with PDC. UTC may be an alternative to PDC for the difficult colon.

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Colorectal Cancer Risk and Screening in Geriatric Patients

Lin

Katz

2019

Cancer Screening in Inflammatory Bowel Disease

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Evaluation of discomfort during colonoscopy with conventional and ultrathin colonoscopes in ulcerative colitis patients

Abstract: The findings indicated that the flexible ultrathin colonoscope PCF-PQ260 has significantly better tolerability in UC patients compared to a conventional colonoscope.

Cited by 16 publications

References 31 publications

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

A pilot study of a novel variable-stiffness stylet for efficient colonoscope insertion with <i>ex-vivo</i> colon model

Ultrathin versus pediatric instruments for colonoscopy in older female patients: A randomized trial

Colorectal Cancer Risk and Screening in Geriatric Patients

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