A prospective trial of variable stiffness colonoscopes with different tip diameters in unsedated patients

Peng-Jen Chen, Yu-Lueng Shih, Heng-Cheng Chu, Wei-Kuo Chang, Tsai-Yuan Hsieh, You-Chen Chao

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVES: Few data exist comparing the clinical versatility of variable stiffness (VS) colonoscopes with different tip diameters and stiffness ranges. We compared the intubation time and success rate, maneuvering ease, and patient comfort of three colonoscopes: pediatric VS (PVSC), nonmagnifying adult VS (AVSC), and magnifying VS (MVSC). METHODS: Two hundred sixteen consecutive patients scheduled for routine colonoscopy were randomized to undergo colonoscopy with one of the three different colonoscopes (PVSC N = 72, AVSC N = 72, MVSC N = 72). Outcome measurements included time required for cecal intubation, success rate for cecal intubation, maneuvering ease, and patient comfort. RESULTS: The overall success rate for cecal intubation was 95.83%. Intubation time was significantly different among the groups (PVSC 12.88 ± 7.11 min, AVSC 9.25 ± 5.16 min, MVSC 9.62 ± 5.55 min; P <0.01). Intubation time with PVSC required about 3 min more when compared with AVSC or MVSC. Multivariate analyses revealed that colonoscopy with AVSC required 3 min less when compared with PVSC (P = 0.03). Age greater than 55 yr, waist circumference, prior hysterectomy, and pain experienced by patients were also factors affecting intubation time. CONCLUSIONS: In this study, a PVSC might not decrease patient discomfort or intubation time. The ideal colonoscope is the AVSC that has a modest diameter and stiffness range and thus is capable of achieving both a short intubation time and an acceptable comfort level. We also should bear in mind that MVSC has an additional function of magnifying observation. © 2008 by Am. Coll. of Gastroenterology.
Original languageEnglish
Pages (from-to)1365-1371
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume103
Issue number6
DOIs
Publication statusPublished - 2008
Externally publishedYes

Fingerprint

Colonoscopes
Intubation
Colonoscopy
Waist Circumference
Gastroenterology
Hysterectomy
Multivariate Analysis
Observation
Pediatrics

Keywords

  • adult
  • article
  • clinical study
  • colonoscopy
  • controlled study
  • digestive tract intubation
  • human
  • hysterectomy
  • major clinical study
  • multivariate analysis
  • outcome assessment
  • pain
  • priority journal
  • prospective study
  • rigidity
  • risk factor
  • scoring system
  • univariate analysis
  • waist circumference
  • Adult
  • Aged
  • Colonoscopes
  • Colonoscopy
  • Equipment Design
  • Female
  • Humans
  • Hypnotics and Sedatives
  • Male
  • Middle Aged
  • Pain
  • Patient Satisfaction
  • Pliability
  • Prospective Studies
  • Single-Blind Method
  • Time Factors
  • Treatment Outcome

Cite this

A prospective trial of variable stiffness colonoscopes with different tip diameters in unsedated patients. / Chen, Peng-Jen; Shih, Yu-Lueng; Chu, Heng-Cheng; Chang, Wei-Kuo; Hsieh, Tsai-Yuan; Chao, You-Chen.

In: American Journal of Gastroenterology, Vol. 103, No. 6, 2008, p. 1365-1371.

Research output: Contribution to journalArticle

Chen, Peng-Jen ; Shih, Yu-Lueng ; Chu, Heng-Cheng ; Chang, Wei-Kuo ; Hsieh, Tsai-Yuan ; Chao, You-Chen. / A prospective trial of variable stiffness colonoscopes with different tip diameters in unsedated patients. In: American Journal of Gastroenterology. 2008 ; Vol. 103, No. 6. pp. 1365-1371.
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abstract = "OBJECTIVES: Few data exist comparing the clinical versatility of variable stiffness (VS) colonoscopes with different tip diameters and stiffness ranges. We compared the intubation time and success rate, maneuvering ease, and patient comfort of three colonoscopes: pediatric VS (PVSC), nonmagnifying adult VS (AVSC), and magnifying VS (MVSC). METHODS: Two hundred sixteen consecutive patients scheduled for routine colonoscopy were randomized to undergo colonoscopy with one of the three different colonoscopes (PVSC N = 72, AVSC N = 72, MVSC N = 72). Outcome measurements included time required for cecal intubation, success rate for cecal intubation, maneuvering ease, and patient comfort. RESULTS: The overall success rate for cecal intubation was 95.83{\%}. Intubation time was significantly different among the groups (PVSC 12.88 ± 7.11 min, AVSC 9.25 ± 5.16 min, MVSC 9.62 ± 5.55 min; P <0.01). Intubation time with PVSC required about 3 min more when compared with AVSC or MVSC. Multivariate analyses revealed that colonoscopy with AVSC required 3 min less when compared with PVSC (P = 0.03). Age greater than 55 yr, waist circumference, prior hysterectomy, and pain experienced by patients were also factors affecting intubation time. CONCLUSIONS: In this study, a PVSC might not decrease patient discomfort or intubation time. The ideal colonoscope is the AVSC that has a modest diameter and stiffness range and thus is capable of achieving both a short intubation time and an acceptable comfort level. We also should bear in mind that MVSC has an additional function of magnifying observation. {\circledC} 2008 by Am. Coll. of Gastroenterology.",
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author = "Peng-Jen Chen and Yu-Lueng Shih and Heng-Cheng Chu and Wei-Kuo Chang and Tsai-Yuan Hsieh and You-Chen Chao",
note = "被引用次數:10 Export Date: 22 March 2016 CODEN: AJGAA 通訊地址: Chen, P.-J.; Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Chenggong Rd., Neihu District, Taipei City 114, Taiwan 化學物質/CAS: Hypnotics and Sedatives 參考文獻: Ee, H.C., Semmens, J.B., Hoffman, N.E., Complete colonoscopy rarely misses cancer (2002) Gastrointest Endosc, 55, pp. 167-71; Appropriate use of gastrointestinal endoscopy (2000) Gastrointest Endosc, 52, pp. 831-7. , American Society for Gastrointestinal Endoscopy; Rex, D.K., Bond, J.H., Winawer, S., Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: Recommendation of the U.S. Multi-Society Task Force on Colorectal Cancer (2002) Am J Gastroenterol, 97, pp. 1296-308; Church, J.M., Complete colonoscopy: How often? and if not, why not? (1994) Am J Gastroenterol, 89, pp. 556-60; Marshall, J.B., Barthel, J.S., The frequency of total colonoscopy and terminal ileal intubation in the 1990s (1993) Gastrointest Endosc, 39, pp. 518-20; Waye, J.D., Bashkoff, E., Total colonoscopy: Is it always possible? (1991) Gastrointest Endosc, 37, pp. 152-4; Saunders, B.P., MacRae, F., Williams, C.B., What makes colonoscopy difficult? (1993) Gut, 34, pp. A181; Kaffes, A.J., Mishra, A., Ding, S.L., A prospective trial of variable stiffness pediatric versus standard instrument colonoscopy (2003) Gastrointest Endosc, 58, pp. 685-9; Rex, E.K., Speeding up cecal intubation: Its role in the efficiency of colonoscopy delivery (2002) Am J Gastroenterol, 97, pp. 6-8; Nelson, D.B., McQuaid, K.R., Bond, J.H., Population-based colonoscopy screening for colorectal cancer is feasible and safe: Preliminary results from the VA colonoscopy screening trial (1999) Gastrointest Endosc, 49, pp. AB65; Shumaker, D.A., Zaman, A., Katon, R., A randomized controlled trial in a training institution comparing a pediatric variable stiffness colonoscope, a pediatric colonoscope, and an adult colonoscope (2002) Gastrointest Endosc, 55, pp. 172-9; Brooker, J.C., Saunders, B.P., Shah, S.G., A new variable stiffness colonoscope makes colonoscopy easier: A randomized controlled trial (2000) Gut, 46, pp. 801-5; Shumaker, D.A., Zamen, A., Katon, R.M., Use of a variable stiffness colonoscope allows completion of colonoscopy after failure with the standard adult colonoscope (2002) Endoscopy, 34, pp. 711-4; Arrowsmith, J.B., Gerstman, B.B., Fleischer, D.E., Results from the American Society for Gastrointestinal Endoscopy/U.S. Food and Drug Administration collaborative study on complication rates and drug use during gastrointestinal endoscopy (1991) Gastrointest Endosc, 37, pp. 421-7; Lehr, R., Sixteen S-squared over D-squared: A relation for crude sample size estimates (1992) Stat Med, 11, pp. 1099-102; Saifuddin, T., Trivedi, M., King, P.D., Usefulness of a pediatric colonoscope for colonoscopy in adults (2000) Gastrointest Endosc, 51, pp. 314-7; Marshall, J.B., Perez, R.A., Madsen, R.W., Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy (2002) Gastrointest Endosc, 55, pp. 838-41; Tanaka, N., Fujii, H., Kajiyama, M., Usefulness of a small-caliber, variable-stiffness colonoscope as a backup in patients with difficult or incomplete colonoscopy (2004) Am J Gastroenterol, 99, pp. 1936-40; Saunders, B.P., Fukumoto, M., Halligan, S., Why is colonoscopy more difficult in women? (1996) Gastrointest Endosc, 43, pp. 124-6; Hull, T., Church, J.M., Colonoscopy-how difficult, how painful? (1994) Surg Endosc, 8, pp. 784-7; Anderson, J.C., Messina, C.R., Cohn, W., Factors predictive of difficult colonoscopy (2001) Gastrointest Endosc, 54, pp. 558-62",
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TY - JOUR

T1 - A prospective trial of variable stiffness colonoscopes with different tip diameters in unsedated patients

AU - Chen, Peng-Jen

AU - Shih, Yu-Lueng

AU - Chu, Heng-Cheng

AU - Chang, Wei-Kuo

AU - Hsieh, Tsai-Yuan

AU - Chao, You-Chen

N1 - 被引用次數:10 Export Date: 22 March 2016 CODEN: AJGAA 通訊地址: Chen, P.-J.; Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Chenggong Rd., Neihu District, Taipei City 114, Taiwan 化學物質/CAS: Hypnotics and Sedatives 參考文獻: Ee, H.C., Semmens, J.B., Hoffman, N.E., Complete colonoscopy rarely misses cancer (2002) Gastrointest Endosc, 55, pp. 167-71; Appropriate use of gastrointestinal endoscopy (2000) Gastrointest Endosc, 52, pp. 831-7. , American Society for Gastrointestinal Endoscopy; Rex, D.K., Bond, J.H., Winawer, S., Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: Recommendation of the U.S. Multi-Society Task Force on Colorectal Cancer (2002) Am J Gastroenterol, 97, pp. 1296-308; Church, J.M., Complete colonoscopy: How often? and if not, why not? (1994) Am J Gastroenterol, 89, pp. 556-60; Marshall, J.B., Barthel, J.S., The frequency of total colonoscopy and terminal ileal intubation in the 1990s (1993) Gastrointest Endosc, 39, pp. 518-20; Waye, J.D., Bashkoff, E., Total colonoscopy: Is it always possible? (1991) Gastrointest Endosc, 37, pp. 152-4; Saunders, B.P., MacRae, F., Williams, C.B., What makes colonoscopy difficult? (1993) Gut, 34, pp. A181; Kaffes, A.J., Mishra, A., Ding, S.L., A prospective trial of variable stiffness pediatric versus standard instrument colonoscopy (2003) Gastrointest Endosc, 58, pp. 685-9; Rex, E.K., Speeding up cecal intubation: Its role in the efficiency of colonoscopy delivery (2002) Am J Gastroenterol, 97, pp. 6-8; Nelson, D.B., McQuaid, K.R., Bond, J.H., Population-based colonoscopy screening for colorectal cancer is feasible and safe: Preliminary results from the VA colonoscopy screening trial (1999) Gastrointest Endosc, 49, pp. AB65; Shumaker, D.A., Zaman, A., Katon, R., A randomized controlled trial in a training institution comparing a pediatric variable stiffness colonoscope, a pediatric colonoscope, and an adult colonoscope (2002) Gastrointest Endosc, 55, pp. 172-9; Brooker, J.C., Saunders, B.P., Shah, S.G., A new variable stiffness colonoscope makes colonoscopy easier: A randomized controlled trial (2000) Gut, 46, pp. 801-5; Shumaker, D.A., Zamen, A., Katon, R.M., Use of a variable stiffness colonoscope allows completion of colonoscopy after failure with the standard adult colonoscope (2002) Endoscopy, 34, pp. 711-4; Arrowsmith, J.B., Gerstman, B.B., Fleischer, D.E., Results from the American Society for Gastrointestinal Endoscopy/U.S. Food and Drug Administration collaborative study on complication rates and drug use during gastrointestinal endoscopy (1991) Gastrointest Endosc, 37, pp. 421-7; Lehr, R., Sixteen S-squared over D-squared: A relation for crude sample size estimates (1992) Stat Med, 11, pp. 1099-102; Saifuddin, T., Trivedi, M., King, P.D., Usefulness of a pediatric colonoscope for colonoscopy in adults (2000) Gastrointest Endosc, 51, pp. 314-7; Marshall, J.B., Perez, R.A., Madsen, R.W., Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy (2002) Gastrointest Endosc, 55, pp. 838-41; Tanaka, N., Fujii, H., Kajiyama, M., Usefulness of a small-caliber, variable-stiffness colonoscope as a backup in patients with difficult or incomplete colonoscopy (2004) Am J Gastroenterol, 99, pp. 1936-40; Saunders, B.P., Fukumoto, M., Halligan, S., Why is colonoscopy more difficult in women? (1996) Gastrointest Endosc, 43, pp. 124-6; Hull, T., Church, J.M., Colonoscopy-how difficult, how painful? (1994) Surg Endosc, 8, pp. 784-7; Anderson, J.C., Messina, C.R., Cohn, W., Factors predictive of difficult colonoscopy (2001) Gastrointest Endosc, 54, pp. 558-62

PY - 2008

Y1 - 2008

N2 - OBJECTIVES: Few data exist comparing the clinical versatility of variable stiffness (VS) colonoscopes with different tip diameters and stiffness ranges. We compared the intubation time and success rate, maneuvering ease, and patient comfort of three colonoscopes: pediatric VS (PVSC), nonmagnifying adult VS (AVSC), and magnifying VS (MVSC). METHODS: Two hundred sixteen consecutive patients scheduled for routine colonoscopy were randomized to undergo colonoscopy with one of the three different colonoscopes (PVSC N = 72, AVSC N = 72, MVSC N = 72). Outcome measurements included time required for cecal intubation, success rate for cecal intubation, maneuvering ease, and patient comfort. RESULTS: The overall success rate for cecal intubation was 95.83%. Intubation time was significantly different among the groups (PVSC 12.88 ± 7.11 min, AVSC 9.25 ± 5.16 min, MVSC 9.62 ± 5.55 min; P <0.01). Intubation time with PVSC required about 3 min more when compared with AVSC or MVSC. Multivariate analyses revealed that colonoscopy with AVSC required 3 min less when compared with PVSC (P = 0.03). Age greater than 55 yr, waist circumference, prior hysterectomy, and pain experienced by patients were also factors affecting intubation time. CONCLUSIONS: In this study, a PVSC might not decrease patient discomfort or intubation time. The ideal colonoscope is the AVSC that has a modest diameter and stiffness range and thus is capable of achieving both a short intubation time and an acceptable comfort level. We also should bear in mind that MVSC has an additional function of magnifying observation. © 2008 by Am. Coll. of Gastroenterology.

AB - OBJECTIVES: Few data exist comparing the clinical versatility of variable stiffness (VS) colonoscopes with different tip diameters and stiffness ranges. We compared the intubation time and success rate, maneuvering ease, and patient comfort of three colonoscopes: pediatric VS (PVSC), nonmagnifying adult VS (AVSC), and magnifying VS (MVSC). METHODS: Two hundred sixteen consecutive patients scheduled for routine colonoscopy were randomized to undergo colonoscopy with one of the three different colonoscopes (PVSC N = 72, AVSC N = 72, MVSC N = 72). Outcome measurements included time required for cecal intubation, success rate for cecal intubation, maneuvering ease, and patient comfort. RESULTS: The overall success rate for cecal intubation was 95.83%. Intubation time was significantly different among the groups (PVSC 12.88 ± 7.11 min, AVSC 9.25 ± 5.16 min, MVSC 9.62 ± 5.55 min; P <0.01). Intubation time with PVSC required about 3 min more when compared with AVSC or MVSC. Multivariate analyses revealed that colonoscopy with AVSC required 3 min less when compared with PVSC (P = 0.03). Age greater than 55 yr, waist circumference, prior hysterectomy, and pain experienced by patients were also factors affecting intubation time. CONCLUSIONS: In this study, a PVSC might not decrease patient discomfort or intubation time. The ideal colonoscope is the AVSC that has a modest diameter and stiffness range and thus is capable of achieving both a short intubation time and an acceptable comfort level. We also should bear in mind that MVSC has an additional function of magnifying observation. © 2008 by Am. Coll. of Gastroenterology.

KW - adult

KW - article

KW - clinical study

KW - colonoscopy

KW - controlled study

KW - digestive tract intubation

KW - human

KW - hysterectomy

KW - major clinical study

KW - multivariate analysis

KW - outcome assessment

KW - pain

KW - priority journal

KW - prospective study

KW - rigidity

KW - risk factor

KW - scoring system

KW - univariate analysis

KW - waist circumference

KW - Adult

KW - Aged

KW - Colonoscopes

KW - Colonoscopy

KW - Equipment Design

KW - Female

KW - Humans

KW - Hypnotics and Sedatives

KW - Male

KW - Middle Aged

KW - Pain

KW - Patient Satisfaction

KW - Pliability

KW - Prospective Studies

KW - Single-Blind Method

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1111/j.1572-0241.2008.01812.x

DO - 10.1111/j.1572-0241.2008.01812.x

M3 - Article

VL - 103

SP - 1365

EP - 1371

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 6

ER -