Journal articles on the topic 'Colonoscopy'
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Veselov, V. V., A. M. Nechipai, E. A. Poltoryhina, and A. V. Vasilchenko. "FIRST EXPERIENCE IN FULL-SPECTRUM COLONOSCOPY." Koloproktologia, no. 2 (June 30, 2017): 36–46. http://dx.doi.org/10.33878/2073-7556-2017-0-2-36-46.
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Colonoscopy with a forward-viewing camera leaves regions that are not visualized in detail. Thus development of video-enoscopy systems with wide angle of view is needed. Full-spectrum colonoscopes providing image of Ultra HD 4K quality are now available in Russia. MATERIALS AND METHODS. Seventy patents were assessed with a full-spectrum colonoscope. In 51 (72,8°%) of them the procedure was performed also for physician's training purposes. Fifteen (21,4%) patients underwent simultaneous full-spectrum and forward-viewing colonoscopies, while in 4 (5,7%) full-spectrum endoscope was used to visualize lesions that were non-assessable with traditional equipment. RESULTS. Applying Jull-spectrum colonoscopy for diagnosis resulted in detecting 170 polyps in 51 patients (polyp detection rate was 47,1%). Simultaneous use of full-spectrum colonoscope after forward-viewing equipment led to 9 additional polyps detection in one patient and 23 additional polyps in another one. In 7 patents full-spectrum colonoscopy allowed detection of polyps that were not found via forward-viewing equipment. CONCLUSION. During full-spectrum colonoscopy inner colonic surface can be visualized with an angle of view of 330° which is twice more than video-capturing area ofa standard forward-viewing endoscope. The equipment allows to significantly increase adenoma detection rate.
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Hamada, Yasuhiko, Kyosuke Tanaka, Masaki Katsurahara, Noriyuki Horiki, Reiko Yamada, Junya Tsuboi, Misaki Nakamura, Satoshi Tamaru, Tomomi Yamada, and Yoshiyuki Takei. "Efficacy of a small-caliber colonoscope for pain in female patients during unsedated colonoscopy: a randomized controlled study." Endoscopy International Open 09, no. 07 (June 17, 2021): E1055—E1061. http://dx.doi.org/10.1055/a-1464-0780.
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Abstract Background and study aims Female sex has been identified as a factor increasing patients’ pain during colonoscopy. The aim of this randomized controlled study was to investigate the efficacy of a small-caliber colonoscope, PCF-PQ260 L, for limiting pain in women during unsedated colonoscopy. Patients and methods Women who underwent unsedated colonoscopy were randomly allocated to either the small-caliber or standard colonoscope group. The primary outcome was overall pain and secondary outcomes were maximum pain and procedural measures. In addition, the effects of colonoscope type were analysed using analysis of covariance and logistic regression with adjustment for stratification factors, age and prior abdomino-pelvic surgery. Results A total of 220 women were randomly assigned to the small-caliber (n = 110) or standard (n = 110) colonoscope groups. Overall and maximum pain scores were significantly lower in the small-caliber colonoscope group than the standard colonoscope group (overall pain, 20.0 vs. 32.4, P < 0.0001; maximum pain, 28.9 vs. 47.2, P < 0.0001). The small-caliber colonoscope group achieved a superior cecal intubation rate (99 % vs. 93 %, P = 0.035). The rate of patient acceptance of unsedated colonoscopy in the future was higher in the small-caliber colonoscope group than in the standard colonoscope group (98 % vs. 87 %, P = 0.003). In addition, the small-caliber colonoscope was superior with respect to reducing pain and improving the rate of patient acceptance of unsedated colonoscopy with adjustment. Conclusions This study demonstrates the efficacy of the small-caliber colonoscope for reducing pain in women and improving their rate of acceptance of unsedated colonoscopy.
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CHENG, WU BIN, MICHAEL A. J. MOSER, SIVARUBAN KANAGARATNAM, and WEN JUN ZHANG. "PREDICATION FOR RELATIVE MOTION OF THE COLONOSCOPE IN COLONOSCOPY." Journal of Mechanics in Medicine and Biology 13, no. 03 (May 14, 2013): 1350023. http://dx.doi.org/10.1142/s0219519413500231.
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Colonoscopy is common procedure frequently carried out. It is not without its problems, which include looping formation. Looping formation prevents the tip of the colonoscope itself from advancing, thus further probing induces a risk of perforation, significant patient discomfort, and failure of colonoscopy. During colonoscopy, the manipulated colonoscope for intubation in the colon goes through the friction between the colonoscope and the colon. Due to major frictional force, the sigmoidal colon forms looping with the scope during intubation. The interactive frictional force between the colon and the colonoscope is highly complex because of frictional contact between two deformable objects. In this paper, contact force computation was formulated into a linear complementarity problem (LCP) by linearizing Signorini's problem, which was adapted into non-interpenetration with unilateral constraints. Frictional force was computed by the mechanical compliance of finite element method (FEM) models with the consideration of dynamic friction between the colonoscope and the intestinal wall. Furthermore, we presented a mathematical model of the elongation of the colon that predicts the motion of scope relative to the intestinal wall in colonoscopy.
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Holubar, Stefan, Amit Dwivedi, J. Eisendorfer, R. Levine, and R. Strauss. "Splenic Rupture: An Unusual Complication of Colonoscopy." American Surgeon 73, no. 4 (April 2007): 393–96. http://dx.doi.org/10.1177/000313480707300417.
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Splenic injury is a known, albeit rare, complication of diagnostic and therapeutic colonoscopy. Within a 6-month period, we observed two colonoscopic splenic injuries. We report these two cases of splenic injury who presented differently after colonoscopy: one presented as frank hemorrhagic shock, and the other as a subacute splenic hemorrhage with symptomatic anemia. The first patient presented with hemorrhagic shock several hours after a diagnostic colonoscopy and required an emergency splenectomy. The second patient presented with symptomatic anemia several days after a diagnostic colonoscopy and was treated by angiographic embolization. Clinical presentation and discussion of the mechanisms of injury, available treatment options, and strategies for preventing colonoscopic splenic injuries are presented. Awareness of this complication is paramount in early recognition and management of this potentially life-threatening injury.
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Iwamuro, Masaya, Kenta Hamada, Seiji Kawano, Yoshiro Kawahara, and Motoyuki Otsuka. "Review of oral and pharyngolaryngeal benign lesions detected during esophagogastroduodenoscopy." World Journal of Gastrointestinal Endoscopy 15, no. 7 (July 16, 2023): 496–509. http://dx.doi.org/10.4253/wjge.v15.i7.496.
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During endoscopy, an endoscopist is inevitably faced with the occasional “difficult colonoscopy,” in which the endoscopist finds it challenging to advance the endoscope to the cecum. Beyond optimization of technique, with minimized looping, minimal insufflation, sufficient sedation, and abdominal splinting when needed, sometimes additional tools may be needed. In this review, we cover available techniques and technologies to help navigate the difficult colonoscopy, including the ultrathin colonoscope, rigidizing overtube, balloon-assisted colonoscopy and the abdominal compression device.
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Rio-Tinto, Ricardo, Jorge Canena, and Jacques Devière. "Candy cane syndrome: A systematic review." World Journal of Gastrointestinal Endoscopy 15, no. 7 (July 16, 2023): 510–17. http://dx.doi.org/10.4253/wjge.v15.i7.510.
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During endoscopy, an endoscopist is inevitably faced with the occasional “difficult colonoscopy,” in which the endoscopist finds it challenging to advance the endoscope to the cecum. Beyond optimization of technique, with minimized looping, minimal insufflation, sufficient sedation, and abdominal splinting when needed, sometimes additional tools may be needed. In this review, we cover available techniques and technologies to help navigate the difficult colonoscopy, including the ultrathin colonoscope, rigidizing overtube, balloon-assisted colonoscopy and the abdominal compression device.
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Wei, Mike T., and Shai Friedland. "Strategies to manage the difficult colonoscopy." World Journal of Gastrointestinal Endoscopy 15, no. 7 (July 16, 2023): 491–95. http://dx.doi.org/10.4253/wjge.v15.i7.491.
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During endoscopy, an endoscopist is inevitably faced with the occasional “difficult colonoscopy,” in which the endoscopist finds it challenging to advance the endoscope to the cecum. Beyond optimization of technique, with minimized looping, minimal insufflation, sufficient sedation, and abdominal splinting when needed, sometimes additional tools may be needed. In this review, we cover available techniques and technologies to help navigate the difficult colonoscopy, including the ultrathin colonoscope, rigidizing overtube, balloon-assisted colonoscopy and the abdominal compression device.
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Wakimoto, Shuichi, Issei Kumagai, and Koichi Suzumori. "Development of Variable Stiffness Colonoscope Consisting of Pneumatic Drive Devices." International Journal of Automation Technology 5, no. 4 (July 5, 2011): 551–58. http://dx.doi.org/10.20965/ijat.2011.p0551.
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Colonoscopy is important and effective medical procedure to detect colonic disorder including cancer of the colon. However, because the large intestine is soft and complex shape, insertion of conventional colonoscopes into the large intestine is difficult, and it depends on doctors’ skill strongly. In many cases, patients feel strong pain. In this research, we aim at development of a novel colonoscope which can change own stiffness partially and realize safe insertion without special techniques. The colonoscope consists of variable stiffness devices. The device is made from silicone rubber and can change its stiffness by pneumatic pressure. In this report, two kinds of variable stiffness devices made from different silicone rubber materials have been developed by molding, and stiffness change characteristics of them are shown experimentally. By applying not only positive pneumatic pressure but also negative pressure, widely stiffness change range is realized. Additionally colonoscopes have been fabricated using them and FMA (Flexible Microactuator). From insertion experiments into the large intestine phantom, advantages and effectiveness have been recognized.
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Chen, Tara, Qiu Tong, and Alexander Kurchin. "Colonoscopic Splenic Injury: A Simplified Radiologic Approach." Case Reports in Gastrointestinal Medicine 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/2615453.
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Colonoscopy is a commonly performed procedure for diagnosis and treatment of large bowel diseases. Recognized complications include bleeding and perforation. Splenic injury during colonoscopy is a rare complication. We report a case of a 73-year-old woman who presented with left-sided abdominal pain after colonoscopy with finding of splenic injury on CT scan. She was managed conservatively. We discuss the diagnostic and therapeutic approach to colonoscopic splenic injury.
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Dworakowska, D., M. Gueorguiev, P. Kelly, J. P. Monson, G. M. Besser, S. L. Chew, S. A. Akker, et al. "Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines." European Journal of Endocrinology 163, no. 1 (July 2010): 21–28. http://dx.doi.org/10.1530/eje-09-1080.
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ObjectiveIt is suggested that patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps. However, the optimum frequency with which colonoscopic screening should be offered remains unclear.DesignTo determine the optimum frequency for repeated colonoscopic surveillance of acromegalic patients.MethodsWe retrospectively reviewed the case records of all patients with acromegaly seen in our centre since 1992: 254 patients had at least one surveillance colonoscopy, 156 patients had a second surveillance colonoscopy, 60 patients had a third surveillance colonoscopy and 15 patients had a fourth surveillance colonoscopy.ResultsThe presence of hyperplastic or adenomatous polyps was assessed in all patients, while one cancer was detected at the second surveillance. At the third surveillance, mean (±s.d.) serum IGF1 levels (ng/ml) in patients with hyperplastic polyps were significantly higher than those with normal colons (P<0.05). The presence of an adenoma rather than a normal colon at the first colonoscopy was associated with a significantly increased risk of adenoma at the second (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9–10.4) and at the third (OR 8.8, 95% CI 2.9–26.5) screens. Conversely, a normal colon at the first surveillance gave a high chance of normal findings at the second (78%) or third surveillance (78%), and a normal colon at the second colonoscopy was associated with normality at the third colonoscopy (81%).ConclusionsRepeated colonoscopic screening of patients with acromegaly demonstrated a high prevalence of new adenomatous and hyperplastic colonic polyps, dependent on both the occurrence of previous polyps and elevated IGF1 levels.
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Park, G., H. Komeylian, A. Kohansal, and M. Stewart. "A106 COLONOSCOPY TEACHING: A SURVEY OF CANADIAN GASTROENTEROLOGY RESIDENTS." Journal of the Canadian Association of Gastroenterology 7, Supplement_1 (February 14, 2024): 78. http://dx.doi.org/10.1093/jcag/gwad061.106.
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Abstract Background With the advancement in equipment and techniques, colonoscopy training continues to evolve. Programs such as the Skills Enhancement for Endoscopy (SEE) curriculum developed by the Canadian Association of Gastroenterology teach techniques such as loop reduction, patient turning, and water immersion aimed at improving adenoma detection, cecal intubation, and patient comfort. While there is vast literature focused on assessing learners’ endoscopic competencies, there is limited data pertaining to the training of specific colonoscopy techniques. Aims To assess various colonoscopy techniques used to train gastroenterology residents in Canada. Methods A survey of gastroenterology trainees was developed to assess specific aspects of their experience with colonoscopy education. This included questions on the frequency of position changes, use of pediatrics colonoscopes, water immersion, loops reduction, and SEE program initiatives. The survey was advertised at the 2023 Gastroenterology Residents-In-Training Course with a link to the survey e-mailed to all attendees. This survey has been re-distributed to the current gastroenterology resident cohort and therefore this abstract’s results are interim data pending further survey responses. Results At the time of survey administration, there were 69 gastroenterology residents registered in Canada. Responses were received from 21(30%) residents; 5 in post graduate year (PGY) 4 and 16 in PGY5. One quarter (24%) of residents reported that colonoscopy teaching methods were uniform amongst faculty members and one third (33%) reported that more than half of their preceptors mentioned SEE program initiatives. Thirty-eight percent of residents reported that more than half of their preceptors suggested position change on insertion when the scope is advancing well on insertion. Majority of residents (90%) reported that water immersion during colonoscope insertion was recommended by most preceptors. Most residents (76%) reported that position change to help with loop reduction was suggested by more than half of their preceptors. Fifty-seven percent of residents reported that more than half of their preceptors commented on type of loop formation and reduction techniques. Once the cecum is reached, a minority of residents (29%) reported that more than half of preceptors recommended position change specifically to improve cecal visualization. Conclusions Certain colonoscopy techniques such as turning patients, water immersion, and loop reduction can assist with adenoma detection rates and patient comfort. However, there exists considerable variability in colonoscopy techniques taught to Canadian gastroenterology residents. Increased standardization among colonoscopy technique education may benefit gastroenterology trainees. Funding Agencies None
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Ginsberg, Gregory G. "Colonoscopy with the Variable Stiffness Colonoscope." Gastrointestinal Endoscopy 58, no. 4 (October 2003): 579–84. http://dx.doi.org/10.1067/s0016-5107(03)01873-x.
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Seward, Edward. "Recent advances in colonoscopy." F1000Research 8 (July 9, 2019): 1028. http://dx.doi.org/10.12688/f1000research.18503.1.
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Colonoscopy continues to evolve as equipment and techniques improve. Traditionally, colonoscopy has focused on adenoma detection, characterisation and resection as the primary aims, and there has certainly been considerable activity over the last few years in terms of addressing these important issues. This review article not only will discuss progress made in these areas but also will focus on when to colonoscope in terms of introduction of faecal immunochemical testing, how to insert with the advent of water-assisted insertion, and how to withdraw using a bundle of evidence-based techniques to improve adenoma detection. In addition, the ramifications of failing to discover polyps and of post-colonoscopy colorectal cancer are highlighted.
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Loeve, Arjo J., Paul Fockens, and Paul Breedveld. "Mechanical Analysis of Insertion Problems and Pain During Colonoscopy: Why Highly Skill-Dependent Colonoscopy Routines are Necessary in the First Place... and How They May be Avoided." Canadian Journal of Gastroenterology 27, no. 5 (2013): 293–302. http://dx.doi.org/10.1155/2013/353760.
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BACKGROUND: Colonoscopy requires highly skill-dependent manoeuvres that demand a significant amount of training, and can cause considerable discomfort to patients, which increases the use of sedatives. Understanding the underlying fundamental mechanics behind insertion difficulties and pain during colonoscopy may help to simplify colonoscopy and reduce the required extent of training and reliance on sedatives.METHODS: A literature search, anatomical studies, models of the colon and colonoscope, and bench tests were used to qualitatively analyze the fundamental mechanical causes of insertion difficulties and pain. A categorized review resulted in an overview of potential alternatives to current colonoscopes.RESULTS: To advance a colonoscope through the colon, the colon wall, ligaments and peritoneum must be stretched, thus creating tension in the colon wall, which resists further wall deformation. This resistance forces the colonoscope to bend and follow the curves of the colon. The deformations that cause insertion difficulties and pain (necessitating the use of complex conventional manoeuvres) are the stretching of ligaments, and stretching of colon wall in the transverse and longitudinal directions, and the peritoneum.CONCLUSIONS: Four fundamental mechanical solutions to prevent these deformations were extracted from the analysis. The current results may help in the development of new colonoscopy devices that reduce – or eliminate – the necessity of using highly skill-dependent manoeuvres, facilitate training and reduce the use of sedatives.
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Brahmania, Mayur, Jei Park, Sigrid Svarta, Jessica Tong, Ricky Kwok, and Robert Enns. "Incomplete Colonoscopy: Maximizing Completion Rates of Gastroenterologists." Canadian Journal of Gastroenterology 26, no. 9 (2012): 589–92. http://dx.doi.org/10.1155/2012/353457.
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BACKGROUND Cecal intubation is one of the goals of a quality colonoscopy; however, many factors increasing the risk of incomplete colonoscopy have been implicated. The implications of missed pathology and the demand on health care resources for return colonoscopies pose a conundrum to many physicians. The optimal course of action after incomplete colonoscopy is unclear.OBJECTIVES: To assess endoscopic completion rates of previously incomplete colonoscopies, the methods used to complete them and the factors that led to the previous incomplete procedure.METHODS: All patients who previously underwent incomplete colonoscopy (2005 to 2010) and were referred to St Paul’s Hospital (Vancouver, British Columbia) were evaluated. Colonoscopies were re-attempted by a single endoscopist. Patient charts were reviewed retrospectively.RESULTS: A total of 90 patients (29 males) with a mean (± SD) age of 58±13.2 years were included in the analysis. Thirty patients (33%) had their initial colonoscopy performed by a gastroenterologist. Indications for initial colonoscopy included surveillance or screening (23%), abdominal pain (15%), gastrointestinal bleeding (29%), change in bowel habits or constitutional symptoms (18%), anemia (7%) and chronic diarrhea (8%). Reasons for incomplete colonoscopy included poor preparation (11%), pain or inadequate sedation (16%), tortuous colon (30%), diverticular disease (6%), obstructing mass (6%) and stricturing disease (10%). Reasons for incomplete procedures in the remaining 21% of patients were not reported by the referring physician. Eighty-seven (97%) colonoscopies were subsequently completed in a single attempt at the institution. Seventy-six (84%) colonoscopies were performed using routine manoeuvres, patient positioning and a variable-stiffness colonoscope (either standard or pediatric). A standard 160 or 180 series Olympus gastroscope (Olympus, Japan) was used in five patients (6%) to navigate through sigmoid diverticular disease; a pediatric colonoscope was used in six patients (7%) for similar reasons. Repeat colonoscopy on the remaining three patients (3%) failed: all three required surgery for strictures (two had obstructing malignant masses and one had a severe benign obstructing sigmoid diverticular stricture).CONCLUSION: Most patients with previous incomplete colonoscopy can undergo a successful repeat colonoscopy at a tertiary care centre with instruments that are readily available to most gastroenterologists. Other modalities for evaluation of the colon should be deferred until a second attempt is made at an expert centre.
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Guardiola, Marta, Walid Dghoughi, Roberto Sont, Alejandra Garrido, Sergi Marcoval, Luz María Neira, Ignasi Belda, and Glòria Fernández-Esparrach. "MiWEndo: Evaluation of a Microwave Colonoscopy Algorithm for Early Colorectal Cancer Detection in Ex Vivo Human Colon Models." Sensors 22, no. 13 (June 29, 2022): 4902. http://dx.doi.org/10.3390/s22134902.
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This study assesses the efficacy of detecting colorectal cancer precursors or polyps in an ex vivo human colon model with a microwave colonoscopy algorithm. Nowadays, 22% of polyps go undetected with conventional colonoscopy, and the risk of cancer after a negative colonoscopy can be up to 7.9%. We developed a microwave colonoscopy device that consists of a cylindrical ring-shaped switchable microwave antenna array that can be attached to the tip of a conventional colonoscope as an accessory. The accessory is connected to an external unit that allows successive measurements of the colon and processes the measurements with a microwave imaging algorithm. An acoustic signal is generated when a polyp is detected. Fifteen ex vivo freshly excised human colons with cancer (n = 12) or polyps (n = 3) were examined with the microwave-assisted colonoscopy system simulating a real colonoscopy exploration. After the experiment, the dielectric properties of the specimens were measured with a coaxial probe and the samples underwent a pathology analysis. The results show that all the neoplasms were detected with a sensitivity of 100% and specificity of 87.4%.
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McIntosh, Keith S., James C. Gregor, and Nitin V. Khanna. "Computer-Based Virtual Reality Colonoscopy Simulation Improves Patient-Based Colonoscopy Performance." Canadian Journal of Gastroenterology and Hepatology 28, no. 4 (2014): 203–6. http://dx.doi.org/10.1155/2014/804367.
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BACKGROUND: Colonoscopy simulators that enable one to perform computer-based virtual colonoscopy now exist. However, data regarding the effectiveness of this virtual training are limited.OBJECTIVE: To determine whether virtual reality simulator training translates into improved patient-based colonoscopy performance.METHODS: The present study was a prospective controlled trial involving 18 residents between postgraduate years 2 and 4 with no previous colonoscopy experience. These residents were assigned to receive 16 h of virtual reality simulator training or no training. Both groups were evaluated on their first five patient-based colonoscopies. The primary outcome was the number of proctor ‘assists’ required per colonoscopy. Secondary outcomes included insertion time, depth of insertion, cecal intubation rate, proctor- and nurse-rated competence, and patient-rated pain.RESULTS: The simulator group required significantly fewer proctor assists than the control group (1.94 versus 3.43; P≤0.001), inserted the colonoscope further unassisted (43 cm versus 24 cm; P=0.003) and there was a trend to intubate the cecum more often (26% versus 10%; P=0.06). The simulator group received higher ratings of competence from both the proctors (2.28 versus 1.88 of 5; P=0.02) and the endoscopy nurses (2.56 versus 2.05 of 5; P=0.001). There were no significant differences in proctor-, nurse- or patient-rated pain, or attention to discomfort.CONCLUSIONS: Computer-based colonoscopy simulation in the initial stages of training improved novice trainees’ patient-based colonoscopy performance.
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Hong, Seung Min, and Dong Hoon Baek. "A Review of Colonoscopy in Intestinal Diseases." Diagnostics 13, no. 7 (March 27, 2023): 1262. http://dx.doi.org/10.3390/diagnostics13071262.
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Since the development of the fiberoptic colonoscope in the late 1960s, colonoscopy has been a useful tool to diagnose and treat various intestinal diseases. This article reviews the clinical use of colonoscopy for various intestinal diseases based on present and future perspectives. Intestinal diseases include infectious diseases, inflammatory bowel disease (IBD), neoplasms, functional bowel disorders, and others. In cases of infectious diseases, colonoscopy is helpful in making the differential diagnosis, revealing endoscopic gross findings, and obtaining the specimens for pathology. Additionally, colonoscopy provides clues for distinguishing between infectious disease and IBD, and aids in the post-treatment monitoring of IBD. Colonoscopy is essential for the diagnosis of neoplasms that are diagnosed through only pathological confirmation. At present, malignant tumors are commonly being treated using endoscopy because of the advancement of endoscopic resection procedures. Moreover, the characteristics of tumors can be described in more detail by image-enhanced endoscopy and magnifying endoscopy. Colonoscopy can be helpful for the endoscopic decompression of colonic volvulus in large bowel obstruction, balloon dilatation as a treatment for benign stricture, and colon stenting as a treatment for malignant obstruction. In the diagnosis of functional bowel disorder, colonoscopy is used to investigate other organic causes of the symptom.
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Othman, Muhammad Faeid, Andee Dzulkarnaen Zakaria, Maya Mazuwin Yahya, Mohd Nizam Md Hashim, Wan Mokhzani Wan Mokhter, Wan Zainira Wan Zain, Ikhwan Sani Mohamad, et al. "Comparing Low Volume Versus Conventional Volume of Polyethylene Glycol for Bowel Preparation during Colonoscopy: A Randomised Controlled Trial." Malaysian Journal of Medical Sciences 30, no. 5 (October 30, 2023): 106–15. http://dx.doi.org/10.21315/mjms2023.30.5.9.
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Background: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration. Methods: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups. Results: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039). Conclusion: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.
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Fricker, Janet. "Upper gastrointestinal tract colonoscopes for colonoscopy." Lancet Oncology 9, no. 2 (February 2008): 100. http://dx.doi.org/10.1016/s1470-2045(08)70021-4.
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Xu, Xiufang, Dongqiong Ni, Yuping Lu, and Xuan Huang. "Diagnostic application of water exchange colonoscopy: A meta-analysis of randomized controlled trials." Journal of International Medical Research 47, no. 2 (January 11, 2019): 515–27. http://dx.doi.org/10.1177/0300060518819626.
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Background Few well-designed studies have investigated water exchange colonoscopy (WE). We performed a meta-analysis to comprehensively evaluate the clinical utility of WE based on high-quality randomized controlled trials (RCTs) and to compare the impacts of WE, water immersion colonoscopy (WI), and gas-insufflation colonoscopy. Methods We searched the Cochrane Library, MEDLINE, Embase, PubMed, Elsevier, CNKI, VIP, and Wan Fang Data for RCTs on WE. We analyzed the results using fixed- or random-effect models according to the presence of heterogeneity. Publication bias was assessed by funnel plots. Results Thirteen studies were eligible for this meta-analysis. The colonoscopic techniques included WE as the study group, and WI and air- or CO2-insufflation colonoscopy as control groups. WE was significantly superior to the control procedures in terms of adenoma detection rate, proportion of painless unsedated colonoscopy procedures, and cecal intubation rate according to odds ratios. WE was also significantly better in terms of maximal pain score and patient satisfaction score according to mean difference. Conclusions WE can remarkably improve the adenoma detection rate, proportion of painless unsedated colonoscopy procedures, patient satisfaction, and cecal intubation rate, as well as reducing the maximal pain score in patients undergoing colonoscopy.
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Araujo, Sergio Eduardo Alonso, Paulo Roberto Arruda Alves, and Angelita Habr-Gama. "Role of colonoscopy in colorectal cancer." Revista do Hospital das Clínicas 56, no. 1 (January 2001): 25–35. http://dx.doi.org/10.1590/s0041-87812001000100005.
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Colorectal cancer (CRC) represents the third most common malignancy throughout the world. Little or no improvement in survival has been effectively achieved in the last 50 years. Extensive epidemiological and genetic data are able to identify more precisely definite risk-groups so screening and early diagnosis can be more frequently accomplished. CRC is best detected by colonoscopy, which allows sampling for histologic diagnosis. Colonoscopy is the gold standard for detection of small and premalignant lesions, although it is not cost-effective for screening average-risk population. Colonoscopic polypectomy and mucosal resection constitute curative treatment for selective cases of invasive CRC. Similarly, alternative trans-colonoscopic treatment can be offered for adequate palliation, thus avoiding surgery.
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de Pinho, João Henrique Sendrete, Lorrane Vieira Siqueira Riscado, Marcos Paulo Moreira Sales, Gabriel Seixa de Souza, Abner Ramos de Castro, and Cristiane de Souza Bechara. "Low-cost Colonoscopic Simulator and Colonoscope to Train Basic Skills in Colonoscopy during Undergraduate Studies." Journal of Coloproctology 42, no. 04 (December 2022): 296–301. http://dx.doi.org/10.1055/s-0042-1757774.
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Abstract Objective To develop a low-cost simulator model and a colonoscope with materials that are easily accessible to offer training on colonoscopy skills during undergraduate studies. Since this is the procedure of choice for colorectal cancer screening, the general practitioner must be able to recognize its main indications, preparation, and complications. Methods Using materials such as a mannequin, a vehicle inspection camera, a conduit, polyvinyl chloride (PVC) pipe, acrylic, wood, and red paint, we built a simulator and a 150-cm long and 20-to-25-mm thick colonoscope. The colonoscope's handle and handhold were made of acrylic, the colonoscope's mobile end was made with articulated PVC rings, and the up and down movements were performed according to the traction of the steel cables. The camera attached to its distal end enables connection to a smartphone to view the image. In the simulator, the conduit was inserted into the mannequin to simulate the curvatures of the colon. Red spray paint was used to simulate the staining of the colonic mucosa in the inner region of the mannequin and the adventitial layer in the outer region. Results We were able to build a simulator and a colonoscope with a total amount of R$ 182.82 (roughly US$ 36.50). Both were tested and proved to be useful in the acquisition of psychomotor and cognitive skills in colonoscopy. Conclusion The simulator and colonoscope developed by us are cost-effective, useful in the acquisition of psychomotor and cognitive skills in colonoscopy, and can facilitate the structuring of a training program for undergraduate students.
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Simanjuntak, Tiroy Sari B. "COLONOSCOPIC EXAMINATION PROFILE AT THE UKI HOSPITAL, EAST JAKARTA FROM JANUARY 2014 - JULY 2015." International Journal of Research -GRANTHAALAYAH 9, no. 4 (May 3, 2021): 263–80. http://dx.doi.org/10.29121/granthaalayah.v9.i4.2021.3865.
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Colonoscopy is a procedure, which is done using a Colonoscope. The technique implemented in evaluating the colon: Picture of the colon, derived from the computed tomography or magnetic resonance imaging, is processed (reconstructed) by the computer to reveal colon lumen in 3D. Colonoscopy is used to diagnose diseases found in the large intestine; however, not all kinds of ailments in the large intestine can be diagnosed by colonoscopy. This study aims to determine the colonoscopy procedure profile in UKI Hospital East Jakarta from 2014 to July 2015. The design used by this research is a descriptive study, which is retrospective to the population of patients that have had a colonoscopy in UKI Hospital from January 2014 to July 2015. This study reveals the colonoscopy procedure profile at UKI Hospital, East Jakarta from January 2014 to July 2015: the most dominant age of the patients receiving colonoscopy is between 50 and 59. Patients are males of Batak ethnicity with a background of high school education. These males' main symptom is abdominal pain, which leads to colitis infection as the primary diagnosis. This study shows that patients who have the colonoscopy done upon them are patients with the age span of 50–59. Most are males due to the factor of lifestyle and stress condition. Background of the patients is working males with high school diplomas. The main complaint found among these patients is abdominal pain. Colitis infection is found to be the primary diagnosis among them.
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SHARMA, N., A. Virk, O. Nardone, S. Smith, P. Rimmer, U. Shivaji, S. Ghosh, and M. Iacucci. "P296 Quality of reporting of lesions detected at surveillance colonoscopy for IBD." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S301—S302. http://dx.doi.org/10.1093/ecco-jcc/jjz203.425.
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Abstract Background International guidelines of ESGE and ASGE have laid out best practice for documentation of lesions at colonoscopy but few performance indicators have been proposed for surveillance colonoscopy in IBD. A recent publication has highlighted the key performance indicators for surveillance colonoscopy.1 We conducted an audit of current quality of colonoscopy reports documenting lesions detected during surveillance colonoscopy. Methods A retrospective analysis of patients who underwent colonoscopy for IBD surveillance over a five year period (2014–2019) at the Queen Elizabeth Hospital, Birmingham, UK was performed. The reports were analysed by independent academic doctors in the gastroenterology division trained in quality of endoscopic report analysis. Optimum criteria for documentation comprised lesion nature (Paris classification), size, documentation of Kudo classification and pit pattern, borders and ulceration. Results A total of 1028 colonoscopies were performed for IBD surveillance and the procedures were standardised with routine dye spraying since 2016. The mean patient age was 47.9 years (SD 16.8). Visual evidence of colonoscopic lesions was recorded in 273 cases. Key performance indicators documented for each endoscopic criterion and lesion nature is noted in the Table. Low-grade dysplasia was detected in 61 patients, and carcinoma in 4 patients; no patient had high-grade dysplasia. Benign lesions such as pseudopolyps were detected in the rest. 7 patients had sessile serrated lesions. Conclusion At IBD surveillance colonoscopy, documentation of lesions is better for the domains of size, Paris classification and Kudo pit pattern, though not perfect. We also highlight that our colonoscopic documentation of borders and presence of ulcerations is done poorly. It is important that comprehensive training is undertaken to improve documentation as it is essential for the proper choice of management of these lesions. Reference
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Kim, Eun Sun, Hoon Jai Chun, Yoon Tae Jeen, Bora Keum, and Hyuk Soon Choi. "How often does the patient repeat screening colonoscopy? A study for personalized recommendation of screening colonoscopy interval." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 527. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.527.
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527 Background: Colorectal cancer (CRC) is the third most common cancer and the second most frequent cause of cancer death of female and fourth most of male in South Korea. Most CRCs develop through the adenoma–carcinoma sequence, which allows for screening and prevention of CRCs by screening colonoscopic examination and polypectomy. However, there have been limited data on personalized optimal time interval of next surveillance colonoscopic examination. The aim of our study is to recommend personalized interval by analysis of various clinical factors obtained by health care examination. Methods: We enrolled the patients who underwent two times more voluntary, complete screening colonoscopy at health care unit of Korea University Medical Center Anam Hospital from July 1, 2004 to July 31, 2010. The clustering analysis using the partitioning around medoids algorithm and Hierarchial cluster were conducted including the 32 clinical, geographic and laboratory data. For each cluster, we then performed survival analysis that provides the probability of having polyps according to the number of days until next colonoscopy. Results: Totally 8,332 patients underwent screening colonoscopy, among them 625 patients performed repeat colonoscopy exam. 625 patients divided four clusters by clustering analysis. Adenoma detection at first screening colonoscopy was the most potent risk factor of develop of adenoma at next screening. Male gender, triglyceride (>134 mg/dL), and age (>56 years old) were significant factor for decision of the personalized interval of next screening colonoscopy. For example, male patient, who had adenoma at fist screening, the predicted risk of adenoma is 50% after 25 months. Conclusions: Our study can provide personalized time interval of next screening colonoscopy according to patients’ individual clinical data. Further study are necessary for validation our results.
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Ko, Hin Hin, Trevor Jamieson, and Brian Bressler. "Acute Pancreatitis and Ileus Postcolonoscopy." Canadian Journal of Gastroenterology 23, no. 8 (2009): 551–53. http://dx.doi.org/10.1155/2009/357059.
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Postpolypectomy bleeding and perforation are the most common complications of colonoscopy. A case of acute pancreatitis and ileus after colonoscopy is described. A 60-year-old woman underwent a gastroscopy and colonoscopy for investigation of iron deficiency anemia. Gastroscopy was normal; however, the colonoscope could not be advanced beyond the splenic flexure due to a tight angulation. Two polypectomies were performed in the descending colon. After the procedure, the patient developed a distended, tender abdomen. Bloodwork was remarkable for an elevated amylase level. An abdominal x-ray and computed tomography scan showed pancreatitis (particularly of the tail), a dilated cecum and a few air-fluid levels. The patient improved within 24 h of a repeat colonoscopy and decompression tube placement. The patient had no risk factors for pancreatitis. The causal mechanism of pancreatitis was uncertain but likely involved trauma to the tail of the pancreas during the procedure. Our patient developed ileus, likely secondary to pancreatitis. The present case is the first report of clinical pancreatitis and ileus associated with colonoscopy.
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Homma, Yuko, Toshiki Mimura, Ai Sadatomo, Koji Koinuma, Hisanaga Horie, Alan Kawarai Lefor, and Naohiro Sata. "Colonoscopic Treatment of a Fecaloma at the Anastomotic Site after Colectomy." Case Reports in Gastroenterology 15, no. 3 (December 27, 2021): 994–1002. http://dx.doi.org/10.1159/000521127.
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Fecalomas most commonly occur in constipated patients and are rarely reported after colectomy. A 55-year-old Japanese female presented with a fecaloma after colectomy, which was impacted at a functional end-to-end anastomosis (FEEA) site. Four and a half years ago, she underwent sigmoidectomy for colon cancer. A follow-up computed tomography (CT) scan revealed an 11 cm incidental fecaloma. The patient was advised to undergo surgery, but she desired nonoperative management because of minimal symptoms, and was referred to our institution. On the day of admission (day 1), mechanical fragmentation of the fecaloma was attempted during the first colonoscopy. Although a large block of stool was evacuated after a second colonoscopic fragmentation on day 8, the third colonoscopy on day 21 and CT scan on day 22 showed no significant change in the fecaloma. Frequent colonoscopic fragmentation was performed, with a fourth, fifth, and sixth colonoscopy on days 24, 29, and 31, respectively. After the size reduction was confirmed at the sixth colonoscopy, the patient was discharged home on day 34. The fecaloma completely resolved after the seventh colonoscopic fragmentation on day 44. Sixteen months after treatment, there is no evidence of recurrent fecaloma. According to the literature, risk factors for fecaloma after colectomy include female gender, left-side colonic anastomosis, and FEEA. FEEA might not be recommended for anastomoses in the left colon, particularly in female patients, to avoid this complication. Colonoscopic fragmentation is recommended for fecalomas at an anastomotic site after colectomy in patients without an absolute indication for surgery.
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Essa, Suhair Aboud, Hiba Dhari Mudhir, and Farah Lateef Rustum. "Diagnostic Yield of Colonoscopy in Patients Presenting with Lower Gastrointestinal Bleeding at a Tertiary Care Center." Iraqi Journal of Community Medicine 37, no. 1 (January 2024): 45–48. http://dx.doi.org/10.4103/irjcm.irjcm_10_24.
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Abstract Background and Aims: Lower gastrointestinal bleeding (LGIB) poses a significant challenge in clinical practice due to its diverse etiologies and potential for serious morbidity and mortality. Colonoscopy is the preferred, valuable diagnostic tool for identifying the underlying cause of LGIB. This study aimed to evaluate colonoscopic findings in patients presenting with LGIB at a tertiary care hospital in Baghdad. Subjects and Methods: This retrospective descriptive study reviewed records of patients, who underwent colonoscopy for LGIB, at the Gastroenterology and Hepatology Teaching Hospital in Baghdad Governorate between January 1 and July 31, 2023. The analysis included age, sex, and endoscopic findings. Results: A total of 228 patients were included, with 124 (54.4%) males and 104 (45.6%) females. The mean age was 39.23 ± 20.57 years. A colonoscopy revealed a diagnostic yield of 68.0%. LGIB was more prevalent among individuals aged 40 years and younger (53.5%). The most common colonoscopic finding was hemorrhoids (20.2%), followed by polyps (13.1%), colitis (9.2%), ulcerative colitis (8.3%), and colorectal cancer (7.9%). Conclusion: This study underscores the importance of colonoscopy in evaluating LGIB. Larger, multicenter studies are recommended to validate these findings and guide clinical practice in LGIB management.
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Chartier, Lucas, Erin Arthurs, and Maida J. Sewitch. "Patient Satisfaction with Colonoscopy: A Literature Review and Pilot Study." Canadian Journal of Gastroenterology 23, no. 3 (2009): 203–9. http://dx.doi.org/10.1155/2009/903545.
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BACKGROUND: Current guidelines recommend that colonoscopic colorectal cancer screening be undertaken every 10 years after the age of 50 years. However, because the procedure does not meet criteria that promote screening uptake, patient satisfaction with colonoscopy may encourage repeat screening.OBJECTIVE: To systematically review the literature and conduct a pilot study of patient satisfaction with the colonoscopy experience.METHODS: All cohort studies from January 1997 to August 2008 in the MEDLINE database that measured either patient satisfaction with colonoscopy, patient willingness to return for colonoscopy under the same conditions or patient preference for colonoscopy compared with other large bowel procedures were identified. The search was supplemented by journal citation lists in the retrieved articles.RESULTS: Of the 29 studies identified, 15 met the inclusion criteria. Consistently, the vast majority of patients (approximately 95%) were very satisfied with their colonoscopy experience. Patient satisfaction was similar for screening and nonscreening colonoscopy. Patient willingness to return for the procedure ranged from 73% to 100%. Of the five studies that examined modality preference, three studies reported the majority of patients preferred colonography to colonoscopy and two studies reported the reverse. Our pilot study findings mirrored those of other studies that were conducted in the United States. The major limitation of the included studies was that patients who were most dissatisfied may have gone elsewhere to have their colonoscopy.CONCLUSIONS: Patients were very satisfied with colonoscopy. The majority were willing to return for repeat testing under the same conditions, and colonoscopy was not preferred over other modalities. However, studies were limited by methodological shortcomings.
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Feng, Xiao Xiao, Fu Bing Jiang, Hai Yan Hu, Hong Gu, Xiao Wei Cai, and Jin Cheng Ni. "Mechanical Analysis of Snake-Like Robot for Colonoscopy." Advanced Materials Research 706-708 (June 2013): 849–54. http://dx.doi.org/10.4028/www.scientific.net/amr.706-708.849.
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In order to develop a robot for colonoscopy, which can provide the same functions as conventional colonoscope, but much less pain and discomfort for patient, a snake-like robot with continuum structure is proposed. The mechanical structure of snake-like robot for colonoscopy is introduced and the angle of single section is calculated. The mechanical model of cantilever beam is built, the force diagram is drawn and the mechanical analysis of single section in bending process is mainly analyzed. Finally, ‘Pro/E’ is used to build model and simulate the process that the snake-like body goes through the colon. This paper lays foundation for the research on snake-like robot for colonoscopy.
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Tuyama, Ana C., and Jerome D. Waye. "W1477: Completion Colonoscopy With a Thin Colonoscope." Gastrointestinal Endoscopy 71, no. 5 (April 2010): AB338. http://dx.doi.org/10.1016/j.gie.2010.03.889.
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González-Fernández, Coty, David García-Rangel, Nancy Aguilar-Olivos, Rafael Barreto-Zúñiga, Adriana Romano-Munive, Guido Grajales-Figueroa, Luis Zamora-Nava, and Félix Téllez-Avila. "Higher adenoma detection rate with the endocuff: a randomized trial." Endoscopy 49, no. 11 (September 12, 2017): 1061–68. http://dx.doi.org/10.1055/s-0043-117879.
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Abstract Background and study aim Different techniques have been introduced to improve the endoscopist’s view and enhance the detection of polyps. The endocuff is a polymer sleeve cap that is connected to the tip of the colonoscope in order to improve visualization of the mucosa during colonoscopy. The aim of the study was to compare adenoma detection rates (ADR) of endocuff-assisted colonoscopy and conventional colonoscopy. Patients and methods Patients 50 years or older were randomized into two groups: an endocuff-assisted colonoscopy group and a conventional colonoscopy group without the endocuff. Results A total of 337 patients were included: 174 in the endocuff group and 163 in the conventional group. The median age was 61 years (interquartile range 55 – 70 years), and 74 % were women. The ADR was higher in the endocuff group than in the conventional group (22.4 % vs. 13.5 %; P = 0.02). The mean number of adenomas was 0.30 (SD 0.25) in the endocuff group and 0.21 (SD 0.26) in the conventional group (P = 0.02). The rate of ileal intubation was lower in the endocuff group (73 % vs. 87 %; P < 0.001). No serious adverse events occurred with the use of the endocuff. Conclusions Endocuff colonoscopy achieved a greater ADR than conventional colonoscopy.Trial registered at ClinicalTrials.gov (NTC02387593).
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DE VISSER, HANS, JOSH PASSENGER, DAVID CONLAN, CHRISTOPH RUSS, DAVID HELLIER, MARIO CHENG, OSCAR ACOSTA, SÉBASTIEN OURSELIN, and OLIVIER SALVADO. "DEVELOPING A NEXT GENERATION COLONOSCOPY SIMULATOR." International Journal of Image and Graphics 10, no. 02 (April 2010): 203–17. http://dx.doi.org/10.1142/s0219467810003731.
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Colonoscopy is considered the gold standard for detection and removal of precancerous polyps in the colon. Being a difficult procedure to master, exposure to a large variety of patient and pathology scenarios is crucial for gastroenterologists' training. Currently, most training is done on patients under supervision of experienced gastroenterologists. Being able to undertake a majority of training on simulators would greatly reduce patient risk and discomfort. A next generation colonoscopy simulator is currently under development, which aims to address the shortfalls of existing simulators. The simulator consists of a computer simulation of the colonoscope camera view and a haptic device that allows insertion of an instrumented colonoscope to drive the simulation and provide force feedback to the user. The simulation combines physically accurate models of the colonoscope, colon and surrounding tissues and organs with photorealistic visualization. It also includes the capability to generate randomized case scenarios where complexity of the colon physiology, pathology and environmental factors, such as colon preparation, can be tailored to suit training requirements. The long term goal is to provide a metrics based training and skill evaluation system that is not only useful for trainee instruction but can be leveraged for skills maintenance and eventual certification.
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Gerges, Christian, Helmut Neumann, Sauid Ishaq, Visvakanth Sivanathan, Peter R. Galle, Horst Neuhaus, and Helmut Neumann. "Evaluation of a novel colonoscope offering flexibility adjuster – a retrospective observational study." Therapeutic Advances in Gastroenterology 14 (January 2021): 175628482110134. http://dx.doi.org/10.1177/17562848211013494.
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Background: Although colonoscopy is the gold standard for colorectal cancer screening, colonic looping may make complete colonoscopy challenging. Commonly available stiffening device colonoscopy has been described as helpful but not effective enough to prevent looping. In this context the effect on cecal intubation time and rate was described differently in various studies and in some studies had no impact on cecal intubation time at all. The aim of this study was to evaluate whether a novel colonoscope with gradual stiffness (Fujifilm EC760R-V/I- flexibility adjuster, Tokyo, Japan) using four significantly different grades of stiffness can be an alternative to established devices in terms of loop prevention, cecal intubation rate and time, adverse events, and patient/examiner satisfaction. Methods: Consecutive patients without previous colorectal surgery were analyzed retrospectively. Colonoscopy was performed with the new colonoscope and performance characteristics, including time to cecum, withdrawal time, total examination time, and patient and endoscopist satisfaction were recorded. Results: Among 180 consecutive procedures, 98.3% of examinations were complete to the cecum. The endoscopic flexibility adjuster was used in 150 of 180 cases (83.3%). Overall, the device was scored by the examiner as helpful to prevent looping in 146 of the 150 cases (97.7%). Mean cecal intubation time was 6.5 min, with 35% of examination performed in under 5 min with a mean withdrawal time of 7 min. Mean total examination time was 18 min. Patient satisfaction was rated as high in all examinations performed. Conclusion: The new flexibility adjuster colonoscope was shown to be helpful in loop prevention, allowed for fast and successful cecal intubation, and led to a high rate of patients satisfaction.
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Vilmann, Andreas Slot, Christian Lachenmeier, Morten Bo Søndergaard Svendsen, Bo Søndergaard, Yoon Soo Park, Lars Bo Svendsen, and Lars Konge. "Using computerized assessment in simulated colonoscopy: a validation study." Endoscopy International Open 08, no. 06 (May 25, 2020): E783—E791. http://dx.doi.org/10.1055/a-1132-5259.
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Abstract Background and study aims Patient safety during a colonoscopy highly depends on endoscopist competence. Endoscopic societies have been calling for an objective and regular assessment of the endoscopists, but existing assessment tools are time-consuming and prone to bias. We aimed to develop and gather evidence of validity for a computerized assessment tool delivering automatic and unbiased assessment of colonoscopy based on 3 dimensional coordinates from the colonoscope. Methods Twenty-four participants were recruited and divided into two groups based on experience: 12 experienced and 12 novices. Participants performed twice on a physical phantom model with a standardized alpha loop in the sigmoid colon. Data was gathered directly from the Olympus ScopeGuide system providing XYZ-coordinates along the length of the colonoscope. Five different motor skill measures were developed based on the data, named: Travel Length, Tip Progression, Chase Efficiency, Shaft movement without tip progression, and Looping. Results The experinced had a lower travel length (P < 0.001), tip progression (P < 0.001), chase efficiency (P = 0.001) and looping (P = 0.006), and a higher shaft movement without tip progression (P < 0.001) reaching the cecum compared with the novices. A composite score was developed based on the five measurements to create a combined score of progression, the 3D-Colonoscopy-Progression-Score (3D-CoPS). The 3D-CoPS revealed a significant difference between groups (experienced: 0.495 (SD 0.303) and novices –0.454 (SD 0.707), P < 0.001). Conclusion This study presents a novel, real-time computerized assessment tool for colonoscopy, and strong evidence of validity was gathered in a simulation-based setting. The system shows promising opportunities for automatic, unbiased and continuous assessment of colonoscopy performance.
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Manigrasso, Michele, Marco Milone, Mario Musella, Pietro Venetucci, Francesco Maione, Ugo Elmore, Gaetano Gallo, et al. "Preoperative Localization in Colonic Surgery (PLoCoS Study): a multicentric experience on behalf of the Italian Society of Colorectal Surgery (SICCR)." Updates in Surgery 74, no. 1 (October 5, 2021): 137–44. http://dx.doi.org/10.1007/s13304-021-01180-7.
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AbstractThe aim of this prospective multicentric study was to compare the accurate colonic lesion localization ratio between CT and colonoscopy in comparison with surgery. All consecutive patients from 1st January to 31st December 2019 with a histologically confirmed diagnosis of dysplastic adenoma or adenocarcinoma with planned elective, curative colonic resection who underwent both colonoscopy and CT scans were included. Each patient underwent conventional colonoscopy and CT to stage the tumour, and the localization results of each procedure were registered. CT and colonoscopic localization were compared with surgical localization, adopted as the reference. Our analysis included 745 patients from 23 centres. After comparing the accuracy of colonoscopy and CT (for visible lesions) in localizing colonic lesions, no significant differences were found between the two preoperative tools (510/661 vs 499/661 correctly localized lesions, p = 0.518). Furthermore, after analysing only the patients who underwent complete colonoscopy and had a visible lesion on CT, no significant difference was observed between conventional colonoscopy and CT (331/427 vs 340/427, p = 0.505). Considering the intraoperative localization results as a reference, a comparison between colonoscopy and CT showed that colonoscopy significantly failed to correctly locate the lesions localized in the descending colon (17/32 vs 26/32, p = 0.031). We did not identify an advantage in using CT to localize colonic tumours. In this setting, colonoscopy should be considered the reference to properly localize lesions; however, to better identify lesions in the descending colon, CT could be considered a valuable tool to improve the accuracy of lesion localization.
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Hassan, Cesare, Giulio Antonelli, Jean-Marc Dumonceau, Jaroslaw Regula, Michael Bretthauer, Stanislas Chaussade, Evelien Dekker, et al. "Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020." Endoscopy 52, no. 08 (June 22, 2020): 687–700. http://dx.doi.org/10.1055/a-1185-3109.
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Main RecommendationsThe following recommendations for post-polypectomy colonoscopic surveillance apply to all patients who had one or more polyps that were completely removed during a high quality baseline colonoscopy. 1 ESGE recommends that patients with complete removal of 1 – 4 < 10 mm adenomas with low grade dysplasia, irrespective of villous components, or any serrated polyp < 10 mm without dysplasia, do not require endoscopic surveillance and should be returned to screening.Strong recommendation, moderate quality evidence.If organized screening is not available, repetition of colonoscopy 10 years after the index procedure is recommended.Strong recommendation, moderate quality evidence. 2 ESGE recommends surveillance colonoscopy after 3 years for patients with complete removal of at least 1 adenoma ≥ 10 mm or with high grade dysplasia, or ≥ 5 adenomas, or any serrated polyp ≥ 10 mm or with dysplasia. Strong recommendation, moderate quality evidence. 3 ESGE recommends a 3 – 6-month early repeat colonoscopy following piecemeal endoscopic resection of polyps ≥ 20 mm.Strong recommendation, moderate quality evidence. A first surveillance colonoscopy 12 months after the repeat colonoscopy is recommended to detect late recurrence.Strong recommendation, high quality evidence. 4 If no polyps requiring surveillance are detected at the first surveillance colonoscopy, ESGE suggests to perform a second surveillance colonoscopy after 5 years. Weak recommendation, low quality evidence.After that, if no polyps requiring surveillance are detected, patients can be returned to screening. 5 ESGE suggests that, if polyps requiring surveillance are detected at first or subsequent surveillance examinations, surveillance colonoscopy may be performed at 3 years. Weak recommendation, low quality evidence.A flowchart showing the recommended surveillance intervals is provided (Fig. 1).
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Hsieh, Yu-Hsi, An-Liang Zhou, and Hwai-Jeng Lin. "Long pediatric colonoscope versus intermediate length adult colonoscope for colonoscopy." Journal of Gastroenterology and Hepatology 23, no. 7pt2 (July 2008): e7-e10. http://dx.doi.org/10.1111/j.1440-1746.2007.04864.x.
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Lüchinger, Annemarie B., Milou P. H. Busard, Velja Mijatovic, Jan Hein T. M. van Waesberghe, Chris J. Mulder, and Peter G. A. Hompes. "Cyclic Hematochezia: A Sign of Intestinal Endometriosis? An Evaluation by Magnetic Resonance Imaging and Colonoscopy." Journal of Endometriosis 3, no. 1 (January 2011): 47–52. http://dx.doi.org/10.5301/je.2011.8325.
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Purpose Intestinal bowel endometriosis is reported in up to 37% of women with proven endometriosis. The aim of this study was to evaluate by colonoscopy and magnetic resonance imaging, patients suspected of deep infiltrating endometriosis (DIE) including the bowel wall that presented with cyclic hematochezia. Methods Twenty-four patients with cyclic hematochezia were retrospectively analyzed on colonoscopic features of colonoscopy, corresponding biopsy data, and outcome of magnetic resonance imaging evaluation. Fifteen out of 24 patients underwent bowel resection because of insufficient response to hormonal treatment (N=14) or obstructive ileus (N=1). Outcome of surgery and histologic examination of the resected specimens were evaluated. Results Colonoscopy proved intestinal endometriosis in only one out of 24 (4%) patients with cyclic hematochezia. In 13 out of 15 bowel resections endometriosis was found at histopathology. The location and dimension of lesions during surgery correlated well with magnetic resonance imaging findings. However, magnetic resonance imaging revealed a limited capacity to detect luminal narrowing of the bowel. Conclusions This study shows that colonoscopic findings of bowel endometriosis are aspecific. Colonoscopy, an invasive investigation, should therefore not be performed to diagnose endometriosis infiltrating the bowel wall. Magnetic resonance imaging provides good diagnostic work-up and in selected patients a roadmap to surgery.
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Libânio, Diogo, and Luís Filipe Azevedo. "Análise da Revisão Cochrane: Cromoscopia Versus Colonoscopia Convencional na Deteção de Pólipos ColoRetais. Cochrane Database Syst Rev. 2016;4:CD006439." Acta Médica Portuguesa 29, no. 10 (October 31, 2016): 583. http://dx.doi.org/10.20344/amp.7968.
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Although colonoscopy is considered the most accurate test for the investigation of colorectal polyps, lesions ≤ 10 mm may be missed in approximately 10%. Chromoscopy may increase the detection of colorectal polyps. A systematic review and meta-analysis was performed to investigate the benefit of cromoscopy in colorectal polyps detection. Seven randomized controlled trials were included (incuding 2,727 participants) comparing polyp detection (both neoplastic and non- neoplastic polyps) in patients submitted to conventional colonoscopy or colonoscopy with chromoscopy. Chromoscopy was associated with a significant improvement in all detection endpoints (number of polyps, number of neoplastic polyps, number of diminutive polyps, number of neoplastic diminutive polyps, proportion of patients with at least one polyp and proportion of patients with at least one neoplastic polyp). However, when highdefinition colonoscopes were used in the control group, chromoscopy benefit does not seem to be significant. Besides, routine use of chromoscopy may have implications in the accessibility of colonoscopy and in the effectiveness of screening programs. Moreover, the benefit of chromoscopy in the era of high-definition colonoscopy is questionable.
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Lee, Han Hee, Hyun Ho Choi, Chun-Hyun Lim, Hyung-Keun Kim, Sung Soo Kim, Hiun-Suk Chae, Hyunjung Cho, and Young-Seok Cho. "Postcolonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 526. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.526.
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526 Background: There are relatively few studies regarding the incidence of postcolonoscopy colorectal cancer (PCCRC) in Asian countries. We evaluated the characteristics of PCCRC in average-risk Korean subjects. Methods: This study included subjects who were ≥ 50 years of age and had undergone a first completed colonoscopy between January 2001 and December 2004, at which no baseline adenoma had been detected, followed by a second colonoscopy 1–5 years later. The incidence and characteristics of advanced neoplasia in these subjects were assessed. Results: A total of 343 subjects underwent follow-up colonoscopy within 5 years. Seventy-three (21.3%) subjects were found to have at least one adenoma upon follow-up colonoscopy. Advanced adenoma was found in eight (2.3%) subjects, and non-advanced adenomas were found in 65 (19.0%). Five patients (1.5%) were diagnosed with invasive CRC following a normal colonoscopy. The putative reason for the PCCRCs was missed lesions in two (40.0%) and new cancer in three (60.0%) cases. Conclusions: The risk of advanced neoplasia (including PCCRCs) within 5 years after a normal baseline colonoscopy in our cohort was not low. Considering that 40% of PCCRCs were attributable to missed lesions, our results emphasize the need for technical improvement of colonoscopic examinations to improve adenoma detection.
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Hines, Robert Brooks, Md Jibanul Haque Jiban, Adrian V. Specogna, Priya Vishnubhotla, Eunkyung Lee, Steven Troy, and Shunpu Zhang. "Timing of first surveillance colonoscopy in stage I colon cancer patients and the association with colon cancer-specific survival." Journal of Clinical Oncology 37, no. 4_suppl (February 1, 2019): 618. http://dx.doi.org/10.1200/jco.2019.37.4_suppl.618.
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618 Background: Surveillance colonoscopy following curative surgery in stage I colon cancer patients is controversial. This study was conducted to assess the relationship between timing of first surveillance colonoscopy and 5-year colon cancer-specific survival. Methods: This was a retrospective cohort study of the Surveillance, Epidemiology, and End Results database combined with Medicare claims. Stage I colon cancer patients (66-84 years of age) were categorized according to receipt of first colonoscopy following cancer-directed surgery as: Year 1, Year 2, Year 3, and No Colonoscopy within 3 years of surgery. Propensity score weighting was used to balance covariates. Cox regression was used to obtain hazard ratios for the relative risk of 5-year colon cancer-specific death, adjusted survival estimates, and the number needed to treat (NNT) with colonoscopy in Year 1 to prevent a colon cancer-specific death in the other groups. Results: There were 8,494 stage I colon cancer patients available for analysis. Regarding 5-year colon cancer-specific mortality, compared to Year 1 patients, the No Colonoscopy group experienced 2.2 times the risk of colon cancer-specific death (HR, 2.23; 95% CI, 1.38 to 3.61). Those who received ≥ 1 additional colonoscopies in the two years following their initial assessment experienced a significant 73% decreased risk of death (HR, 0.27; 95% CI, 0.16 to 0.45). Delaying colonoscopy (Years 2 & 3) did not result in a statistically significant increased risk of death. Although the absolute difference in 5-year adjusted survival was small, if all patients in the No Colonoscopy group received a colonoscopy in Year 1, 46.2% (n = 49.9) of the 108 colon cancer deaths that occurred in this group could have been prevented. Conclusions: Although stage I colon cancer patients have a good prognosis, patients who received colonoscopy within one year of cancer-directed surgery experienced significantly better survival than patients who did not receive colonoscopy within 3 years of surgery. The results of this study justify efforts to ensure that stage I colon cancer patients receive colonoscopic surveillance testing approximately 1 year following cancer-directed surgery.
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Walter, Benjamin, Alexander Hann, Rena Frank, and Alexander Meining. "A 3D-printed cap with sideoptics for colonoscopy: a randomized ex vivo study." Endoscopy 49, no. 08 (April 26, 2017): 808–12. http://dx.doi.org/10.1055/s-0043-105071.
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Abstract Background Adequate polyp detection is crucial to colonoscopy; however, detection can be impaired. In particular, flat polyps located behind folds or near the colonic flexures appear to be a problem. We present a cheap and easily adjustable 3D-printed tool to enhance the view of a standard colonoscope using additional commercially available sideoptics. Materials and methods A cap adjustable to a standard endoscope was printed by a 3 D printer and had two microcameras fixed to offer two additional views. Fourteen endoscopists performed one standard and one sideoptic-enhanced colonoscopy in a randomized order. Flat lesions were simulated in an endoscopy training model. Time for withdrawal was measured, along with the number of flat lesions detected. Results Withdrawal time did not differ significantly between standard and sideoptic-enhanced colonoscopy (329 vs. 389 seconds). The median number of detected flat lesions per endoscopic examination was significantly higher using the sideoptic tool (8 vs. 6.5; P = 0.001). Conclusions A 3D-printed sideoptic-enhanced cap including two microcameras may be a cheap, easy, and feasible add-on to improve adenoma detection rates in routine colonoscopy.
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Murasugi, Shun, Ayumi Ito, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige. "Clinical Characterization of Ulcerative Colitis in Patients with Primary Sclerosing Cholangitis." Gastroenterology Research and Practice 2020 (November 7, 2020): 1–8. http://dx.doi.org/10.1155/2020/7969628.
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Objectives. The clinical/colonoscopic features of ulcerative colitis (UC) associated with primary sclerosing cholangitis (PSC), the prognostic impact of UC, and the utility of UC screening in PSC patients are unknown. We characterized UC associated with PSC and assessed UC’s impact on the prognosis of PSC and the importance of colonoscopic UC screening in PSC patients. Methods. We retrospectively analyzed the cases of 77 patients treated for PSC at a single center (April 2000–July 2019). We reviewed the clinical/colonoscopic profiles of the concurrent UC patients and compared the clinical profiles, survival, and primary causes of death between the patients with/without UC ( n = 35 / n = 42 ). The details of all patients’ colonoscopies were reviewed. Results. The concurrent UC group: 17 men, 18 women, diagnosed with PSC at the mean (SD) age of 36 (17) years; 21 patients (60%) had no UC symptoms. Colonoscopy revealed pancolitis in all patients, predominantly affecting the right-sided colon in 30 patients (86%). Lesions were scattered. Backwash ileitis ( n = 13 , 37%) and rectal sparing ( n = 18 , 51%) were observed. Most patients had mild UC; some had moderate or more severe UC (median Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score 2; range, 1–5). Ludwig’s stage determined by liver biopsy did not correlate with the Mayo endoscopic score for UC. The patients with UC were diagnosed with PSC at a significantly younger age than those without UC (mean (SD), 36 [17] years vs. 55 [19] years, p < 0.0001 ) and had a significantly higher 5-year survival rate (97.1% vs. 70.5%, p = 0.0028 ). UC was detected in 19 of 34 asymptomatic patients (56%) who underwent colonoscopy screening. Conclusions. Our cohort’s clinical/colonoscopic features of UC associated with PSC are more moderate or severe UC than previous cases. The coexistence of UC might affect the prognosis of PSC. In this regard, colonoscopy in PSC patients is an important examination for determining prognosis. There is also asymptomatic UC in patients with PSC. In this regard, screening for colonoscopy in PSC patients is essential. When a diagnosis of PSC is made, immediate colonoscopy is a priority with UC complications in mind.
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Sanagapalli, Santosh, Kriti Agnihotri, Rupert Leong, and Crispin John Corte. "Antispasmodic drugs in colonoscopy: a review of their pharmacology, safety and efficacy in improving polyp detection and related outcomes." Therapeutic Advances in Gastroenterology 10, no. 1 (October 3, 2016): 101–13. http://dx.doi.org/10.1177/1756283x16670076.
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Antispasmodic drugs are cheap, effective and generally safe. They may improve outcomes in colonoscopy, however their use has not been consistent or widespread. This manuscript reviews the three most commonly used antispasmodics in colonoscopy, namely, hyoscine butylbromide (and related ammonium compounds), glucagon and peppermint oil. The pharmacology, action and safety of the agents, as well as the evidence for them improving colonoscopic outcomes will be discussed. In addition to polyp detection, other colonoscopic outcome endpoints of interest include cecal and ileal intubation, and patient comfort. The drugs studied were all found to be effective gastrointestinal antispasmodics with good safety profiles. There is insufficient evidence to conclude whether antispasmodics improve cecal intubation rate, predominantly because the baseline rates are already high. Antispasmodics probably have efficacy in reducing cecal intubation time especially in those with marked colonic spasm. Antispasmodics do not offer significant benefit in polyp detection or improving patient comfort during colonoscopy. Future studies should focus on inexperienced colonoscopists as well as those with marked colonic spasm, in whom the greatest benefit seems to lie.
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Bhattarai, Subash, Ramesh Raj Acharya, Bishnu Jwarchan, and Dipesh Karki. "Clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage: a descriptive cross-sectional study." Asian Journal of Medical Sciences 11, no. 4 (July 1, 2020): 40–45. http://dx.doi.org/10.3126/ajms.v11i4.28718.
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Background: Most of the bleeding in the lower gastrointestinal tract are usually located in the rectum, colon and terminal ileum. Colonoscopy is an invasive procedure used for both diagnostic and therapeutic purposes for detection of lower gastrointestinal (GI) tract pathologies and haemorrhage.
Aims and Objective: The purpose of the study was to understand the clinical profile and colonoscopic findings in patients with lower gastrointestinal haemorrhage.
Materials and Methods: Seventy-two patients presenting with lower GI haemorrhage were included in the study. All patients underwent colonoscopy after achieving hemodynamic stability and bowel preparation. Clinical profile and colonoscopic findings were studied.
Results: The common aetiologies of lower GI haemorrhage were haemorrhoids followed by nonspecific colitis, colorectal polyp and carcinoma of colon. Rectum followed by sigmoid harbored majority of pathologies that presented with lower GI haemorrhage.
Conclusions: The diagnosis of the pathological lesion and management of underlying cause not only prevents another episode of lower GI haemorrhage but also help in reducing morbidity and mortality. Colonoscopy or at least sigmoidoscopy is strongly recommended for evaluation, diagnosis and management of lower GI haemorrhage.
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Secchi, Maria Francesca, Carlo Torre, Giovanni Dui, Francesco Virdis, and Mauro Podda. "The Close Relationship between Large Bowel and Heart: When a Colonic Perforation Mimics an Acute Myocardial Infarction." Case Reports in Surgery 2018 (July 16, 2018): 1–6. http://dx.doi.org/10.1155/2018/8020197.
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Colonoscopic perforation is a serious and potentially life-threatening complication of colonoscopy. Its incidence varies in frequency from 0.016% to 0.21% for diagnostic procedures, but may be seen in up to 5% of therapeutic colonoscopies. In case of extraperitoneal perforation, atypical signs and symptoms may develop. The aim of this report is to raise the awareness on the likelihood of rare clinical features of colonoscopic perforation. A 72-year-old male patient with a past medical history of myocardial infarction presented to the emergency department four hours after a screening colonoscopy with polypectomy, complaining of neck pain, retrosternal oppressive chest pain, dyspnea, and rhinolalia. Right chest wall and cervical subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and bilateral subdiaphragmatic free air were reported on the chest and abdominal X-rays. The patient was treated conservatively, with absolute bowel rest, total parental nutrition, and broad-spectrum intravenous antibiotics. Awareness of the potentially unusual clinical manifestations of retroperitoneal perforation following colonoscopy is crucial for the correct diagnosis and prompt management of colonoscopic perforation. Conservative treatment may be appropriate in patients with a properly prepared bowel, hemodynamic stability, and no evidence of peritonitis. Surgical treatment should be considered when abdominal or chest pain worsens, and when a systemic inflammatory response arises during the conservative treatment period.
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Fenlon, H. M., P. D. Clarke, and J. T. Ferrucci. "Virtual colonoscopy: imaging features with colonoscopic correlation." American Journal of Roentgenology 170, no. 5 (May 1998): 1303–9. http://dx.doi.org/10.2214/ajr.170.5.9574607.
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Bat, Leon, and Christopher B. Williams. "Usefulness of pediatric colonoscopes in adult colonoscopy." Gastrointestinal Endoscopy 35, no. 4 (July 1989): 329–32. http://dx.doi.org/10.1016/s0016-5107(89)72803-0.
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