TY - JOUR
T1 - CO2 insufflation for potentially difficult colonoscopies
T2 - Efficacy when used by less experienced colonoscopists
AU - Uraoka, Toshio
AU - Kato, Jun
AU - Kuriyama, Motoaki
AU - Hori, Keisuke
AU - Ishikawa, Shin
AU - Harada, Keita
AU - Takemoto, Koji
AU - Hiraoka, Sakiko
AU - Fujita, Hideyuki
AU - Horii, Joichiro
AU - Saito, Yutaka
AU - Yamamoto, Kazuhide
PY - 2009
Y1 - 2009
N2 - AIM: To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS: One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insufflation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist (EC) group and a less experienced colonoscopist (LEC) group. Study measurements included a 100-mm visual analogue scale (VAS) for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS: Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group ( P < 0.001, two-way ANOVA) from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group ( P = 0.29), however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group ( P = 0.023) immediately after colonoscopies and up to 4 h afterwards. CONCLUSION: CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.
AB - AIM: To clarify the effectiveness of CO2 insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS: One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO2 or standard air insufflation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist (EC) group and a less experienced colonoscopist (LEC) group. Study measurements included a 100-mm visual analogue scale (VAS) for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS: Examination times did not differ, however, VAS scores in the CO2 group were significantly better than in the air group ( P < 0.001, two-way ANOVA) from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group ( P = 0.29), however, VAS scores for CO2 insufflation were significantly better than air insufflation in the LEC group ( P = 0.023) immediately after colonoscopies and up to 4 h afterwards. CONCLUSION: CO2 insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.
KW - Colonoscopy
KW - Difficult colonoscopy
KW - Experienced colonoscopist
KW - Training
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U2 - 10.3748/wjg.15.5186
DO - 10.3748/wjg.15.5186
M3 - Article
C2 - 19891018
AN - SCOPUS:73449139752
VL - 15
SP - 5186
EP - 5192
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 41
ER -