Investigators from Portland, Oregon, USA, compared the efficacy of a new pediatric variable stiffness colonoscope with that of standard pediatric and adult colonoscopes, in the performance of routine colonoscopy.
Some 363 consecutive patients were randomized to undergo colonoscopy with a pediatric variable stiffness (n = 122), pediatric (n = 114), or adult colonoscope (n = 127).
Primary outcomes recorded were minutes to the cecum and completeness of the examination.
Secondary outcomes included patient tolerance, use of abdominal compression, and endoscopists' assessment of the difficulty of the procedure.
Cecal intubation rates were not found to be statistically different between the groups: variable stiffness (94%), pediatric (97%), and adult (90%).
| Cecal intubation rates were not significantly changed using the different colonoscopes.
| Gastrointestinal Endoscopy |
Furthermore, there was no significant difference in mean insertion time, patient tolerance, use of abdominal compression, or endoscopists' global assessment or examination difficulty between groups.
Overall, the initial completion rate of 93% increased to 97% on switching to a different colonoscope.
Colonoscopy was unsuccessful more often, and was more time-consuming, in women who had undergone hysterectomy.
Dr Douglas A. Shumaker, of the Oregon Health Sciences University, Portland, said on behalf of his colleagues, "The variable stiffness colonoscope performs well, but does not appear to offer any distinct advantage over standard pediatric or adult colonoscopes for routine colonoscopy."
"Further study may identify subgroups of patients that benefit from this new technology," he concluded.