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 22 February 2018

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News

Variable stiffness colonoscopes in unsedated patients

Variable stiffness colonoscopes allow favorable examination, irrespective of the examiner's experience, find researchers in the latest issue of the American Journal of Gastroenterology.

News image

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A new variable stiffness colonoscope (VSC) is expected to control loop formation and to lessen patient discomfort.

In this prospective study, a research team from Japan compared the efficacy of VSC with a conventional colonoscope (CC) in unsedated colonoscopy. The team randomly assigned 467 patients to undergo colonoscopy with either VSC or CC by an endoscopist, including experienced and less-experienced examiners.

They recorded the percentages of completed procedure and the time to cecal intubation.
A significantly lower mean pain score was recorded in variable stiffness colonoscope patients, compared with conventional colonoscope patients.
American Journal of Gastroenterology

Patients were asked to rate pain on a 5-point pain score.

The team found that the percentages of completed procedure with VSC and CC were 98% and 95%, respectively, by less-experienced examiners. These values were 99% and 98%, respectively, when the procedure was performed by experienced examiners.

Furthermore, the time for cecal intubation with VSC and CC was 15.7 and 18.5 minutes, respectively, by less-experienced examiners. Times were 9.8 and 10.6 minutes, respectively, for experienced examiners.

The team recorded a significantly lower mean pain score in VSC patients, compared with CC patients, irrespective of experience of the examiner.

In addition, the percent of patients rating the procedure as moderately or severely painful was significantly lower with VSC than with CC. Dr Ichiro Yoshikawa’s team concluded, “Our results indicated that VSC allows favorable examination compared with CC regarding completeness, time to cecal intubation, and comfort of patients undergoing unsedated colonoscopy, irrespective of the examiner’s experience”.

“These features suggest VSC as the preferred colonoscope for patients undergoing unsedated colonoscopy”.

In a related editorial in the same publication, Dr Todd Baron, from Arizona, USA, discusses the technological advance that variable stiffness colonoscopes (VSC) bring to GI endoscopy.

Dr Baron concludes that, “There is still not one colonoscope that is ideal for all patients”

“Until the ideal colonoscope is developed, which is suitable for all situations, the endoscopist may need to be equipped with several instruments”.

Am J Gastroenterol 2002; 97(12): 2942-3, 3052-5
11 December 2002

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