title: A randomized controlled trial in a training institution comparing a pediatric variable stiffness colonoscope, a pediatric colonoscope, and an adult colonoscope.
abstract: BACKGROUND
  There are few comparative data on the efficacy of different colonoscopes. This study compared the efficacy of a new pediatric variable stiffness colonoscope with that of standard pediatric and adult colonoscopes in the performance of routine colonoscopy.
  
  
  METHODS
  Three hundred sixty-three 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.
  
  
  RESULTS
  Cecal intubation rates were not statistically different between the groups: variable stiffness (94.3%), pediatric (96.5%), and adult (89.8%) (p = 0.099). 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Oregon Health Sciences University, Division of Gastroenterology, and Department of Public Health and Preventive Medicine, Portland, Oregon 97201-3098, USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Shumaker
authors.forename: Atif
authors.initials: A
authors.lastname: Zaman
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Katon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D020685:Colonoscopes; D003113:Colonoscopy; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018583:Pliability; D012015:Reference Standards