A prospective trial of variable stiffness colonoscopes with different tip diameters in unsedated patients.
OBJECTIVE
Few data exist comparing the clinical versatility of variable stiffness (VS) colonoscopes with different tip diameters and stiffness ranges. We compared the intubation time and success rate, maneuvering ease, and patient comfort of three colonoscopes: pediatric VS (PVSC), nonmagnifying adult VS (AVSC), and magnifying VS (MVSC).


METHODS
Two hundred sixteen consecutive patients scheduled for routine colonoscopy were randomized to undergo colonoscopy with one of the three different colonoscopes (PVSC N = 72, AVSC N = 72, MVSC N = 72). Outcome measurements included time required for cecal intubation, success rate for cecal intubation, maneuvering ease, and patient comfort.


RESULTS
The overall success rate for cecal intubation was 95.83%. Intubation time was significantly different among the groups (PVSC 12.88 +/- 7.11 min, AVSC 9.25 +/- 5.16 min, MVSC 9.62 +/- 5.55 min; P < 0.01). Intubation time with PVSC required about 3 min more when compared with AVSC or MVSC. Multivariate analyses revealed that colonoscopy with AVSC required 3 min less when compared with PVSC (P= 0.03). Age greater than 55 yr, waist circumference, prior hysterectomy, and pain experienced by patients were also factors affecting intubation time.


CONCLUSIONS
In this study, a PVSC might not decrease patient discomfort or intubation time. The ideal colonoscope is the AVSC that has a modest diameter and stiffness range and thus is capable of achieving both a short intubation time and an acceptable comfort level. We also should bear in mind that MVSC has an additional function of magnifying observation.
Chen
Peng-Jen
PJ
Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Shih
Yu-Lueng
YL
Chu
Heng-Cheng
HC
Chang
Wei-Kuo
WK
Hsieh
Tsai-Yuan
TY
Chao
You-Chen
YC
D000328:Adult; D000368:Aged; D020685:Colonoscopes / Q000009:adverse effects; D003113:Colonoscopy / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D018583:Pliability; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives