Usefulness of warm water and oil assistance in colonoscopy by trainees.
OBJECTIVE
Success rate of cecal intubation, endoscopist's difficulty, and procedure-related patient pain are still problems for beginners performing colonoscopy. New methods to aid colonoscopic insertion such as warm water instillation and oil lubrication have been proposed. The aim of this study is to evaluate the feasibility of using warm water or oil in colonoscopy.


METHODS
Colonoscopy was performed in 117 unsedated patients by three endoscopists-in-training. Patients were randomly allocated to three groups, using a conventional method with administration of antispasmodics, warm water instillation, and oil lubrication, respectively. Success rate of total intubation within time limit (15 min), cecal intubation time, degree of endoscopist's difficulty, and level of patient discomfort were compared among the three groups.


RESULTS
Cecal intubation time was shorter in the warm water group than in the conventional and oil groups. Degree of procedural difficulty was lower in the warm water group, and patient pain score was higher in the oil lubrication group, compared with the other groups. However, there was no significant difference in success rate of intubation within time limit among the three groups.


CONCLUSIONS
The warm water method is a simple, safe, and feasible method for beginners. Oil lubrication may not be a useful method compared with conventional and warm water method.
Park
Sung Chul
SC
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seongbuk-gu, Seoul, 136-705, Korea.
Keum
Bora
B
Kim
Eun Sun
ES
Jung
Eun Suk
ES
Lee
Sehe Dong
SD
Park
Sanghoon
S
Seo
Yeon Seok
YS
Kim
Yong Sik
YS
Jeen
Yoon Tae
YT
Chun
Hoon Jai
HJ
Um
Soon Ho
SH
Kim
Chang Duck
CD
Ryu
Ho Sang
HS
D000328:Adult; D000368:Aged; D002432:Cecum / Q000473:pathology; D003108:Colonic Diseases / Q000473:pathology*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005762:Gastroenterology / Q000193:education* / Q000379:methods*; D006358:Hot Temperature; D006801:Humans; D054327:Lubricants / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009821:Oils / Q000627:therapeutic use; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010276:Parasympatholytics / Q000627:therapeutic use; D014851:Wakefulness; D014867:Water
D054327:Lubricants; D009821:Oils; D010276:Parasympatholytics; D014867:Water