A novel device to improve colon cleanliness during colonoscopy.
OBJECTIVE
Effective colonoscopy depends on adequate visualization of the intestine, which might be ensured by intraprocedural use of a cleansing device. We investigated the performance of a novel endoscopic device with regard to cleanliness, safety, and tolerability during colonoscopy, compared with standard cleansing.


METHODS
At a single center, colonoscopy patients in whom the cecum was accessed and at least one bowel segment was inadequately cleansed were assigned to either use of a disposable catheter cleansing device (JetPrep), used through the endoscope working channel, or standard manual cleansing using a 50-ml syringe. The cleansing quality, for each segment and before and after irrigation, was recorded using a 4-point scale ranging from excellent (grade 1, no more than small bits of adherent feces) to poor (grade 4, large amount of fecal residue).


RESULTS
38 patients were included, 19 in each group. Reasons for referral included colorectal cancer screening (52 %), or blood loss (31 %). Each segment showed improvement after cleansing with JetPrep. Overall cleansing grade improved by a mean of 0.74 points (standard deviation [SD] 0.82) in the investigation group compared with 0.19 (0.40) in the control group (P < 0.0001), and right colon cleansing improved by 1.59 points (0.71) versus 0.31 (0.48) in the controls (P < 0.0001). There was no significant difference in procedure time between the groups. No adverse events or side effects were encountered.


CONCLUSIONS
The JetPrep disposable catheter device is safe and efficient for intraprocedural cleansing of a suboptimally prepared colon, allowing higher quality colonoscopy.
Department of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Haifa, Israel. abraham.eliakim@sheba.health.gov.il
R
R
Eliakim
K
K
Yassin
J
J
Lachter
Y
Y
Chowers
D000368:Aged; D057785:Catheters; D003106:Colon / Q000473:pathology; D020685:Colonoscopes / Q000639:trends*; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D057186:Comparative Effectiveness Research; D004209:Disposable Equipment; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D013594:Syringes; D007507:Therapeutic Irrigation / Q000295:instrumentation / Q000379:methods / Q000639:trends; D016896:Treatment Outcome