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A prospective randomized study of the use of an ultrathin colonoscope versus a pediatric colonoscope in sedation-optional colonoscopy

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Abstract

Background

Ultrathin colonoscopes (UTC) reportedly produce less pain during colonoscopy than standard colonoscopes. The aim of this study was to assess the tolerability of an UTC compared with that of a pediatric colonoscope.

Methods

A total of 270 adult patients scheduled to undergo colonoscopy were randomized, with 134 allocated to the UTC group and 136 to the pediatric colonoscope group. Pain was assessed using a visual analog scale. For all procedures, sedation was administered only if requested. Overall pain, rate and time of cecal and terminal ileum intubation, number of patients requesting sedation, adenoma detection rates (ADR), and rate of complications were measured and analyzed.

Results

Among all patients, the medians of maximum pain and overall pain were significantly lower in the UTC group than in the pediatric colonoscope group (23 vs. 38, P < 0.001; 12 vs. 22, P = 0.0003, respectively). Significantly fewer patients requested sedation in the UTC group than in the pediatric colonoscope group (1.4 vs. 6.6%; P = 0.0269). No significant differences were seen in either the rate and time of successful cecal and terminal ileum intubation, or in other procedure-related outcomes, including ADR.

Conclusions

Compared with a pediatric colonoscope, the UTC was associated with reduced overall and maximum pain during colonoscopy, with no difference in ADR.

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Acknowledgements

The authors wish to thank the endoscopy staff for their assistance.

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Authors and Affiliations

  1. Department of Gastroenterology, Mizonokuchi Hospital, Teikyo University School of Medicine, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan

    Koichiro Sato & Ichiro Yasuda

  2. Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan

    Sayo Ito, Daisuke Hihara, Kenji Tominaga & Iruru Maetani

  3. Department of Gastroenterology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya-Shi, Saitama Prefecture, Japan

    Tomoyuki Kitagawa

  4. Hirahata Clinic, 1-24-6 Shibuya, Shibuya-Ku, Tokyo, Japan

    Koichi Hirahata

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  1. Koichiro Sato
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  2. Sayo Ito
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Correspondence to Koichiro Sato.

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Disclosures

Koichiro Sato, Sayo Ito, Tomoyuki Kitagawa, Koichi Hirahata, Daisuke Hihara, Kenji Tominaga, Ichiro Yasuda, and Iruru Maetani have no conflict of interest or financial ties to disclose.

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Sato, K., Ito, S., Kitagawa, T. et al. A prospective randomized study of the use of an ultrathin colonoscope versus a pediatric colonoscope in sedation-optional colonoscopy. Surg Endosc 31, 5150–5158 (2017). https://doi.org/10.1007/s00464-017-5581-2

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  • DOI: https://doi.org/10.1007/s00464-017-5581-2

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