6533b7ddfe1ef96bd1274ae0

RESEARCH PRODUCT

A novel device for intracolonoscopy cleansing of inadequately prepared colonoscopy patients: a feasibility study.

Aura A. J. Van EschKelly E. Van KeulenJörn M. SchattenbergH NeumannManon C.w. SpaanderWietske KievitPeter D. Siersema

subject

BisacodylMalemedicine.medical_specialtyColonColonoscopyOther Research Radboud Institute for Molecular Life Sciences [Radboudumc 0]Drug Administration SchedulePolyethylene GlycolsTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]03 medical and health sciencesAll institutes and research themes of the Radboud University Medical Center0302 clinical medicinePatient satisfactionInterquartile rangemedicineHumansNew deviceBisacodylTherapeutic IrrigationIntraoperative Caremedicine.diagnostic_testbusiness.industryCatharticsGastroenterologyCecal intubationColonoscopyEquipment DesignMiddle AgedSurgeryClinical trialRegimenTreatment OutcomePatient Satisfaction030220 oncology & carcinogenesisInflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5]Feasibility Studies030211 gastroenterology & hepatologyFemalebusinessmedicine.drug

description

Abstract Background The importance of high quality preprocedural bowel preparation is widely acknowledged, but suboptimal bowel cleansing still occurs in up to 20 % of all colonoscopy patients. The aim of this study was to evaluate the performance of a novel intraprocedural cleaning device for cleaning poorly prepared colons. Methods This multicenter feasibility study included patients aged 18 – 75 years who were referred for colonoscopy. Intraprocedural cleaning was performed in patients after a limited preprocedural bowel preparation regimen (2 days of dietary restrictions and 2 × 10 mg bisacodyl). The primary outcome was the proportion of adequately prepared patients (Boston Bowel Preparation scale [BBPS] ≥ 2 in each segment) before and after segmental washing with the new device. Secondary outcomes included: cecal intubation rate, procedure time, system usability, patient satisfaction, and safety. Results 47 patients (42.6 % male), with a median age of 61 years (interquartile range [IQR] 46 – 67 years), were included at three clinical sites. Cecal intubation was achieved in 46/47 patients (97.9 %). The cleaning device significantly improved the proportion of patients with adequate bowel cleansing (from 19.1 % to 97.9 %; P < 0.001) and median BBPS score (from 3.0 [IQR 0.0 – 5.0] to 9.0 [IQR 8.0 – 9.0]). Median cecal intubation time and total procedure time were 16.5 minutes (IQR 9.0−28.3) and 34.0 minutes (IQR 25.0 – 42.8), respectively. Physicians were satisfied with the ease of use of the device and it was well tolerated by patients. No severe adverse events occurred during the study period. Conclusions This feasibility study suggests that the intraprocedural cleaning device appears to be safe and effective in cleaning poorly prepared colons to an adequate level, allowing a thorough colorectal examination.

10.1055/a-0632-1927https://pubmed.ncbi.nlm.nih.gov/30572366