BACKGROUND: The water method is easy-to-learn and improves colonoscopy outcomes. Dye-spray chromoendoscopy enhances ADR but has not been widely accepted for routine application in screening or surveillance colonoscopy. HYPOTHESIS: With dye added to the water used in the water method, ADR can be enhanced compared with the water or air method alone. OBJECTIVE: To compare ADR determined by the air method, water method alone, and water method with indigo carmine (0.008%) added. DESIGN: Review of prospectively collected data in a performance improvement program. SETTING: VA endoscopy unit. PATIENT: Screening or surveillance colonoscopy. METHODS: Patients (n=50/group) underwent colonoscopy with each of the three methods. Water method involved warm water infusion in lieu of air insufflation coupled with removal of residual air by suction and residual feces by water exchange. ADR and procedural data were collected prospectively to monitor performance. MAIN OUTCOME MEASUREMENTS: ADR. RESULTS: ADR in the air method, water method alone and water method with indigo carmine were 36%, 40% and 62%, respectively. Water method with indigo carmine produced significantly higher ADR than the air or water method alone (p<0.05). LIMITATIONS: Non-randomized data, single VA site, retrospective comparison. Absence of significant difference between air and water methods could be a type II error due to small number of patients CONCLUSIONS: The approach with indigo carmine added to the water used in the water method yielded significantly higher ADR than the water or the air method alone. The data suggest that a prospective RCT to compare the different methods is warranted.
BACKGROUND: The water method is easy-to-learn and improves colonoscopy outcomes. Dye-spray chromoendoscopy enhances ADR but has not been widely accepted for routine application in screening or surveillance colonoscopy. HYPOTHESIS: With dye added to the water used in the water method, ADR can be enhanced compared with the water or air method alone. OBJECTIVE: To compare ADR determined by the air method, water method alone, and water method with indigo carmine (0.008%) added. DESIGN: Review of prospectively collected data in a performance improvement program. SETTING: VA endoscopy unit. PATIENT: Screening or surveillance colonoscopy. METHODS:Patients (n=50/group) underwent colonoscopy with each of the three methods. Water method involved warm water infusion in lieu of air insufflation coupled with removal of residual air by suction and residual feces by water exchange. ADR and procedural data were collected prospectively to monitor performance. MAIN OUTCOME MEASUREMENTS: ADR. RESULTS: ADR in the air method, water method alone and water method with indigo carmine were 36%, 40% and 62%, respectively. Water method with indigo carmine produced significantly higher ADR than the air or water method alone (p<0.05). LIMITATIONS: Non-randomized data, single VA site, retrospective comparison. Absence of significant difference between air and water methods could be a type II error due to small number of patients CONCLUSIONS: The approach with indigo carmine added to the water used in the water method yielded significantly higher ADR than the water or the air method alone. The data suggest that a prospective RCT to compare the different methods is warranted.
Authors: Louis Michel Wong Kee Song; Douglas G Adler; Bipan Chand; Jason D Conway; Joseph M B Croffie; James A Disario; Daniel S Mishkin; Raj J Shah; Lehel Somogyi; William M Tierney; Bret T Petersen Journal: Gastrointest Endosc Date: 2007-07-23 Impact factor: 9.427
Authors: Joseph W Leung; Lynne D Do; Rodelei M Siao-Salera; Catherine Ngo; Dhavan A Parikh; Surinder K Mann; Felix W Leung Journal: J Interv Gastroenterol Date: 2011-01
Authors: Nancy N Baxter; Meredith A Goldwasser; Lawrence F Paszat; Refik Saskin; David R Urbach; Linda Rabeneck Journal: Ann Intern Med Date: 2008-12-15 Impact factor: 25.391
Authors: Maria Pellisé; Glòria Fernández-Esparrach; Andrés Cárdenas; Oriol Sendino; Elena Ricart; Eva Vaquero; Antonio Z Gimeno-García; Cristina Rodríguez de Miguel; Michel Zabalza; Angels Ginès; Josep M Piqué; Josep Llach; Antoni Castells Journal: Gastroenterology Date: 2008-07-09 Impact factor: 22.682
Authors: Joseph W Leung; Surinder K Mann; Rodelei Siao-Salera; Kanat Ransibrahmanakul; Brian Lim; Hazel Cabrera; Wilhemina Canete; Paul Barredo; Rebeck Gutierrez; Felix W Leung Journal: Gastrointest Endosc Date: 2009-06-24 Impact factor: 9.427
Authors: Fw Leung; Jo Harker; Jw Leung; Rm Siao-Salera; Sk Mann; Fc Ramirez; S Friedland; A Amato; F Radaelli; S Paggi; V Terruzzi; Yh Hsieh Journal: J Interv Gastroenterol Date: 2011-07-01