A randomized controlled trial comparing water infusion and air insufflation as scope insertion technique in the training of primary care physicians for screening flexible sigmoidoscopy
Refereed conference paper presented and published in conference proceedings


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AbstractBackground: Recently, the use of water infusion (WI) or water exchange techniques have been shown to reduce patient discomfort during colonoscope insertion and to increase the success rate of unsedated colonoscopy, but data on the use of WI in flexible sigmoidoscopy (FS) remains scarce. This study aims to evaluate the impact of WI as scope insertion technique in the training of primary care physicians (PCP) for screening FS.
Methods: 8 PCPs without prior endoscopy experience received training for screening FS under supervision by gastroenterologists from 2015-2017. FS trainees were randomized to use either WI or air insufflation (AI) during scope insertion. Trainees were mandated to complete ≥ 50 FS per person before competency assessment. The mean percentage of unassisted FS insertion within 10 minutes using WI or AI in the initial 40 FS, patient discomfort, and scope insertion time to descending colon were analyzed.
Results: A total of 408 FS were performed by 8 trainees (201 in WI group, 207 in AI group). The baseline characteristics of patients in WI and AI groups were similar. The mean percentage of unassisted FS insertion within 10 minutes using WI or AI were 68.8% vs 79.4%, p=0.041 in the initial 40 FS, and 70.6% vs 79.2%, p=0.052 in the overall FS training, respectively. The mean percentage of unassisted FS insertion from the 41st FS and beyond were similar (78.0% vs 78.7%, p=1). The mean intra-endoscopy pain score (4.0/10 vs 4.0/10, p= 0.977) and the mean scope insertion time (8.3 vs 7.8mins, p=0.207) were similar.
Conclusion: In this study, the use of AI by PCP in the initial 40 FS training resulted in a higher rate of unassisted FS insertion. The mean percentage of unassisted FS insertion from the 41st FS and beyond, and patient discomfort were similar using either WI or AI.
Acceptance Date21/06/2017
All Author(s) ListTang RSY, Kyaw MH, Lam KLY, Lam TYT, Ho AMY, Wong MCS, Lau JYW, Wu JCY
Name of ConferenceAsian Pacific Digestive Week 2017
Start Date of Conference23/09/2017
End Date of Conference26/09/2017
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Proceedings TitleJournal of Gastroenterology and Hepatology
Year2017
Month9
Volume Number32
Issue NumberSupplement 3
PublisherWiley
Place of PublicationAustralia
Pages142 - 142
ISSN0815-9319
eISSN1440-1746
LanguagesEnglish-United States
KeywordsSigmoidoscopy, colorectal cancer

Last updated on 2021-22-02 at 00:58