Endoscopy 2019; 51(04): S72
DOI: 10.1055/s-0039-1681383
ESGE Days 2019 oral presentations
Friday, April 5, 2019 17:00 – 18:30: Education Club C
Georg Thieme Verlag KG Stuttgart · New York

PROSPECTIVE COMPARISON OF AN ADULT, AN INTERMEDIATE PEDIATRIC AND A LONG PEDIATRIC COLONOSCOPE IN THE TRAINING PROCESS OF GASTROINTESTINAL FELLOWS TO ACHIEVE HIGH-QUALITY COLONOSCOPIC PRACTICE

G Tribonias
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
2   General Hospital of Nikaia 'Agios Panteleimon', Gastroenterology Department, Athens, Greece
,
G Lyrakos
2   General Hospital of Nikaia 'Agios Panteleimon', Gastroenterology Department, Athens, Greece
,
G Penesis
2   General Hospital of Nikaia 'Agios Panteleimon', Gastroenterology Department, Athens, Greece
,
D Charisis
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
,
N Daferera
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
,
B Lykiardopoulos
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
,
K Al-Shaheen
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
,
H Hjortswang
1   Linköping University Hospital, Gastroenterology, Linköping, Sweden
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

Few data are available on the influence of colonoscope length and diameter for trainees, which could affect both the training process and colonoscopy quality. We conducted this prospective observational cohort study to investigate which scope is more suitable for starting the colonoscopy training apropos technical competence, quality indicators and patient's comfort during diagnostic colonoscopy.

Methods:

A total of 126 consecutive patients were enrolled in the study and assigned into three groups: adult colonoscope (AC, n = 41), intermediate length pediatric colonoscope (IPC, n = 43) and long length pediatric colonoscope (LPC, n = 42). Primary outcomes recorded were completeness to the examination (cecum and terminal ileum intubation) and minutes to the cecum. Secondary outcomes included patient tolerance, position change, use of abdominal compression, loop formation, kind of loop and overall difficulty of the procedure.

Results:

Cecal intubation rates were not statistically different between the groups: adult colonoscope (87,8%), intermediate pediatric colonoscope (81,4%) and long pediatric colonoscope (92,8%). On the contrary terminal ileal intubation rate differed significantly among the three groups (p =0,015) with long pediatric colonoscope having the higher ileal intubation rate (66,7% vs. 60,9%/AC and 37,2%/IPC). There were significant differences in position change (fewer with LPC/1,36 vs. AC/2,15 and IPC/2,09 – p =0,027) and midazolam administered mg-dose (lower with LPC/0,52 vs. AC/1,07 and IPC/0,93 – p= 0,032). Loop formation with subsequent resolution was confirmed to relate significantly with higher pain for the patient with all of the three colonoscope types.

Conclusions:

The long length pediatric colonoscope performs better in trainee hands than adult and intermediate length pediatric colonoscope in terms of reaching competency and quality indicators (ileal intubation) with lower discomfort for the patients during colonoscopic procedures (lower midazolam dose and fewer positional changes). It could be considered the most suitable scope for trainees to start a high-quality colonoscopy training.