Background and study aims: The variable stiffness colonoscope (VSC) may have theoretical advantages over standard
adult colonoscopes (SACs), though data are conflicting. We conducted a meta-analysis
to compare the efficacies of the VSC and SAC.
Study design: We searched Medline (1966 – 2008) and abstracts of gastroenterology scientific meetings
in the 5 years to February 2008, only for randomized clinical trials (RCTs) of adult
patients. Trial quality was assessed using the Delphi list. In a meta-analysis with
a fixed effects model, cecal intubation rates, cecal intubation times, abdominal pain
scores, sedation used, and use of ancillary maneuvers, were compared in separate analyses,
using weighted mean differences (WMDs), standardized mean differences (SMDs), or odds
ratios (ORs).
Results: Seven RCTs satisfied the inclusion criteria (1923 patients), four comparing VSC with
SAC procedures in adults, and three evaluating the pediatric VSC. There was no significant
heterogeneity among the studies. The overall trial quality was adequate. Cecal intubation
rate was higher with the use of VSC (OR = 2.08, 95 % confidence interval [CI] 1.29
to 3.36). The VSC was associated with lower abdominal pain scores and a decreased
need for sedation during colonoscopy. Cecal intubation time was similar for the two
colonscope types (WMD = – 0.21 minutes, 95 % CI – 0.85 to 0.43). Because of the nature
of the intervention no studies were blinded. There was no universal method for using
the VSC.
Conclusions: Compared with the SAC, VSC use was associated with a higher cecal intubation rate,
less abdominal pain, and decreased need for sedation. However, cecal intubation times
were similar for the two colonoscope types.
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AB52-AB58
P. K. RoyMD
Division of Gastroenterology
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