Left Lateral Tilt-down Position During Colonoscopy Insertion

Study Overview
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Brief Summary
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The purpose of this study is to determine whether the left lateral tilt-down position, which includes procedures that involve placing patients on their left lateral side at an angle to make their heads lower than their feet, is more beneficial than the left lateral horizontal body position (patient horizontally laying on their left side, traditionally used for colonoscopies) to decrease descending colon insertion time, the difficulty of colonoscopy procedure and patients' pain.

Detailed Description
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Supine with tilt-down position (trendelenburg position) is used in abdominal and gynecological surgery to allow better access to the pelvic organs, as gravity pulls the bowel out of the pelvic cavity and the rectosigmoid angle straightens, which may also be favorable for colonoscopy insertion. However, few published studies have explored the value of tilt-down position in the colonoscopy (left lateral horizontal body position are usually used) and there is consequently little evidence to support left lateral tilt-down position or left lateral horizontal body position. So the investigators perform a randomized controlled trial of left lateral tilt-down position versus left lateral horizontal position for colonoscopy to investigate the safety and efficacy of lateral tilt-down position.

Official Title
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The Role of Left Lateral Tilt-down Position During Colonoscopy Insertion: a Randomized Controlled Trial

Conditions
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Colonoscopy Insertion

Intervention / Treatment
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* Procedure: left lateral tilt-down position
* Procedure: left lateral horizontal position


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients whose age is between 18-75 Patients who have indications for diagnostic or therapeutic colonoscopy . Patients who have signed inform consent form Exclusion Criteria: Patients who have undergone colonic resection Patients with glaucoma Patients with intracranial and/or central nervous system disease, including cerebral infarction and cerebral hemorrhage. Patients with severe chronic cardiopulmonary and renal disease. Patients with uncontrolled acid reflux disease or active nausea/vomiting. Patients who are unwilling or unable to consent. Patients who are not suitable for colonoscopy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: left lateral tilt-down position<br>patients will be positioned on left lateral tilt-down position during colonoscopy until sigmoid-descending junction were examined, and then patients will be positioned on the left lateral horizontal position during colonoscopy | Procedure: left lateral tilt-down position<br>* patients will be positioned on their left side and at an angle of 20 degree<br>|
| Active Comparator: left lateral horizontal body position<br>patients will be positioned on the left lateral horizontal position during colonoscopy insertion | Procedure: left lateral horizontal position<br>* patients will be horizontally positioned on their left side<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cecal colon insertion time |  | This outcome is measured when cecal colon is intubated during a colonoscopy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| patients' discomfort of colonoscopy | patients' discomfort will be assessed by a 10-cm visual analog scale | 2 hours | 
| endoscopists' perception of difficulty of colonoscopy | difficulty of colonoscopy will be assessed by a 10-cm visual analog scale | 2 hours | 
| decending insertion time |  | This outcome is measured when decending colon is intubated during a colonoscopy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colonoscopy insertion, tilt-down position