Water Injection Colonoscopy vs Air Insufflation Colonoscopy in Training the Beginners

Study Overview
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Brief Summary
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Water injection colonoscopy has been a generally accepted method in training the beginners of colonoscopy for its low pain and less cecal intubation time, we would conduct this study to investigate more advantages of this method and make most use of it for beginners' training.

Detailed Description
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Colonoscopy is the gold standard for diagnosing the large bowel diseases, caecum intubation is the success of the colonoscopy, although with the progress of the function and the technique, for most patients, when facing with inexperienced examiners, conventional air insufflation colonoscopy is still a painful experience. Despite of the application of the technique of abdomen compression, position change of the patients and the sedatives or analgesics, to master well of the colonoscopy for the first-learners still needs much practice. Up to now, many studies has showed that compared with air insufflation colonoscopy, water-related colonoscopy could shorten the cecal intubation time and relieve the pain of the patients,especially for training the beginners，the effect was notable, but the present researches on water assisted technique has still been confined to following aspects:1.Water infusing was based on air insufflation; predetermined amount of water was infused ,and water was infused while passing through certain segment of the bowel(such as the left half of colon) ; 2.When training the first-learners, certain dose of sedatives or analgesics was injected; 3.The patients recruited were less. Colonoscopies in this study would be performed by in-training examiners, water would be injected completely instead of air insufflation while advancing the colonoscope, the amount of the water infused would not be predetermined but vary from individuals, and all the patients would be examined without any sedatives or analgesics.

Official Title
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Water Injection Colonoscopy vs Air Insufflation Colonoscopy in Training the Beginners

Conditions
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Colon Disease, Rectal Disease, Pain

Intervention / Treatment
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* Other: Air insufflation
* Other: Water injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnostic colonoscopy; Subjets able to provide informed consent Exclusion Criteria: Prior partial or complete colectomy; Patients who decline to participate; Patients with poor bowel preparation; Contraindications of the colonoscopy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Air insufflation colonoscopy<br>Air insufflation colonoscopy is the conventional colonoscopy,which is inflating air to help searching the bowel cavity while advancing the colonoscope until reaching the cecum.All the patients were examined without sedation during the whole procedure. | Other: Air insufflation<br>* Air is inflated into the bowel to help searching the cavity while advancing the colonoscope until reaching the cecum.<br>|
| Experimental: Water injection colonoscopy<br>Water injection colonoscopy : Cut off air inflating before examination. Water was injected through the working channel to follow the intestinal cavity until reaching the caecum .All the patients were examined without sedation during the whole procedure. | Other: Water injection<br>* Water was injected through the working channel instead of air to follow the intestinal cavity until reaching the caecum.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The success rate of the cecal intubation within 15 min(%) |  | This will be calculated after the completion of the whole trial,which is about 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The cecal intubation time(min); |  | This will be collected at their procedure appointment which is expected to be 2 to 3 hours in length | 
| The time to reach the splenic flexure(min) |  | This will be collected at their procedure appointment which is expected to be 2 to 3 hours in length | 
| VAS abdominal pain score |  | Data collected usually within 10minutes post procedure | 
| The frequency of the colonoscope shortening maneuver while advancing the colonoscope |  | This will be collected at their procedure appointment which is expected to be 2 to 3 hours in length. | 
| Length of colonoscope at time of cecal intubation(cm) |  | This will be collected at their procedure appointment which is expected to be 2 to 3 hours in length. | 
| Volume of water used during water colonoscopy(ml) |  | This will be collected at their procedure appointment which is expected to be 2 to 3 hours in length. | 
| General data of the patients recruited-age |  | Data collected usually within 10minutes post procedure . | 
| General data of the patients recruited-gender |  | Data collected usually within 10minutes post procedure . | 
| General data of the patients recruited-BMI |  | Data collected usually within 10minutes post procedure . | 
| General data of the patients recruited-abdominal or pelvic surgery history |  | Data collected usually within 10minutes post procedure . | 
| General data of the patients recruited-bowel preparation |  | Data collected usually within 10minutes post procedure . |