Water-aided colonoscopy: A systematic review

Felix W. Leung, Arnaldo Amato, Christian Ell, Shai Friedland, Judith O. Harker, Yu Hsi Hsieh, Joseph W. Leung, Surinder K. Mann, Silvia Paggi, Jrgen Pohl, Franco Radaelli, Francisco C Ramirez, Rodelei Siao-Salera, Vittorio Terruzzi

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Water-aided methods for colonoscopy are distinguished by the timing of removal of infused water, predominantly during withdrawal (water immersion) or during insertion (water exchange). To discuss the impact of these approaches on colonoscopy pain and adenoma detection rate (ADR). Systematic review. Randomized, controlled trial (RCT) that compared water-aided methods and air insufflation during colonoscope insertion. Patients undergoing colonoscopy. Medline, PubMed, and Google searches (January 2008-December 2011) and personal communications of manuscripts in press were considered to identify appropriate RCTs. Pain during colonoscopy and ADR. RCTs were grouped according to whether water immersion or water exchange was used. Reported pain scores and ADR were tabulated based on group assignment. Pain during colonoscopy is significantly reduced by both water immersion and water exchange compared with traditional air insufflation. The reduction in pain scores was qualitatively greater with water exchange as compared with water immersion. A mixed pattern of increases and decreases in ADR was observed with water immersion. A higher ADR, especially proximal to the splenic flexure, was obtained when water exchange was implemented. Differences in the reports limit application of meta-analysis. The inability to blind the colonoscopists exposed the observations to uncertain bias. Compared with air insufflation, both water immersion and water exchange significantly reduce colonoscopy pain. Water exchange may be superior to water immersion in minimizing colonoscopy discomfort and in increasing ADR. A head-to-head comparison of these 3 approaches is required.

Original languageEnglish (US)
Pages (from-to)657-666
Number of pages10
JournalGastrointestinal Endoscopy
Volume76
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Colonoscopy
Water
Immersion
Adenoma
Pain
Insufflation
Air
Colonoscopes
Transverse Colon
Manuscripts
PubMed

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Leung, F. W., Amato, A., Ell, C., Friedland, S., Harker, J. O., Hsieh, Y. H., ... Terruzzi, V. (2012). Water-aided colonoscopy: A systematic review. Gastrointestinal Endoscopy, 76(3), 657-666. https://doi.org/10.1016/j.gie.2012.04.467

Water-aided colonoscopy : A systematic review. / Leung, Felix W.; Amato, Arnaldo; Ell, Christian; Friedland, Shai; Harker, Judith O.; Hsieh, Yu Hsi; Leung, Joseph W.; Mann, Surinder K.; Paggi, Silvia; Pohl, Jrgen; Radaelli, Franco; Ramirez, Francisco C; Siao-Salera, Rodelei; Terruzzi, Vittorio.

In: Gastrointestinal Endoscopy, Vol. 76, No. 3, 09.2012, p. 657-666.

Research output: Contribution to journalArticle

Leung, FW, Amato, A, Ell, C, Friedland, S, Harker, JO, Hsieh, YH, Leung, JW, Mann, SK, Paggi, S, Pohl, J, Radaelli, F, Ramirez, FC, Siao-Salera, R & Terruzzi, V 2012, 'Water-aided colonoscopy: A systematic review', Gastrointestinal Endoscopy, vol. 76, no. 3, pp. 657-666. https://doi.org/10.1016/j.gie.2012.04.467
Leung FW, Amato A, Ell C, Friedland S, Harker JO, Hsieh YH et al. Water-aided colonoscopy: A systematic review. Gastrointestinal Endoscopy. 2012 Sep;76(3):657-666. https://doi.org/10.1016/j.gie.2012.04.467
Leung, Felix W. ; Amato, Arnaldo ; Ell, Christian ; Friedland, Shai ; Harker, Judith O. ; Hsieh, Yu Hsi ; Leung, Joseph W. ; Mann, Surinder K. ; Paggi, Silvia ; Pohl, Jrgen ; Radaelli, Franco ; Ramirez, Francisco C ; Siao-Salera, Rodelei ; Terruzzi, Vittorio. / Water-aided colonoscopy : A systematic review. In: Gastrointestinal Endoscopy. 2012 ; Vol. 76, No. 3. pp. 657-666.
@article{e8999a1b0f20442fb5cdf731b5096900,
title = "Water-aided colonoscopy: A systematic review",
abstract = "Water-aided methods for colonoscopy are distinguished by the timing of removal of infused water, predominantly during withdrawal (water immersion) or during insertion (water exchange). To discuss the impact of these approaches on colonoscopy pain and adenoma detection rate (ADR). Systematic review. Randomized, controlled trial (RCT) that compared water-aided methods and air insufflation during colonoscope insertion. Patients undergoing colonoscopy. Medline, PubMed, and Google searches (January 2008-December 2011) and personal communications of manuscripts in press were considered to identify appropriate RCTs. Pain during colonoscopy and ADR. RCTs were grouped according to whether water immersion or water exchange was used. Reported pain scores and ADR were tabulated based on group assignment. Pain during colonoscopy is significantly reduced by both water immersion and water exchange compared with traditional air insufflation. The reduction in pain scores was qualitatively greater with water exchange as compared with water immersion. A mixed pattern of increases and decreases in ADR was observed with water immersion. A higher ADR, especially proximal to the splenic flexure, was obtained when water exchange was implemented. Differences in the reports limit application of meta-analysis. The inability to blind the colonoscopists exposed the observations to uncertain bias. Compared with air insufflation, both water immersion and water exchange significantly reduce colonoscopy pain. Water exchange may be superior to water immersion in minimizing colonoscopy discomfort and in increasing ADR. A head-to-head comparison of these 3 approaches is required.",
author = "Leung, {Felix W.} and Arnaldo Amato and Christian Ell and Shai Friedland and Harker, {Judith O.} and Hsieh, {Yu Hsi} and Leung, {Joseph W.} and Mann, {Surinder K.} and Silvia Paggi and Jrgen Pohl and Franco Radaelli and Ramirez, {Francisco C} and Rodelei Siao-Salera and Vittorio Terruzzi",
year = "2012",
month = "9",
doi = "10.1016/j.gie.2012.04.467",
language = "English (US)",
volume = "76",
pages = "657--666",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Water-aided colonoscopy

T2 - A systematic review

AU - Leung, Felix W.

AU - Amato, Arnaldo

AU - Ell, Christian

AU - Friedland, Shai

AU - Harker, Judith O.

AU - Hsieh, Yu Hsi

AU - Leung, Joseph W.

AU - Mann, Surinder K.

AU - Paggi, Silvia

AU - Pohl, Jrgen

AU - Radaelli, Franco

AU - Ramirez, Francisco C

AU - Siao-Salera, Rodelei

AU - Terruzzi, Vittorio

PY - 2012/9

Y1 - 2012/9

N2 - Water-aided methods for colonoscopy are distinguished by the timing of removal of infused water, predominantly during withdrawal (water immersion) or during insertion (water exchange). To discuss the impact of these approaches on colonoscopy pain and adenoma detection rate (ADR). Systematic review. Randomized, controlled trial (RCT) that compared water-aided methods and air insufflation during colonoscope insertion. Patients undergoing colonoscopy. Medline, PubMed, and Google searches (January 2008-December 2011) and personal communications of manuscripts in press were considered to identify appropriate RCTs. Pain during colonoscopy and ADR. RCTs were grouped according to whether water immersion or water exchange was used. Reported pain scores and ADR were tabulated based on group assignment. Pain during colonoscopy is significantly reduced by both water immersion and water exchange compared with traditional air insufflation. The reduction in pain scores was qualitatively greater with water exchange as compared with water immersion. A mixed pattern of increases and decreases in ADR was observed with water immersion. A higher ADR, especially proximal to the splenic flexure, was obtained when water exchange was implemented. Differences in the reports limit application of meta-analysis. The inability to blind the colonoscopists exposed the observations to uncertain bias. Compared with air insufflation, both water immersion and water exchange significantly reduce colonoscopy pain. Water exchange may be superior to water immersion in minimizing colonoscopy discomfort and in increasing ADR. A head-to-head comparison of these 3 approaches is required.

AB - Water-aided methods for colonoscopy are distinguished by the timing of removal of infused water, predominantly during withdrawal (water immersion) or during insertion (water exchange). To discuss the impact of these approaches on colonoscopy pain and adenoma detection rate (ADR). Systematic review. Randomized, controlled trial (RCT) that compared water-aided methods and air insufflation during colonoscope insertion. Patients undergoing colonoscopy. Medline, PubMed, and Google searches (January 2008-December 2011) and personal communications of manuscripts in press were considered to identify appropriate RCTs. Pain during colonoscopy and ADR. RCTs were grouped according to whether water immersion or water exchange was used. Reported pain scores and ADR were tabulated based on group assignment. Pain during colonoscopy is significantly reduced by both water immersion and water exchange compared with traditional air insufflation. The reduction in pain scores was qualitatively greater with water exchange as compared with water immersion. A mixed pattern of increases and decreases in ADR was observed with water immersion. A higher ADR, especially proximal to the splenic flexure, was obtained when water exchange was implemented. Differences in the reports limit application of meta-analysis. The inability to blind the colonoscopists exposed the observations to uncertain bias. Compared with air insufflation, both water immersion and water exchange significantly reduce colonoscopy pain. Water exchange may be superior to water immersion in minimizing colonoscopy discomfort and in increasing ADR. A head-to-head comparison of these 3 approaches is required.

UR - http://www.scopus.com/inward/record.url?scp=84865142510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865142510&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2012.04.467

DO - 10.1016/j.gie.2012.04.467

M3 - Article

C2 - 22898423

AN - SCOPUS:84865142510

VL - 76

SP - 657

EP - 666

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 3

ER -