Endoscopy 2012; 44(07): 655-659
DOI: 10.1055/s-0032-1309807
Original article
© Georg Thieme Verlag KG Stuttgart · New York

A novel device to improve colon cleanliness during colonoscopy

R. Eliakim
Department of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Haifa, Israel
,
K. Yassin
Department of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Haifa, Israel
,
J. Lachter
Department of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Haifa, Israel
,
Y. Chowers
Department of Gastroenterology, Rambam Health Care Campus, Rappaport School of Medicine, Haifa, Israel
› Author Affiliations
Further Information

Publication History

submitted 13 March 2011

accepted after revision 13 March 2012

Publication Date:
21 June 2012 (online)

Background and study aim: Effective colonoscopy depends on adequate visualization of the intestine, which might be ensured by intraprocedural use of a cleansing device. We investigated the performance of a novel endoscopic device with regard to cleanliness, safety, and tolerability during colonoscopy, compared with standard cleansing.

Patients and methods: At a single center, colonoscopy patients in whom the cecum was accessed and at least one bowel segment was inadequately cleansed were assigned to either use of a disposable catheter cleansing device (JetPrep), used through the endoscope working channel, or standard manual cleansing using a 50-ml syringe. The cleansing quality, for each segment and before and after irrigation, was recorded using a 4-point scale ranging from excellent (grade 1, no more than small bits of adherent feces) to poor (grade 4, large amount of fecal residue).

Results: 38 patients were included, 19 in each group. Reasons for referral included colorectal cancer screening (52 %), or blood loss (31 %). Each segment showed improvement after cleansing with JetPrep. Overall cleansing grade improved by a mean of 0.74 points (standard deviation [SD] 0.82) in the investigation group compared with 0.19 (0.40) in the control group (P < 0.0001), and right colon cleansing improved by 1.59 points (0.71) versus 0.31 (0.48) in the controls (P < 0.0001). There was no significant difference in procedure time between the groups. No adverse events or side effects were encountered.

Conclusions: The JetPrep disposable catheter device is safe and efficient for intraprocedural cleansing of a suboptimally prepared colon, allowing higher quality colonoscopy.

 
  • References

  • 1 Ristvedt SL, McFarland EG, Weinstock LB et al. Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol 2003; 98: 578-585
  • 2 Imperiali G, Minoli G, Meucci GM et al. Effectiveness of a continuous quality improvement program on colonoscopy practice. Endoscopy 2007; 39: 314-318
  • 3 Eliakim R, Yassin K, Niv Y et al. Prospective multicenter performance evaluation of the second generation colon capsule in comparison to colonoscopy. Endoscopy 2009; 41: 1026-1031
  • 4 Eliakim R, Fireman Z, Gralnek IM et al. Evaluation of the PillCam Colon capsule in the detection of colonic pathology: results of the first multicenter, prospective, comparative study. Endoscopy 2006; 38: 963-970
  • 5 Van Gossum A, Munoz-Navas M, Fernandez-Urien I et al. Capsule endoscopy versus colonoscopy for the detection of polyps and cancer. N Engl J Med 2009; 361: 264-270
  • 6 Khan S, Ahmed J, Lim M et al. Colonoscopy in the octogenarian population: Diagnostic and survival outcomes from a large series of patients. Surgeon 2011; 9: 195-199
  • 7 Chan W-K, Saravanan A, Manikam J et al. Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy. BMC Gastroenterology 2011; 11: 86
  • 8 Leung JW, Do LD, Siao-Salera RM et al. Retrospective analysis showing the water method increased adenoma detection rate – a hypothesis generating observation. J Interv Gastroenterol 2011; 1: 3-7
  • 9 Leung FW. A hypothesis-generating review of the water method for difficult colonoscopy. Scand J Gastroenterol 2011; 46: 517-521
  • 10 Leung FW, Leung JW, Siao-Salera RM et al. The water method significantly enhances detection of diminutive lesions (adenoma and hyperplastic polyp combined) in the proximal colon in screening colonoscopy – data derived from two RCT in US veterans. J Interv Gastroenterol 2011; 1: 48-52