The Utility of Timed Segmental Withdrawal During Screening Colonoscopy
| Status: | Completed |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 4/2/2016 |
| Start Date: | January 2014 |
| End Date: | December 2015 |
| Contact: | Mohamed Othman, MD |
| Email: | mohamed.othman@ttuhsc.edu |
| Phone: | 915-215-5205 |
The Utility of Timed Segmental Withdrawal During Screening Colonoscopy for Increasing Adenoma Detection Rate. A Randomized Controlled Clinical Trial
The purpose of colonoscopy (colon examination with flexible tube and a camera) is to find
early precancerous growth in the colon (polyps) and remove them before they turn into
cancer. The doctor performing the procedure will first advance the colonoscope to the end of
the colon (cecum) and then he will examine the colon for polyps while he is withdrawing the
colonoscope. The period of time that the doctor spent examining the colon called "withdrawal
time". Usually doctors will spend at least 6 minutes examining the colon after he reached
the cecum. The investigators are proposing that dedicating half of the withdrawal time
during colonoscopy in examining the right side of the colon, will increase the detection of
polyps in the right side of the colon.
early precancerous growth in the colon (polyps) and remove them before they turn into
cancer. The doctor performing the procedure will first advance the colonoscope to the end of
the colon (cecum) and then he will examine the colon for polyps while he is withdrawing the
colonoscope. The period of time that the doctor spent examining the colon called "withdrawal
time". Usually doctors will spend at least 6 minutes examining the colon after he reached
the cecum. The investigators are proposing that dedicating half of the withdrawal time
during colonoscopy in examining the right side of the colon, will increase the detection of
polyps in the right side of the colon.
Research design: This is a prospective, randomized trial comparing the ADR between patients
undergoing a screening colonoscopy in four different groups: 1) at least 3 minutes from the
total withdrawal time dedicated to the right side of the colon, 2) at least 4 minutes from
the total withdrawal time dedicated to the right side of the colon, 3) 6 minutes total
withdrawal time regardless of time spent in any segment, 4) 8 minutes total withdrawal time
regardless of the time spent in any segment. Randomization will be done in blocks after
stratification. Four gastroenterologists and two fellows matched base on similar ADR and
stratified on each arm of the study (segmental versus non-segmental withdrawal) will be
performing the procedures. The estimated sample size of the four arms of the study is 400
patients.
undergoing a screening colonoscopy in four different groups: 1) at least 3 minutes from the
total withdrawal time dedicated to the right side of the colon, 2) at least 4 minutes from
the total withdrawal time dedicated to the right side of the colon, 3) 6 minutes total
withdrawal time regardless of time spent in any segment, 4) 8 minutes total withdrawal time
regardless of the time spent in any segment. Randomization will be done in blocks after
stratification. Four gastroenterologists and two fellows matched base on similar ADR and
stratified on each arm of the study (segmental versus non-segmental withdrawal) will be
performing the procedures. The estimated sample size of the four arms of the study is 400
patients.
Inclusion Criteria:
- adults undergoing colonoscopy for screening or surveillance purposes
Exclusion Criteria:
- prior history of colonic surgeries
- Crohn's colitis or ulcerative colitis
- prior history of colon cancer
- poor bowel preparation
- pregnancy
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