Colonoscopy in the Prone Position for Patients With BMI Greater Than 30
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 90 |
| Updated: | 5/4/2018 |
| Start Date: | December 10, 2017 |
| End Date: | December 2018 |
Colonoscopy in the Prone Position for Patients With BMI Greater Than 30 Is Superior to Standard Left Lateral Decubitus Position
In the United States, colonoscopy has become the most commonly used screening test for
colorectal cancer. Colonoscopy is typically performed with the patient starting in the left
lateral decubitus position, however there is little data to support this practice and
starting position is variable amongst individual gastroenterology physicians.
The investigators plan to randomize patients with Body Mass Index >30 that are presenting to
the University of Virginia for colonoscopy to either the prone or left lateral decubitus
position. The investigators will then record and compare cecal intubation times as well as
amount of sedation used and complications to help determine which position is superior for
this patient population.
colorectal cancer. Colonoscopy is typically performed with the patient starting in the left
lateral decubitus position, however there is little data to support this practice and
starting position is variable amongst individual gastroenterology physicians.
The investigators plan to randomize patients with Body Mass Index >30 that are presenting to
the University of Virginia for colonoscopy to either the prone or left lateral decubitus
position. The investigators will then record and compare cecal intubation times as well as
amount of sedation used and complications to help determine which position is superior for
this patient population.
Patients that have been scheduled for colonoscopy will undergo chart review. Patients who
meet inclusion criteria will be invited to participate at the time consent is obtained for
the colonoscopy. Participants will then be randomized to one of two colonoscopy starting
positions.
After randomization, patients will begin the colonoscopy in either the prone position or left
lateral decubitus position.
It is common practice to re-position the patient during endoscopy (including supine and prone
positions) and some endoscopists commonly employ prone starting position for obese patients,
although there is no estimate in the literature as to the prevalence of this practice.
No additional interventions will be performed for research purposes. During the colonoscopy,
the endoscopist will be allowed, as usual, to adjust patient position as needed to complete
the procedure. Cecal intubation time, amount of sedation used, and any intra-procedural
complications (hypoxia, hypotension, etc) will be recorded for data analysis. This
information is standardly recorded in the procedure report in the patient's medical record.
The study will not affect any interventions performed during the colonoscopy such as polyp
removal or biopsies as, clinically indicated. Per endoscopy unit protocol, patients will be
monitored in the recovery area and discharged home with supervision. The study requires no
further direct patient interaction after the colonoscopy is completed. Charts will be
reviewed at 30 days to assess for any delayed and unexpected complications.
meet inclusion criteria will be invited to participate at the time consent is obtained for
the colonoscopy. Participants will then be randomized to one of two colonoscopy starting
positions.
After randomization, patients will begin the colonoscopy in either the prone position or left
lateral decubitus position.
It is common practice to re-position the patient during endoscopy (including supine and prone
positions) and some endoscopists commonly employ prone starting position for obese patients,
although there is no estimate in the literature as to the prevalence of this practice.
No additional interventions will be performed for research purposes. During the colonoscopy,
the endoscopist will be allowed, as usual, to adjust patient position as needed to complete
the procedure. Cecal intubation time, amount of sedation used, and any intra-procedural
complications (hypoxia, hypotension, etc) will be recorded for data analysis. This
information is standardly recorded in the procedure report in the patient's medical record.
The study will not affect any interventions performed during the colonoscopy such as polyp
removal or biopsies as, clinically indicated. Per endoscopy unit protocol, patients will be
monitored in the recovery area and discharged home with supervision. The study requires no
further direct patient interaction after the colonoscopy is completed. Charts will be
reviewed at 30 days to assess for any delayed and unexpected complications.
Inclusion Criteria:
- BMI >30
- Undergoing screening or diagnostic colonoscopy with conscious sedation
Exclusion Criteria:
- Pregnant women (self reported).
- Cognitively impaired patients
- History of colonic resection
- Cannot lay in prone position
- History of colon malignancy
- Procedure aborted due to inadequate bowel prep
- Severe pulmonary problems (including baseline oxygen use)
- Inability to provide consent for themselves
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