The prone 12 o'clock position reduces ileal intubation time during colonoscopy compared to the left lateral 6 o'clock (standard) position
| Autor: | Arjuna P. De Silva, Suramya D Perera Keragala, Udaya Kalubowila, H. Janaka de Silva, Anuradha S Dassanayake, Ravindu S. Kumarasena, Madunil A. Niriella, Arunasalam Pathmeswaran |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Colonoscopy Pilot Projects law.invention Randomized controlled trial Interquartile range law Ileum medicine Prone Position Intubation Fluoroscopy Humans lcsh:RC799-869 Aged medicine.diagnostic_test business.industry Gastroenterology General Medicine Gold standard (test) Middle Aged Surgery Clinical trial Prone position lcsh:Diseases of the digestive system. Gastroenterology Female business Research Article |
| Zdroj: | BMC Gastroenterology BMC Gastroenterology, Vol 11, Iss 1, p 89 (2011) |
| ISSN: | 1471-230X |
| Popis: | Background Ileal intubation is the gold standard for a complete colonoscopy. However, despite evidence of clinical benefit ileoscopy is not always attempted due to perceived technical difficulty. Our aim was to compare time taken for ileal intubation using a new position-the prone 12 o'clock position (PP) with the standard method (left lateral 6 o'clock position-LLP). Methods We performed a pilot study using fluoroscopy to determine the best patient position for ileal intubation. This was the prone 12 o'clock position. Patients were colonoscoped in the left lateral position and then randomized to ileal intubation in the 6 o'clock position(LL) or the 12 o'clock (PP) position. Results 202 consecutive patients were referred for colonoscopy. Colonoscopy was performed on 150 patients [82 females, mean (SD) age 53 (16) years]. 75 patients were randomized for ileal intubation in the PP and 75 patients in the LLP. Overall, the ileum was successfully intubated in 145 (96%) patients [74 (98.7%) in the PP and71 (94.7%) in the LLP]. The median (Interquartile Range) ileal intubation time was 12 (10) seconds in the PP and 87 (82) seconds in the LLP (p < 0.0001; Mann-Whitney U test). The ileum was abnormal in 11 (7.5%) patients. Conclusions During colonoscopy, the prone 12 o'clock position gives a more direct approach to the ileo-caecal valve and significantly reduces ileal intubation time. Trial registration Trial registry: Sri Lanka Clinical Trial Registry Clinical trial registry number: SLCTR/2009/002 |
| Databáze: | OpenAIRE |
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