Abstract
The aim of this prospective study was to assess patient comfort during nonsedated screening sigmoidoscopy with the use of a standard 60-cm sigmoidoscope compared with a thinner 100-cm upper endoscope. Patients undergoing routine colon cancer screening with sigmoidoscopy were randomly assigned to either a 60-cm sigmoidoscope or a 100-cm upper endoscope. The procedure time, depth of insertion, anatomic landmarks, and presence of polyps were documented. Likert 7-point scales and visual analog scales (VAS) were performed to measure comfort and symptoms immediately after the procedure and again in 1 week. These scales, procedure time, insertion depth, percent reaching transverse colon, and percent with polyps were analyzed. Eighty-one patients were enrolled with 38 in the 100-cm group and 43 in the 60-cm group. Patients in the 100-cm group reported greater comfort on the VAS compared with the 60-cm group (P = .035) as well as less cramping on the initial Likert scale (P = .017). One week later, the 100-cm group reported higher comfort (P = .015) and less bloating (P = .040). Procedure time was longer for the 100-cm group (8.8 versus 5.9 minutes; P = .001). Insertion depth was 74 versus 56 cm (P = .001), and percent reaching splenic flexure was 76% versus 35% (P = .001) in the 100 and 60 cm groups, respectively. More adenomas were found with the 100-cm scope (P = .035). The use of a thinner and longer endoscope is more comfortable than a standard sigmoidoscope. Although a 100-cm endoscope procedure takes longer to perform, it allows better evaluation of the colon and misses fewer adenomas.
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The views expressed in this article are those of the authors and should not be construed to represent in any way those of the Department of Defense or the Department of the Army.
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Interim data resented in poster form October 2004 at the American College of Gastroenterology Annual Meeting in Orlando, FL and oral presentation November 2004 at the Army American College of Physicians Meeting in Crystal City, VA.
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Fincher, R.K., Myers, J., McNear, S. et al. Comfort and Efficacy of a Longer and Thinner Endoscope for Average Risk Colon Cancer Screening. Dig Dis Sci 52, 2892–2896 (2007). https://doi.org/10.1007/s10620-006-9642-y
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DOI: https://doi.org/10.1007/s10620-006-9642-y