Meta-analysis of the performance of ultrathin vs. standard colonoscopes
- 16 November 2016
- journal article
- research article
- Published by Georg Thieme Verlag KG in Endoscopy
- Vol. 49 (04), 351-358
- https://doi.org/10.1055/s-0042-117110
Abstract
Background and study aims: Colonoscopy should reliably intubate the cecum with minimal patient discomfort and without complications. Use of thinner endoscopes to overcome pain during the procedure has shown promise. However, the use of thinner scopes could lead to excess looping and difficulty with therapeutic procedures. The aim of this meta-analysis was to analyze the performance of ultrathin colonoscopes (UTC) and standard colonoscopes for routine colonoscopy. Patients and methods: We searched several electronic databases for all randomized controlled trials and nonrandomized (prospective) studies that compared the efficacies of UTC (diameter ≤ 9.8 mm) and standard colonoscopes. We used fixed effect or random effects models to compare cecal intubation rate, cecal intubation time, pain score, and polyp and adenoma detection rates using standard mean differences (SMD) or odds ratios (OR) with 95 % confidence intervals (CI). Results: Seven studies (2191 patients) met the inclusion criteria. There was no significant heterogeneity among studies except for pain scores. The cecal intubation rate was higher with UTC (OR 2.30; 95 %CI 1.31 to 4.03). There was no difference in the cecal intubation time between UTC and standard colonoscopes. Pain scores were significantly lower with UTC than with standard colonoscopes (SMD – 0.59, 95 %CI – 0.93 to – 0.25). Polyp and adenoma detection rates were similar for both types of colonoscope. Conclusion: Use of UTC appears to improve the cecal intubation rate and reduce abdominal pain but does not affect polyp detection. Future trials are needed to evaluate the therapeutic performance of UTC vs. standard colonoscopes.This publication has 10 references indexed in Scilit:
- Risks Associated With Anesthesia Services During ColonoscopyGastroenterology, 2016
- Evaluation of discomfort during colonoscopy with conventional and ultrathin colonoscopes in ulcerative colitis patientsDigestive Endoscopy, 2014
- Propofol sedation for colonoscopy with a new ultrathin or a standard endoscope: a prospective randomized controlled studyEndoscopy, 2013
- Water-aided colonoscopy: a systematic reviewGastrointestinal Endoscopy, 2012
- A prospective randomized study on the benefits of a new small-caliber colonoscopeEndoscopy, 2012
- Reduced pain during screening colonoscopy with an ultrathin colonoscope: a randomized controlled trialEndoscopy, 2012
- A randomized comparison of ultrathin and standard colonoscope in cecal intubation rate and patient toleranceGastrointestinal Endoscopy, 2012
- Ultrathin-caliber colonoscopy: is thin truly in?Gastrointestinal Endoscopy, 2012
- Routine colonoscopy with a standard gastroscope. A randomized comparative trial in a western populationInternational Journal of Colorectal Disease, 2007
- Sedation-Free Colonoscopy Using an Upper Endoscope Is Tolerable and Effective in Patients with Low Body Mass Index: A Prospective Randomized StudyThe American Journal of Gastroenterology, 2006