Impact of a transparent hood on the performance of total colonoscopy: a randomized controlled trial

摘要

Background: Clinical demand for total colonoscopy (TCS) is increasing. Improvement of the cecal intubation rate and shortening of the examination time would expand the capacity for TCS.Objective: To assess the efficacy of a transparent hood attached to the tip of a colonoscope for cecal intubation in TCS.Design: Prospective, randomized, controlled study. Setting: Single tertiary-referral center. Interventions: TCS.Main Outcome Measurements: Cecal intubation time and rate, complications, patient discomfort, and detection rate of colonic polyps.Methods: Patients who were to undergo screening and/or surveillance TCS for colorectal cancer were invited to participate in the study. Cecal intubation time and rate, complications, patient discomfort, and detection rate of colonic polyps were evaluated.Results: A total of 592 patients enrolled in this study were randomly allocated to the hood group and no-hood group. The mean (SD) cecal intubation time in the hood group and the no-hood group was 10.2 +- 12.5 minutes and 13.4 +- 15.8 minutes, respectively (P = .0241). The effect of its use was more prominent in the expert endo-scopists group compared with those with moderate experience. The cecal intubation rate and the detection rate of small polyps in the 2 groups were similar. The grade of patient discomfort was significantly lower in the hood group. No complications were encountered with the use of the hood.Conclusions: Use of a transparent hood on the tip of a colonoscope shortened the time required for cecal intubation and decreased patient discomfort; such use was more effective among experts in shortening the examination time.