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Article: The Water Exchange Method for Colonoscopy-effect of Coaching

TitleThe Water Exchange Method for Colonoscopy-effect of Coaching
Authors
Issue Date2012
PublisherLandes Bioscience. The Journal's web site is located at http://www.landesbioscience.com/journals/jig/
Citation
Journal of Interventional Gastroenterology, 2012, v. 2 n. 3, p. 122-125 How to Cite?
AbstractThe growing popularity of water immersion is supported by its long history as an adjunct to air insufflation; after facilitating colonoscope passage, the infused water is conveniently removed during withdrawal. Water exchange, a modification of water immersion to minimize discomfort in scheduled unsedated patients in the U.S. is new. Even though it may be superior in reducing pain and increasing adenoma detection, the paradigm shift to complete exclusion of air during insertion necessitates removal of infused water containing residual feces, a step often perceived as laborious and time-consuming. The nuances are the efficient steps to remove infused water predominantly during insertion to maintain minimal distension and deliver salvage cleansing. Mastery of the novel maneuvers with practice returns insertion time towards baseline. In this observational study the impact of direct verbal coaching on the primary outcome of intention-to-treat cecal intubation was assessed. The results showed that 14 of 19 (74%) experienced colonoscopists achieved 100% intention-to-treat cecal intubation. Initiation of the examination with water exchange did not preclude completion when conversion to the more familiar air insufflation method was deemed necessary to achieve cecal intubation (total 98%). The overall intention-to-treat cecal intubation rate was 88%, 90% in male and 87% in female. Only 2.7% of bowel preparation was rated as poor during withdrawal. The mean volume of water infused and cecal intubation time was 1558 ml and 18 min, respectively. Direct coaching appears to facilitate understanding of the nuances of the water exchange method. Studies of individual learning curves are necessary.
Persistent Identifierhttp://hdl.handle.net/10722/199150
ISSN
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, FWen_US
dc.contributor.authorCheung, Ren_US
dc.contributor.authorFan, RSen_US
dc.contributor.authorFischer, LSen_US
dc.contributor.authorFriedland, Sen_US
dc.contributor.authorHo, SBen_US
dc.contributor.authorHsieh, YHen_US
dc.contributor.authorHung, IFNen_US
dc.contributor.authorLi, MKen_US
dc.contributor.authorMatsui, Sen_US
dc.contributor.authorMcquaid, KRen_US
dc.contributor.authorOhning, Gen_US
dc.contributor.authorOjuri, Aen_US
dc.contributor.authorSato, Ten_US
dc.contributor.authorShergill, AKen_US
dc.contributor.authorShoham, MAen_US
dc.contributor.authorSimons, TCen_US
dc.contributor.authorWalter, MHen_US
dc.contributor.authorYen, Aen_US
dc.date.accessioned2014-07-22T01:04:57Z-
dc.date.available2014-07-22T01:04:57Z-
dc.date.issued2012en_US
dc.identifier.citationJournal of Interventional Gastroenterology, 2012, v. 2 n. 3, p. 122-125en_US
dc.identifier.issn2154-1280en_US
dc.identifier.urihttp://hdl.handle.net/10722/199150-
dc.description.abstractThe growing popularity of water immersion is supported by its long history as an adjunct to air insufflation; after facilitating colonoscope passage, the infused water is conveniently removed during withdrawal. Water exchange, a modification of water immersion to minimize discomfort in scheduled unsedated patients in the U.S. is new. Even though it may be superior in reducing pain and increasing adenoma detection, the paradigm shift to complete exclusion of air during insertion necessitates removal of infused water containing residual feces, a step often perceived as laborious and time-consuming. The nuances are the efficient steps to remove infused water predominantly during insertion to maintain minimal distension and deliver salvage cleansing. Mastery of the novel maneuvers with practice returns insertion time towards baseline. In this observational study the impact of direct verbal coaching on the primary outcome of intention-to-treat cecal intubation was assessed. The results showed that 14 of 19 (74%) experienced colonoscopists achieved 100% intention-to-treat cecal intubation. Initiation of the examination with water exchange did not preclude completion when conversion to the more familiar air insufflation method was deemed necessary to achieve cecal intubation (total 98%). The overall intention-to-treat cecal intubation rate was 88%, 90% in male and 87% in female. Only 2.7% of bowel preparation was rated as poor during withdrawal. The mean volume of water infused and cecal intubation time was 1558 ml and 18 min, respectively. Direct coaching appears to facilitate understanding of the nuances of the water exchange method. Studies of individual learning curves are necessary.en_US
dc.languageengen_US
dc.publisherLandes Bioscience. The Journal's web site is located at http://www.landesbioscience.com/journals/jig/en_US
dc.relation.ispartofJournal of Interventional Gastroenterologyen_US
dc.titleThe Water Exchange Method for Colonoscopy-effect of Coachingen_US
dc.typeArticleen_US
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_US
dc.identifier.authorityHung, IFN=rp00508en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.4161/jig.23732en_US
dc.identifier.pmid23805391en_US
dc.identifier.pmcidPMC3655365en_US
dc.identifier.hkuros230524en_US
dc.identifier.volume2en_US
dc.identifier.issue3en_US
dc.identifier.spage122en_US
dc.identifier.epage125en_US
dc.publisher.placeUnited Statesen_US

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