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

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 endoscopists 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.