Magnetic endoscopic imaging versus standard colonoscopy in a routine colonoscopy setting: a randomized, controlled trial.

BACKGROUND

Knowing the position of the endoscope within the abdomen is important for performing a high-quality, painless colonoscopy. The recently introduced magnetic endoscopic imaging (MEI) system provides a continuous, real-time image of the endoscope during the entire procedure.

OBJECTIVE

To compare MEI versus standard colonoscopy with on-demand fluoroscopy on unsedated patients, as performed by experienced and inexperienced endoscopists.

DESIGN

Randomized, controlled trial.

SETTING

Endoscopy outpatient clinic.

PATIENTS

This study involved 810 consecutive patients (391 randomized to standard group; 419 randomized to MEI) referred for colonoscopy.

INTERVENTION

MEI or standard approach (involving on-demand fluoroscopy) during colonoscopy.

MAIN OUTCOME MEASUREMENTS

Perceived patient pain and cecal intubation rate and time to cecum.

RESULTS

For inexperienced endoscopists, the cecal intubation rate was significantly higher in the MEI group (77.8%) compared with the standard group (56.0%), P = .02 but not for experienced endoscopists (94.0% for MEI and 96.0% for standard group, P = .87). Inexperienced endoscopists had less need for assistance from a senior colleague when they used MEI (18.5%) compared with the standard technique (40.0%), P = .02. Mean (± standard deviation) time to reach the cecum was 14.0 ± 12.2 minutes in the MEI group and 15.3 ± 14.2 minutes in the standard group, P = .67.

LIMITATIONS

Single center, unblinded study.

CONCLUSION

Inexperienced endoscopists improved their colonoscopy performance when they used MEI, compared with the standard technique, but experienced endoscopists did not. The MEI may be advantageous to use for colonoscopy centers educating endoscopists. (

CLINICAL TRIAL REGISTRATION NUMBER

NCT00519129.).