Rothstein R I, Littenberg B
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Gastrointest Endosc. 1995 Jun;41(6):566-72. doi: 10.1016/s0016-5107(95)70192-3.
A new fiberoptic sigmoidoscopic system has been developed that utilizes a disposable sheath to cover and protect all working surfaces of the endoscope from contamination. The reusable part of the endoscope has no air, water, or suction/biopsy channels. These are incorporated in the disposable sheath, which is easily removed after use to provide each patient with a contamination-free endoscope. A prospective, randomized, controlled trial was performed to compare the disposable, sheathed, flexible sigmoidoscope with standard sigmoidoscopes. Clinical evaluations of the new sigmoidoscope system were performed at 15 facilities. Visual analog rating scales were used to record evaluations of endoscope performance and reprocessing by endoscopists and reprocessing personnel. The time to perform procedures, depth of insertion, and total instrument downtime were also recorded. One hundred forty-three procedures (70 standard, 73 sheathed) were performed. No significant difference was found for overall depth of insertion (50 versus 48 cm), although fewer sheathed endoscopes reached to 60 cm than did standard endoscopes (51% versus 30%). The sheathed system had a slightly longer mean procedure time than the standard (5.6 versus 6.7 minutes), but a significantly shortened overall downtime (32.8 vs 8.1 minutes). The standard system was preferred by the endoscopists. Reprocessing personnel preferred the disposable system. The disposable sigmoidoscope system has important advantages of decreased instrument turn-around time and potentially increased staff and patient safety, and future models should be improved to meet physicians' concerns.
一种新型的纤维光学乙状结肠镜系统已被开发出来，该系统使用一次性护套来覆盖和保护内窥镜的所有工作表面免受污染。内窥镜的可重复使用部分没有空气、水或抽吸/活检通道。这些通道包含在一次性护套中，使用后可轻松移除，从而为每位患者提供无污染的内窥镜。进行了一项前瞻性、随机、对照试验，以比较一次性带护套柔性乙状结肠镜与标准乙状结肠镜。在15个机构对新型乙状结肠镜系统进行了临床评估。使用视觉模拟评分量表记录内镜医师和再处理人员对内镜性能和再处理的评估。还记录了操作时间、插入深度和仪器总停机时间。共进行了143例操作（70例使用标准乙状结肠镜，73例使用带护套乙状结肠镜）。尽管到达60厘米深度的带护套乙状结肠镜比标准乙状结肠镜少（分别为51%和30%），但整体插入深度没有显著差异（分别为50厘米和48厘米）。带护套系统的平均操作时间比标准系统略长（分别为5.6分钟和6.7分钟），但总停机时间显著缩短（分别为32.8分钟和8.1分钟）。内镜医师更喜欢标准系统。再处理人员更喜欢一次性系统。一次性乙状结肠镜系统具有减少仪器周转时间以及潜在提高工作人员和患者安全性的重要优势，未来的型号应加以改进以满足医生的关注。
