Prospective multicenter randomized controlled trial comparing adenoma detection rate in colonoscopy using water exchange, water immersion, and air insufflation.

摘要: Background and Aims Adenoma detection rate (ADR), defined as the proportion of patients with at least one adenoma any size, is a quality indicator. We tested hypothesis that water exchange (WE) improves ADR but immersion (WI) has no adverse effect on compared air insufflation (AI). Methods A prospective study was conducted Dalin Tzu Chi Hospital in southern Taiwan Hualien eastern randomly assigned to WE, WI, or AI stratification by 3 study colonoscopists. The primary outcome ADR. Results From July 2013 December 2015, 651 were recruited randomized into 3 groups 1:1:1 ratio (217 per group). Overall, met standards: WE 49.8% (95% CI, 43.2%-56.4%), 37.8% 31.6%-44.4%), WI 40.6% 34.2%-47.2%). Compared AI, significantly increased ( P  = .016). There difference between WE. ADRs comparable. confirmed longer insertion time, higher cleanliness score, similar positive colonoscopy (APPC) withdrawal time polypectomy. Subgroup analysis found propofol-sedated patients. Multivariate generalized linear mixed model revealed age ≥50 years, (vs AI), indication, previous history colonoscopy, >8 minutes significant predictors Conclusions Confirmation prior reports showing not further strengthened validity our observations. differences justify assessment role colorectal cancer prevention. Similar APPC times suggest adequate inspection performed colonoscope each arms. (Clinical trial registration number: NCT01894191.)