The prone 12 o'clock position reduces ileal intubation time during colonoscopy compared to the left lateral 6 o'clock (standard) position

Ileal intubation is the gold standard for a complete colonoscopy. However, despite evidence of clinical benefit ileoscopy is not always attempted due to perceived technical difficulty. Our aim was to compare time taken for ileal intubation using a new position-the prone 12 o'clock position (PP)...

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Bibliographic Details
Published in:BMC gastroenterology 2011-08, Vol.11 (1), p.89-89, Article 89
Main Authors: De Silva, Arjuna P, Kumarasena, Ravindu S, Perera Keragala, Suramya D, Kalubowila, Udaya, Niriella, Madunil, Dassanayake, Anuradha S, Pathmeswaran, Arunasalam, de Silva, H Janaka
Format: Article
Language:English
Subjects:
Adult
Aged
Colonoscopy
Colonoscopy - methods
Female
Fluoroscopy
Humans
Ileum
Intubation
Male
Middle Aged
Pilot Projects
Prone Position
Time Factors
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Summary:Ileal intubation is the gold standard for a complete colonoscopy. However, despite evidence of clinical benefit ileoscopy is not always attempted due to perceived technical difficulty. Our aim was to compare time taken for ileal intubation using a new position-the prone 12 o'clock position (PP) with the standard method (left lateral 6 o'clock position-LLP). We performed a pilot study using fluoroscopy to determine the best patient position for ileal intubation. This was the prone 12 o'clock position. Patients were colonoscoped in the left lateral position and then randomized to ileal intubation in the 6 o'clock position(LL) or the 12 o'clock (PP) position. 202 consecutive patients were referred for colonoscopy. Colonoscopy was performed on 150 patients [82 females, mean (SD) age 53 (16) years]. 75 patients were randomized for ileal intubation in the PP and 75 patients in the LLP. Overall, the ileum was successfully intubated in 145 (96%) patients [74 (98.7%) in the PP and 71 (94.7%) in the LLP]. The median (Interquartile Range) ileal intubation time was 12 (10) seconds in the PP and 87 (82) seconds in the LLP (p < 0.0001; Mann-Whitney U test). The ileum was abnormal in 11 (7.5%) patients. During colonoscopy, the prone 12 o'clock position gives a more direct approach to the ileo-caecal valve and significantly reduces ileal intubation time. Sri Lanka Clinical Trial Registry Clinical trial registry number: SLCTR/2009/002.
ISSN:1471-230X
1471-230X
DOI:10.1186/1471-230X-11-89