BACKGROUND/AIMS: There are no established guidelines for bowel preparation formulation for bowel cleansing, nor is there an optimal method of dealing with inadequate bowel cleansing. This study investigated bowel preparation formulation preferences and responses to bowel preparation situations using surveys. METHODS: The study surveyed 221 Korean lower gastrointestinal endoscopists from January to March 2015 and assessed their responses. RESULTS: The analysis indicated that 2-L polyethylene glycol (PEG) plus ascorbic acid (Asc) was the preferred method (76.5%) and most responders expressed satisfaction with the formulation in both potency and safety. To address poor bowel preparation on the day of colonoscopy, the majority of physicians chose to order ingestion of additional preparations and proceed with the colonoscopy as scheduled (56.6%). In addition, concerns about renal safety and electrolyte stability were raised regarding oral sodium phosphate. CONCLUSIONS: This study found that 2-L PEG+Asc was preferred for potency and safety, and that Korean endoscopists preferred to proceed with colonoscopy in poor bowel preparation situations rather than choose an alternate diagnostic modality.
Ascorbic Acid ; Cathartics ; Colonoscopy ; Eating ; Methods ; Polyethylene Glycols ; Sodium

Colorectal polyps are classified as neoplastic or non-neoplastic on the basis of malignant potential. All neoplastic polyps should be completely removed because both the incidence of colorectal cancer and the mortality of colorectal cancer patients have been found to be strongly correlated with incomplete polypectomy. The majority of colorectal polyps discovered on diagnostic colonoscopy are diminutive and small polyps; therefore, complete resection of these polyps is very important. However, there is no consensus on a method to remove diminutive and small polyps, and various techniques have been adopted based on physician preference. The aim of this article was to review the diverse techniques used to remove diminutive and small polyps and to suggest which technique will be the most effective.
Colonoscopy ; Colorectal Neoplasms ; Consensus ; Humans ; Incidence ; Methods ; Mortality ; Polyps*

No abstract available.
Colonic Diseases/*surgery ; Colonoscopy/*methods ; Female ; Humans ; Male ; *Stents

Colon capsule endoscopy (CCE) is a relatively new diagnostic procedure for patients with suspected colonic diseases. This convenient, noninvasive method enables the physician to explore the entire colon without significant discomfort to the patient. However, while CCE can be performed painlessly without bowel air insufflation, the need for vigorous bowel preparation and other technical limitations exist. Due to such limitations, CCE has not replaced conventional colonoscopy. In this review, we discuss historical and recent advances in CCE including technical issues, ideal bowel preparation, indications and contraindications and highlight further technical advancements and clinical studies which are needed to develop CCE as a potential diagnostic tool.
Capsule Endoscopy* ; Colon* ; Colonic Diseases ; Colonoscopy ; Humans ; Insufflation ; Methods

PURPOSE: Colonoscopy is one of the most effective diagnostic and therapeutic tools for colorectal diseases. We aim to propose a master-slave robotic colonoscopy that is controllable in remote site using conventional colonoscopy. MATERIALS AND METHODS: The master and slave robot were developed to use conventional flexible colonoscopy. The robotic colonoscopic procedure was performed using a colonoscope training model by one expert endoscopist and two unexperienced engineers. To provide the haptic sensation, the insertion force and the rotating torque were measured and sent to the master robot. RESULTS: A slave robot was developed to hold the colonoscopy and its knob, and perform insertion, rotation, and two tilting motions of colonoscope. A master robot was designed to teach motions of the slave robot. These measured force and torque were scaled down by one tenth to provide the operator with some reflection force and torque at the haptic device. The haptic sensation and feedback system was successful and helpful to feel the constrained force or torque in colon. The insertion time using robotic system decreased with repeated procedures. CONCLUSION: This work proposed a robotic approach for colonoscopy using haptic feedback algorithm, and this robotic device would effectively perform colonoscopy with reduced burden and comparable safety for patients in remote site.
*Algorithms ; Colonoscopes ; Colonoscopy/instrumentation/*methods ; Equipment Design ; *Feedback ; Humans ; Robotics/*methods ; Torque

OBJECTIVESTo study the usefulness of CT virtual colonoscopy (CTVC) in patients with incomplete conventional colonoscopy (CC) and assess the statistical differences between two methods of colorectal segment examination.

METHODSSixty patients with incomplete CC underwent volume scanning using spiral CT. CT VC images were obtained using a navigator software in workstation. All patients were confirmed by surgical or CC biopsy histology. Statistical analysis was done using t test comparing two sample percentages.

RESULTSCTVC succeeded in 55/60 patients (91.7%) who had incomplete CC. Additional lesions were identified in the proximal colon in 15/55 patients (27.3%), including 1 primary carcinoma, 16 polyps in 13 patients and 1 ulcerative colonitis. The main cause of incomplete CC was occlusive mass; others were redundant, tortuous colon loops, and excessive colonic spasm. There was a statistically significant difference between the two methods in colorectal segment examination.

CONCLUSIONCTVC is a feasible and effective adjunctive method for evaluating the entire colorectal segment following an incomplete CC procedure. It offers a new approach for colorectal examination.

Adult ; Aged ; Colonoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods

Incidence and mortality of colorectal cancer has increased significantly in recent years. Screening for colorectal cancer is the most effective method to decrease mortality. Colorectal adenoma is the precancerous lesion of colorectal cancer and can be detected through colonoscopy, which is the crucial in the early diagnosis and early treatment for colorectal cancer. The first step of screening is the selection of target population and the second step is colorectal examination. The selection of candidate for screening has direct effect on the efficacy of screening. The methods in common use include fecal occult blood test, questionnaire for high risk factors of colorectal cancer, colonoscopy, sigmoidoscopy, and CT virtual colonoscopy. Among those, colonoscopy is the most reliable method and widely used in the screening for colorectal cancer.
China ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; Early Detection of Cancer ; methods ; Humans ; Mass Screening ; methods ; Occult Blood

OBJECTIVETo evaluate the efficacy of acupuncture analgesia in reducing patient's discomfort during colonoscopy.

METHODSEighty outpatients scheduled to undergo colonoscopy were randomly divided into an electroacupuncture (EA) group and a control group, 40 cases in each group. The patients in the EA group received electroacupuncture analgesia at the right Zusanli (ST 36) and Shangjuxu (ST 37), and left Yinlingquan (SP 9) and Sanyinjiao (SP 6), and bilateral Hegu (LI 4) from 30 minutes before colonoscopy to the end of colonoscopy. And the control group did not receive any treatment. Blood pressure (BP), heart rate (HR) in the both groups were continuously monitored during colonoscopy; the pain degrees during colonoscope inserting and passing the sigmoid, splenic flexure and hepatic flexure were observed. The time to reach cecum, adverse reaction and patient's satisfactoriness were recorded.

RESULTSColonoscopy was well tolerated in all the 80 patients. Pain degrees during colonoscope inserting and passing the sigmoid and splenic flexure in the EA group were significantly lower than those in the control group (P < 0.01); the time to reach cecum in the EA group (9.58 +/- 3.386) min was significantly shorter than that in the control group (12.96 +/- 6.4) min (P < 0.05); patient's satisfactoriness in the EA group was significantly higher than that in the control group (P < 0.05). There was no significant difference in HR and BP values between the two groups.

CONCLUSIONAcupuncture analgesia can effectively alleviate the discomfort of patients during colonoscopic examination, shorten the duration of colonoscopy, with a higher satisfactoriness of the patient.

Acupuncture Analgesia ; methods ; Acupuncture Points ; Adult ; Colonoscopy ; methods ; Female ; Humans ; Male ; Middle Aged

BACKGROUND: Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions. METHODS: We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight. RESULTS: From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals. CONCLUSIONS Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.
Humans ; Colonoscopy/methods* ; Endoscopy, Gastrointestinal ; Endoscopy, Digestive System/methods* ; Surveys and Questionnaires ; Adenoma ; China

OBJECTIVETo develop a virtual navigation mode to enlarge the field of view and decrease the deformation of the visual area.

METHODThe method was implemented in 3 steps. The entire colon was first divided into consecutive sections, and each section was split into two halves by a plane. The virtual camera was finally assigned onto each half of the sections for navigation.

RESULTSAdequate subsections were achieved with this method, which also offer an enlarged field of view for the benefit of focal inspection.

CONCLUSIONThe division navigation mode is suitable for the development of a virtual colonoscopy navigation and diagnosis system.

Colon ; anatomy & histology ; diagnostic imaging ; Colonography, Computed Tomographic ; methods ; Colonoscopy ; methods ; Computer Simulation ; Humans ; Tomography, X-Ray Computed ; methods