COMPARISON OF ONE-PERSON TECHNIQUE AND TWO-PERSON TECHNIQUE FOR COLONOSCOPE INSERTION: A RANDOMIZED CONTROLLED TRIAL

초록

Background The one-person technique (OPT) for colonoscope insertion is recommended by professional societies and regarded as the standard practice. However, the two-person technique (TPT) has shown several advantages over the OPT. The aim of this study was to evaluate the performance of TPT compared to OPT. Methods In this prospective study, consecutive individuals presenting for outpatient colonoscopy were randomized to undergo colonoscopy by OPT or by TPT. The colonoscopies were performed by six endoscopists, two of whom were inexperienced, two with intermediate skills, and two who were experts. The primary end-points were quality indicators for colonoscopy including adenoma detection rate, cecal intubation rate, cecal insertion time, and total colonoscopy time. A secondary outcome was procedure tolerability, as assessed by both patients and endoscopists. Results Two hundred and four subjects (117 males, mean age 54.3) were randomized to either one (n= 102) or two-person (n=102) colonoscopy. The adenoma detection rate was 30.4% in OPT group and 34.3% in TPT group. (p=0.55). No significant differences between the two groups were found in terms of cecal intubation rate (98/102 vs 98/102), insertion time (411 sec vs 381 sec), and total examination time (1426 sec vs 1296 sec). However, patients receiving the TPT had lower pain scores than the OPT. Endoscopist fatigue measured with FACIT-F was also significantly lower in two-man method groups. Conclusion The two-person colonoscopy method was not shown to be technically or clinically superior, but can improve patient tolerance and reduce endoscopist fatigue.