TY - JOUR
T1 - One or two operator technique and quality performance of colonoscopy
T2 - A randomised controlled trial
AU - Paggi, Silvia
AU - Rondonotti, Emanuele
AU - Amato, Arnaldo
AU - Baccarin, Alessandra
AU - Spinzi, Giancarlo
AU - Radaelli, Franco
PY - 2014
Y1 - 2014
N2 - Background: The two-operator technique for colonoscopy, with the endoscopy assistant actively advancing and withdrawing the scope, is still commonly practiced in Europe. As uncontrolled data has suggested that the one-operator technique is associated with a higher adenoma detection rate, we tested the hypothesis that the two-operator-technique can achieve comparable performances in terms of adenoma detection. Methods: Non-inferiority trial in which consecutive adult outpatients were randomised to undergo colonoscopy by one (one-operator) or by four endoscopists. Each performed half the procedures by one-operator and half by two-operator technique independently of routine clinical practice. Main outcome measure was adenoma detection rate. Results: 352 subjects (49% males, mean age 60 ± 12.1 years) were randomised to one (n= 176) or to two-operator technique (n= 176) colonoscopy. No significant differences were found in adenoma detection (33% vs. 30.7%, p= 0.65), or cecal intubation rate, procedure times, and patient tolerability. No differences were found in the subgroup analysis according to routinely adopted colonoscopy technique. Conclusions: This study does not confirm a higher adenoma detection rate for one-operator technique colonoscopy. Changing current practice to improve adenoma detection rate for endoscopists routinely using two-operator technique is not warranted.
AB - Background: The two-operator technique for colonoscopy, with the endoscopy assistant actively advancing and withdrawing the scope, is still commonly practiced in Europe. As uncontrolled data has suggested that the one-operator technique is associated with a higher adenoma detection rate, we tested the hypothesis that the two-operator-technique can achieve comparable performances in terms of adenoma detection. Methods: Non-inferiority trial in which consecutive adult outpatients were randomised to undergo colonoscopy by one (one-operator) or by four endoscopists. Each performed half the procedures by one-operator and half by two-operator technique independently of routine clinical practice. Main outcome measure was adenoma detection rate. Results: 352 subjects (49% males, mean age 60 ± 12.1 years) were randomised to one (n= 176) or to two-operator technique (n= 176) colonoscopy. No significant differences were found in adenoma detection (33% vs. 30.7%, p= 0.65), or cecal intubation rate, procedure times, and patient tolerability. No differences were found in the subgroup analysis according to routinely adopted colonoscopy technique. Conclusions: This study does not confirm a higher adenoma detection rate for one-operator technique colonoscopy. Changing current practice to improve adenoma detection rate for endoscopists routinely using two-operator technique is not warranted.
KW - Adenoma detection rate
KW - Colonoscopy technique
KW - One operator
KW - Two operators
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U2 - 10.1016/j.dld.2014.03.007
DO - 10.1016/j.dld.2014.03.007
M3 - Article
C2 - 24721107
AN - SCOPUS:84903814602
VL - 46
SP - 616
EP - 620
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 7
ER -