Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 25, 2016; 8(6): 295-300
Published online Mar 25, 2016. doi: 10.4253/wjge.v8.i6.295
Use of automated irrigation pumps improves quality of bowel preparation for colonoscopy
Sujan Ravi, Rana Sabbagh, Fadi Antaki
Sujan Ravi, Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States
Sujan Ravi, Rana Sabbagh, Fadi Antaki, Division of Gastroenterology, John D. Dingell Veterans Affairs Medical Center and Wayne State University School of Medicine, Detroit, MI 48201, United States
Sujan Ravi, Rana Sabbagh, Detroit Medical Center, Detroit, MI 48201, United States
Author contributions: Ravi S, Sabbagh R and Antaki F designed the study; Ravi S and Sabbagh R collected data; Ravi S and Antaki F performed data analysis and interpretation, drafting of manuscript and draft revision; Ravi S, Sabbagh R and Antaki F approved the final manuscript.
Supported by Resources and the use of facilities at the John D. Dingell VA Medical Center, Detroit, MI, United States (the views expressed in this article are those of the authors and do not represent those of the Department of Veterans Affairs or the United States Government).
Institutional review board statement: The study was approved by the Wayne State University Institutional Review Board (IRB# 025911M1E(V)) and the John D. Dingell Veterans Affairs Medical Center Research Committee.
Informed consent statement: A waiver of informed consent was granted by the Wayne State University Institutional Review Board (IRB) as the study satisfied the following criteria: (1) risk is no more than minimal, (2) the waiver does not adversely affect the rights and welfare of research participants and (3) the research could not be practicably carried out without the waiver. All research participants had signed informed consent for the colonoscopy procedure.
Conflict-of-interest statement: None of the authors have any financial conflict of interest in relationship to the submitted manuscript.
Data sharing statement: No other data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fadi Antaki, MD, AGAF, Associate Professor of Medicine, Division of Gastroenterology, John D. Dingell Veterans Affairs Medical Center and Wayne State University School of Medicine, 4646 John R Road, C-3825, Detroit, MI 48201, United States. fadi.antaki@va.gov
Telephone: +1-313-5763389 Fax: +1-313-5761237
Received: June 28, 2015
Peer-review started: July 6, 2015
First decision: August 16, 2015
Revised: October 23, 2015
Accepted: January 16, 2016
Article in press: January 19, 2016
Published online: March 25, 2016
Processing time: 268 Days and 3.2 Hours
Abstract

AIM: To evaluate the effectiveness of automated irrigation pumps (AIPs) in improving the quality of the bowel preparation and the yield of colonoscopy.

METHODS: A retrospective observational study was conducted at a single medical center. Outpatient colonoscopies performed during a 4-mo time period when AIPs were not in use, were compared to colonoscopies performed during control period. The main outcomes measured were quality of bowel preparation, procedures aborted due to poor preparation, recommendations to repeat at short interval due to sub-optimal bowel preparation and adenoma detection rates.

RESULTS: One thousand and thirty-seven colonoscopies were included. A higher proportion of cases did not achieve a satisfactory bowel preparation when AIPs were not used (24.4% vs 10.3%, P < 0.01). The number of procedures aborted due to inadequate preparation was not significantly different, however a repeat procedure at a short interval was recommended in a higher proportion of cases when AIPs were not used (21.3% vs 6.9%, P < 0.01). Good or excellent preparation was 2.91 (95%CI: 2.04-4.15) times more likely when AIPs were used. Detection of polyps and adenomas was not significantly different.

CONCLUSION: AIP use during colonoscopy results in a higher proportion of colonic preparation rated as satisfactory, although polyp detection rate is not significantly affected. Recommendations for repeat colonoscopy at shorter interval significantly decrease with the use of AIPs. This study supports the use of the irrigation pumps in endoscopy units to improve the quality of colonoscopy.

Keywords: Automated irrigation pumps; Adenoma; Quality; Polyps; Bowel preparation; Surveillance interval; Colonoscopy

Core tip: The use of automated irrigation pumps during colonoscopy results in higher quality of preparation and decreases recommendations for repeating colonoscopy at short interval.