A randomized controlled trial comparing right lateral decubitus and left lateral decubitus starting position on outcomes in colonoscopy

Greene, Alison (2020) A randomized controlled trial comparing right lateral decubitus and left lateral decubitus starting position on outcomes in colonoscopy. Masters thesis, Memorial University of Newfoundland.

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Abstract

Patient positioning in colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distention and improve navigation through the large bowel. We sought to determine if right lateral (RL) starting position compared to the standard left lateral (LL) starting position could improve outcomes in colonoscopy. Patients presenting for their scheduled colonoscopy were consented for the trial and randomized to RL or LL starting position. Variables including age, sex, BMI, time to cecal intubation, adenoma detection rate (ADR), NAPCOMs pain score, amount of sedation administered, and quality of bowel preparation were collected during their colonoscopy. The primary outcome was time to cecal intubation. All colonoscopists who had successfully completed upskilling courses were included in the trial. A total of 185 patients were included in the analysis - 94 patients were randomized to RL and 91 patients were randomized to LL. No difference was found in time to cecal intubation comparing the starting position of RL (542.6s) to LL (497.85s) (p=0.354). There was also no difference in cecal intubation rate (RL - 94.9%, LL – 94.8%, p=0.960), ADR (RL – 56.3%, LL – 64.8%, p=0.240), or patient comfort (p=0.078) comparing the starting position. In conclusion, no difference was found for outcomes in colonoscopy comparing the RL and LL starting position.

Item Type: Thesis (Masters)
URI: http://research.library.mun.ca/id/eprint/14382
Item ID: 14382
Additional Information: Includes bibliographical references (pages 71-77).
Keywords: Colonoscopy, starting position, right lateral decubitus, cecal intubation time
Department(s): Medicine, Faculty of
Date: May 2020
Date Type: Submission

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