Comparative Efficacy of Water & Indigo Carmine vs. Water or Air Method on Adenoma Detection Rate (ADR) - a Randomized Controlled Trial (RCT)
Colorectal Neoplasms
About this trial
This is an interventional treatment trial for Colorectal Neoplasms focused on measuring adenoma detection, screening colonoscopy, water exchange method, chromoendoscopy
Eligibility Criteria
Inclusion Criteria:
- asymptomatic Veterans scheduled for first time screening colonoscopy and agree to be randomized will be enrolled.
Exclusion Criteria:
- patients who decline to be randomized, non screening cases.
Sites / Locations
- VA Northern California Health Care System, Mather, CA
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
water (exchange) method
water (exchange) plus dye method
air method
Residual pocket of air will be suctioned. Water is infused using a peristaltic pump to facilitate scope advancement until the cecum is reached. Dirty water will be suctioned and clean water is infused. Air will not be insufflated until the cecum is reached. Residual water is suctioned and air insufflated on scope withdrawal to facilitate biopsy and removal of lesions.
Residual pocket of air will be suctioned. Water with 0.008% indigocarmine is infused using a peristaltic pump to facilitate scope advancement until the cecum is reached. Dirty water will be suctioned and clean water is infused. Air will not be insufflated until the cecum is reached. Residual water is suctioned and air insufflated on scope withdrawal to facilitate biopsy and removal of lesions
The colonoscope is inserted gently and advanced slowly using minimal air insufflation, if necessary, the assistant will provide abdominal compression or the patient's position will be changed to facilitate scope passage. The scope is inserted until the cecum is reached. Air is insufflated on scope withdrawal for visualization and water irrigation is used to remove any adherent feces covering the mucosa. Biopsy or polypectomy is performed where indicated.