Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 4903-4910
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.4903
Clinical impact of endoscopy position detecting unit (UPD-3) for a non-sedated colonoscopy
Masakatsu Fukuzawa, Junichi Uematsu, Shin Kono, Sho Suzuki, Takemasa Sato, Naoko Yagi, Yuichiro Tsuji, Kenji Yagi, Chika Kusano, Takuji Gotoda, Takashi Kawai, Fuminori Moriyasu
Masakatsu Fukuzawa, Junichi Uematsu, Shin Kono, Sho Suzuki, Takemasa Sato, Naoko Yagi, Yuichiro Tsuji, Kenji Yagi, Chika Kusano, Takuji Gotoda, Fuminori Moriyasu, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
Masakatsu Fukuzawa, Takashi Kawai, Endoscopy Center, Tokyo Medical University Hospital, Tokyo 160-0023, Japan
Author contributions: Fukuzawa M planned this work and wrote the manuscript; Fukuzawa M, Uematsu J, Kono S, Suzuki S, Sato T, Yagi N, Tsuji Y and Yagi K performed the endoscopic procedure and supported the research; Kusano C and Fukuzawa M performed the statistical analysis; Gotoda T, Kawai T and Moriyasu F drafted and revised the manuscript.
Ethics approval: The study was not reviewed and approved by the Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to examination.
Conflict-of-interest: The authors have no conflict of interest directly relevant to the contents of this article.
Data sharing: Participants gave informed consent for data sharing. No additional data are 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:
Correspondence to: Masakatsu Fukuzawa, MD, PhD, Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjukuku, Tokyo 160-0023, Japan.
Telephone: +81-3-33426111 Fax: +81-3-53816654
Received: December 15, 2014
Peer-review started: December 16, 2014
First decision: December 26, 2014
Revised: January 12, 2015
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: April 28, 2015

AIM: To evaluate whether an endoscopy position detecting unit (UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale (VAS) pain scores, regardless of the colonoscopist’s level of experience.

METHODS: A total of 260 patients (170 men and 90 women) who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group (no UPD-3 guidance). Colonoscopies were performed by experts (experience of more than 1000 colonoscopies) or trainees (experience of less than 100 colonoscopies). Cecal intubation rates, cecal intubation times, insertion methods (straight insertion: shortening the colonic fold through the bending technique; roping insertion: right turn shortening technique) and patient discomfort were assessed. Patient discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of pain.

RESULTS: The cecum intubation rates, cecal intubation times, number of cecal intubations that were performed in < 15 min and insertion methods were not significantly different between the conventional group and the UPD-3-guided group. The number of patients who experienced pain during the insertion was markedly less in the UPD-3-guided group than in the conventional group. Univariate and multivariate analysis showed that the following factors were associated with lower VAS pain scores during endoscope insertion: insertion method (straight insertion) and UPD-3 guidance in the trainee group. For the experts group, univariate analysis showed that only the insertion method (straight insertion) was associated with lower VAS pain scores.

CONCLUSION: Although UPD-3 guidance did not shorten intubation times, it resulted in less patient pain during endoscope insertion compared with conventional endoscopy for the procedures performed by trainees.

Keywords: Colonoscopy, Training, Endoscopy position detecting unit

Core tip: Non-sedated colonoscopy may be an uncomfortable or painful examination. It is very important for the colonoscopist to understand the shape of the endoscope during its insertion to successfully accomplish cecal intubation with minimal pain. ScopeGuide endoscopy position detecting unit (UPD-3) is designed to provide real-time three-dimensional images of the shape and configuration of the colonoscope inside the body. This study was conducted to evaluate the clinical impact of UPD-3, regardless of the level of experience of the colonoscopist. According to this study, ScopeGuide UPD-3 is useful for reducing patient abdominal discomfort during colonoscopies performed by trainees.