A Novel Device: The Colon-Air-Discharge-Tube, Is Easier, Safer and Lesser Discomfort to the Patients During Total Colonoscopy

Abstract

Background & Aims: Colonoscopy is a widely utilized diagnostic procedure for colon diseases. However, it is frequently a painful for the patients. One of the reasons is excessive air in the colon, which causes elongation of it. We examined whether a novel air-discharge-tube decreased the colonoscopy time and the pain. Methods: This consists of a 30-cm vinyl tube (4 mm diameter) and have four segments (A: a 5-cm intake segment into the rectum with holes, B: a 1.5-cm plastic ball that gets hooked by the anal sphincter, C: a 6-cm built in spring to avoid collapse of the tube because of the pressure between the sphincter and the fiber scope in the anal canal, D: a discharge segment about 20 cm in length extending out of the anal, with holes; excessive air and fluid are continuously discharged via this tube. Between August 2004 and November 2004, 33 male (age, 54.1 ± 13.5 y) and 14 female (age, 55.5 ± 12.1 y) underwent colonoscopy at our hospital with informed consents. None of the patients had any history of abdominal surgery. The patients were randomly divided into two groups, one in which the tube was used (Group A), and the other in which it was not (Group B). And the time to the Sigmoid-Descending Colon Junction (SDJ) and the time to the cecum were measured with the insert length of fiber. The pain was scored on a visual analog scale (VAS) for the patients who had history of colonoscopy before this study. Results: The overall success rate of scope insertion up to the cecum was 100% (47/47 cases). The Group A consisted 23 patients (17M/6F, age 51.5 ± 14.8 y) and the Group B consisted 24 patients (16M/8F, age 57.4 ± 10.5 y, P = 0.12). The time to the SDJ was significantly decreased in Group A (142.0 ± 44.0″) as compared to that in Group B (199.6 ± 77.1″, P = 0.0031), and the length to the SDJ was shorter in Group A (52.6 ± 17.1 cm) than in Group B (66.3 ± 15.0 cm, P = 0.0056). The time to the cecum was also significantly decreased in Group A (323.0 ± 109.8″) as compared to that in Group B (522.3 ± 166.1″, P = 0.000016). However, the length to the cecum was not significantly different between the two groups (Group A: 79.1 ± 7.3 cm vs. Group B: 80.4 ± 7.5 cm, P = 0.56). The VAS of the pain was significantly lower in Group A (6.8 ± 3.0; 13M/3F) than in Group B (9.2 ± 1.7; 11M/2F, P = 0.015). Conclusion: The colon-air-discharge tube decreased the time to the cecum and the pain associated with colonoscopy.