Is Oil-Assisted Colonoscopy Useful?

Abstract

Background: Cecal completion rates, procedure-related pain, and the difficulty of endoscopists are still problems to the beginners of colonoscopy. New methods to aid colonoscopic insertion such as warm water instillation and oil lubrication were proposed. The aim of this study was to evaluate the feasibility of warm water and oil method in colonoscopic insertion. Methods: Colonoscopy was performed in 117 unsedated patients by endoscopists-in-training. Patients were randomly allocated to 3 groups. In standard group (n=39), conventional method with administration of antispasmodic agent was used. In warm water group (n=41), 200 cc of water at 36°C was instilled into the sigmoid colon in the early phase of the insertion. In oil group (n=37), each 30 cc of commercially available seed cooking oil was instilled into the sigmoid colon, at the splenic and hepatic flexure. The success rate for total intubation within limited time, the cecal intubation time, the level of patient discomfort, and the degree of difficulty of endoscopists were compared among the three groups. Results: Cecal intubation time was shorter in warm water group than oil group (p<0.05). Procedural difficulty of endoscopists was increased in oil and standard group compared with warm water group (p<0.05). Patients' pain was higher in oil group than in the other two groups (p<0.05). The disadvantages of oil method were caused by hampered vision, persistent bowel spasm, and difficult handling due to lubricated shaft. However, there was no significant difference in the success rates for intubation within limited time among the three groups. Conclusions: Warm water method was a simple, safe, and feasible method to beginners during colonoscopy. However, oil lubrication method may not be a useful method compared to standard and warm water method.