http://hdl.handle.net/2282/347 Search the Channel search http://teora.hit.no/dspace/simple-search http://hdl.handle.net/2282/506 Title: Evaluation of a novel colonoscope designed for easier passage of flexures : a randomised study <br/> <br/>Authors: Hoff, Geir; Bretthauer, Michael; Huppertz-Hauss, Gert; Sauar, Jostein; Paulsen, Jørn; Dahler, Stein; Kjellevold, Øystein <br/> <br/>Abstract: Background and Study Aims: A new colonoscope (XCF-Q160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and Methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCF-Q160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’ grading of pain in a questionnaire. Results: Cecal intubation rates were 85 % and 87 % for standard and prototype endoscopes, respectively (P = 0.57). On-demand sedation was given to nine (7 %) and 15 (11 %) of the patients, respectively (P = 0.17). Of the patients, 256 (85 %) returned their questionnaire, with 87 (63 %) in the standard group and 109 (77 %) in the prototype group reporting that they had experienced ‘no pain/slight pain’ (P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation. http://hdl.handle.net/2282/505 Title: Colonoscopy without sedation <br/> <br/>Authors: Hoff, Geir http://hdl.handle.net/2282/428 Title: Quality control in colorectal cancer screening: systematic microbiological investigation of endoscopes used in the NORCCAP (Norwegian Colorectal Cancer Prevention) trial <br/> <br/>Authors: Bretthauer, Michael; Jørgensen, Anita; Kristiansen, Bjørn Erik; Hofstad, Bjørn; Hoff, Geir <br/> <br/>Abstract: BACKGROUND: Endoscopic colorectal cancer (CRC) screening is currently implemented in many countries. Since endoscopes cannot be sterilised, the transmission of infectious agents through endoscopes has been a matter of concern. We report on a continuous quality control programme in a large-scale randomised controlled trial on flexible sigmoidoscopy screening of an average-risk population. Continuously, throughout a two-year screening period, series of microbiological samples were taken from cleaned ready-to-use endoscopes and cultured for bacterial growth. RESULTS: 8573 endoscopies were performed during the trial period. Altogether, 178 microbiological samples (2%) were taken from the biopsy channels and surfaces from the endoscopes. One sample (0.5%) showed faecal contamination (Enterobacter cloacae), and 25 samples (14%) showed growth of environmental bacteria. CONCLUSIONS: Growth of bacteria occurs in a clinical significant number of samples from ready-to-use endoscopes. Pathogenic bacteria, however, were found only in one sample. Improvement of equipment design and cleaning procedures are desirable and continuous microbiological surveillance of endoscopes used in CRC screening is recommended. http://hdl.handle.net/2282/426 Title: Air and carbon dioxide volumes insufflated during colonoscopy <br/> <br/>Authors: Bretthauer, Michael; Hoff, Geir; Thiis-Evensen, Espen; Huppertz-Hauss, Gert; Skovlund, Eva <br/> <br/>Abstract: BACKGROUND: During colonoscopy, air or carbon dioxide is insufflated to secure adequate visualization of the colon, and endoscopy trainees are reminded to use as little gas as possible to avoid patient discomfort. However, the volume of gas insufflated by endoscopists during colonoscopy is unknown. The aim of the present study was to measure volumes of carbon dioxide and air insufflated during colonoscopy. METHODS: A total 249 consecutive patients participating in a colorectal cancer screening program were randomized to undergo colonoscopy with either carbon dioxide or air insufflation. Gas volumes insufflated during the procedure were measured with a mass-flowmeter. Four experienced endoscopists performed all of the examinations. RESULTS: Gas volumes were successfully measured in 218 (87%) patients. A mean of 8.3 L of carbon dioxide (range 1.2-19.8 L) and 8.2 L of air (range 1.8-18 L) were insufflated (p = 0.9). Mean volumes insufflated per minute were estimated to be 0.26 L and 0.24 L, respectively, in the carbon dioxide and air groups (p = 0.5). Statistically significant differences in the volumes of gas insufflated per minute were observed among some of the endoscopists. CONCLUSIONS: The volumes of carbon dioxide and air used during colonoscopy can be estimated. Differences in volumes of gas used by experienced endoscopists were detected.