ReviewCurrent treatment options in gastroenterology2017
Water-Assisted Colonoscopy.
Review in Current treatment options in gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03571061 (Comparisons of Sigmoid-colon Water Immersion, the Whole Colon Water Immersion and Carbon Dioxide), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparisons of Sigmoid-colon Water Immersion, the Whole Colon Water Immersion and Carbon Dioxide (CO2) Insufflation on Cecal Intubation Time in Potentially Difficult Colonoscopy by Difficult Colonoscopy Score(DCS) >1.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Diagnostic application of water exchange colonoscopy: A meta-analysis of randomized controlled trials.The Journal of international medical research · 2019Pooled it
- Is water exchange superior to water immersion for colonoscopy? A systematic review and meta-analysis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationPooled it
- Impact of withdrawal time on the adenoma detection rate in elderly patients during unsedated colonoscopy: a retrospective multicenter study.BMC gastroenterology · 2025Article
- Water-assisted colonoscopy in inflammatory bowel diseases: From technical implications to diagnostic and therapeutic potentials.World journal of gastrointestinal endoscopy · 2024Review
- Colon capsule retention in a patient with large bowel stenosis due to diverticulosis - a case report.Therapeutic advances in chronic disease · 2023Article
- Key quality indicators in colonoscopy.Gastroenterology report · 2023Review
- Colonoscopy quality improvement after initial training: A cross-sectional study of intensive short-term training.Endoscopy international open · 2023Article
- Insights Into Water Exchange Colonoscopy.Gastroenterology & hepatology · 2022Article
- When to Perform a Colonoscopy in Diverticular Disease and Why: A Personalized Approach.Journal of personalized medicine · 2022Review
- Practical considerations for colorectal cancer screening in older adults.World journal of gastrointestinal oncology · 2022Review
- Colonoscopy-related colonic ischemia.World journal of gastroenterology · 2021Review
- Comparison of Water Immersion Versus Air Insufflation Colonoscopy Under Various Bowel Preparation Conditions.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2021Article
- Comparison of application value between conventional air insufflation and water infusion in colonoscopy.International journal of clinical and experimental pathology · 2020Article
- How to perform water exchange colonoscopy, with tips and tricks.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2019Article
- Underwater polypectomy without submucosal injection for colorectal lesions ≤ 20 mm in size-a multicenter retrospective observational study.Surgical endoscopy · 2019Observational
- Is water exchange superior to water immersion in detecting adenomas during colonoscopies? Results from a Bayesian network meta-analysis.Oncotarget · 2018Article
- Can Water Exchange Improve Patient Tolerance in Unsedated Colonoscopy A Prospective Comparative Study.GE Portuguese journal of gastroenterology · 2018Article
- Colonoscope Insertion: Is the Future Underwater.GE Portuguese journal of gastroenterology · 2018Article
- How to perform water-aided colonoscopy, with differences between water immersion and water exchange: a teaching video demonstration.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2018Article
- Pediatric Colonoscopy: The Changing Patterns and Single Institutional Experience Over a Decade.Clinical endoscopy · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
opinion statementThe current review will attempt to describe the important lessons learned from published randomized controlled trials (RCT) comparing water immersion (WI) or water exchange (WE) techniques with gas insufflation colonoscopy. Air insufflation (AI) to distend the colon to permit visualization and passage through the lumen was developed for diagnostic colonoscopy. When screening colonoscopy was adopted, the same AI method was used. Interval cancers, diagnosed within 3 to 5 years after an index screening colonoscopy, appeared to be linked to low adenoma detection rate (ADR). Conscious sedation was introduced to manage insertion pain a few decades ago, incurring moderate costs of nursing staff, space for recovery, patient burdens of escort requirement, and at home recovery time. Recent advancement to deep sedation entailed additional costs of anesthesia staff support. In the past decade, investigators worldwide evaluated the use of water-assisted methods as an adjunct or in lieu of gas insufflation during insertion to minimize discomfort and improve ease of insertion. For convenience, one approach embraced the removal of infused water during withdrawal (WI). A subsequent evolution entailed removal of infused water predominantly during insertion (WE), specifically designed to further minimize insertion pain. Results of RCT shed light on the impact of WI and WE on insertion pain (primary outcome) and adenoma detection (secondary outcome). Water immersion is easier to learn and apply than WE, but mastery of the WE technique appears to have two major advantages. Current RCT data suggest that both WI and WE decrease insertion pain and facilitate completion of difficult colonoscopy, with WE having a superior impact than WI. Water exchange was serendipitously associated with an increase in ADR; this has been repeatedly confirmed in follow-up studies. When it is unknown which patient's colonoscopy will be difficult, it would seem prudent for the average colonoscopist to optimize the chance of success and increase in ADR by using WE from the very start.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.