ArticleJGH open : an open access journal of gastroenterology and hepatology2026
Water Exchange Improves Detection of Advanced Colorectal Neoplasia: Pooled Analysis of Four Randomized Trials.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: To test whether water exchange improves advanced neoplasia detection rate (ANDR) by pooling data from four randomized controlled trials (RCTs) conducted in Taiwan with similar designs, patient populations, and endoscopists. Background: Water exchange colonoscopy has been shown to improve adenoma detection rate (ADR) compared to air insufflation. However, its effect on ANDR, a surrogate marker for colorectal cancer risk, remains unclear due to small sample sizes in individual studies. Methods: Patient demographics, procedural outcomes, ADR, and ANDR from four RCTs comparing water exchange and air insufflation were pooled and analyzed. Results: A total of 1048 patients were included. Baseline characteristics were similar between groups. Water exchange significantly increased overall ADR (54.0% vs. 45.7%, Conclusions: Pooled analysis of four comparable RCTs showed that water exchange colonoscopy significantly improves overall and proximal colon ANDR compared to air insufflation. Further studies are needed to determine whether this translates into a reduced risk of interval colorectal cancer.
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