ArticleTherapeutic advances in gastroenterology2026
Real-world evidence of water exchange colonoscopy improving adenoma detection rates: A propensity score-matched analysis.
Article in Therapeutic advances in gastroenterology, 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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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.
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7 authors.
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Abstract
Background: Randomized trials show that water exchange (WE) colonoscopy improves adenoma detection rate (ADR), but its effectiveness and workflow trade-offs in routine, high-volume practice remain uncertain. Objectives: To evaluate the real-world performance of WE versus conventional air insufflation for adenoma detection, bowel preparation quality, and procedure efficiency. Design: Retrospective propensity score matched cohort study. Methods: Outpatient colonoscopies performed from January 2019 through October 2024 at a high-volume Taiwanese center were analyzed. WE procedures were matched 1:1 with air insufflation controls on prespecified covariates. The primary outcome was ADR. Secondary outcomes included segment-specific detection, advanced adenomas detection, sessile serrated lesion detection, bowel preparation quality, and procedure times. Results: The matched cohort included 4,322 colonoscopies (2,161 per group). WE increased ADR by 14.0 percentage points (57.9% vs 44.0%; Conclusions: In real-world, high-volume practice, WE substantially improved neoplasia detection and bowel cleansing, with the greatest benefit in the right colon and persistence of effect against a high-performing air insufflation baseline. The time cost was predictable, supporting WE as an effective insertion technique when maximizing diagnostic yield is prioritized.
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