Effect of Cap-Fitted Colonoscopy on Miss Rates at Colonoscopy

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Indiana University
ClinicalTrials.gov Identifier:
NCT00577083
First received: December 11, 2007
Last updated: April 29, 2014
Last verified: April 2014

December 11, 2007
April 29, 2014
November 2006
October 2009   (final data collection date for primary outcome measure)
The number of polyps found during the first colonoscopy will be compared to the number of polyps found during the second colonoscopy to determine the miss rate. [ Time Frame: after the second colonoscopy is completed ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00577083 on ClinicalTrials.gov Archive Site
The time required to remove and retrieve polyps with and without the cap on will be measured using a stopwatch as a secondary end point. [ Time Frame: after both colonoscopies are completed ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Effect of Cap-Fitted Colonoscopy on Miss Rates at Colonoscopy
Effect of Cap-Fitted Colonoscopy on Miss Rates at Colonoscopy

This is a test in which a thin, black, flexible tube with a lighting system on the end is passed through the anus, into the rectum, in order to examine the large bowel or intestine, also called the colon. Colonoscopy is a very good test for examining the colon for polyps (warty growths that can turn into cancer), but it is not perfect. In fact, about 30% of polyps that are under 5 mm (about 1/5 of an inch) in size are missed during colonoscopy because they are hiding behind folds and bends in the colon. This research study is being done to determine if performing colonoscopy with a cap on the tip of the colonoscope will reduce the miss rate for polyps. A cap is a clear plastic hood that fits on the tip of the colonoscope and sticks out about 1/3 of an inch. During colonoscopy, the cap can be pressed against a fold or ridge in order to flatten it, so that the lining on the other side can be more easily seen. This may reduce the miss rate for colon polyps.

Patient will undergo tandem colonoscopy on the same day using propofol sedation. Patients will undergo one colonoscopy without the cap and a second colonoscopy with the cap on. We will endeavor to keep the total examination time equal between the groups and approximately six minutes. The order in which patients receive the two colonoscopies (i.e. cap or without cap first) will be randomized. Any polyps detected during the first colonoscopy will be removed during that procedure. During the withdrawal phase, the time for examination will be measured with a stopwatch, and the stopwatch will be stopped at any time a polyp is located and restarted when the polyp has been removed and retrieved. The stopwatch will also be stopped for suctioning fluid or washing debris from the colon surface. Any polyp detected and removed during the first colonoscopy will be counted as the detection for that procedure. During the second colonoscopy, all polyps will also be removed when detected. Any polyp identified and removed during the second procedure will be counted as a miss for the first procedure. All polyps will be sent separately for pathologic evaluation. The time required to remove and retrieve polyps with and without the cap on will be measured using a stopwatch as a secondary end point. The primary end point will be the miss rate for colonoscopy with the cap and colonoscopy without the cap.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Screening
Polyps
Device: Cap-fitted colonoscopy
Subjects will be randomized to either initial cap-fitted colonoscopy or regular colonoscopy. Patients in the initial regular arm, will undergo cap-fitted colonoscopy for their second, tandem examination. Patients in the initial cap-fitted arm, will under undergo regular colonoscopy (without the cap) for their second, tandem examination.
Other Names:
  • cap-fitted colonoscopy
  • cap-assisted colonoscopy
  • colonoscopy with detachable hood
  • Experimental: Initial cap-fitted
    Initial cap-fitted colonoscopy for the first insertion
    Intervention: Device: Cap-fitted colonoscopy
  • Active Comparator: Initial regular
    no cap on the end of the colonoscope for the first insertion
    Intervention: Device: Cap-fitted colonoscopy
Hewett DG, Rex DK. Cap-fitted colonoscopy: a randomized, tandem colonoscopy study of adenoma miss rates. Gastrointest Endosc. 2010 Oct;72(4):775-81. Epub 2010 Jun 25.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
106
October 2009
October 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • 50 years of age or older, undergoing scheduled colonoscopy and able to give informed consent.

Exclusion Criteria:

  • Previous surgical resection of the colon or rectum
  • ASA class III or higher
  • Inflammatory bowel disease
  • Current use of anticoagulants.
Both
50 Years and older
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00577083
0501-30
Yes
Indiana University
Indiana University
Not Provided
Principal Investigator: Douglas K Rex, MD Indiana University School of Medicine
Indiana University
April 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP