Efficacy of artificial intelligence for adenoma detection in water exchange colonoscopy: A two-center randomized controlled trial.

Background Water exchange (WE) and artificial intelligence-based computer-aided detection (CADe) separately improve the adenoma detection rate (ADR) and adenomas per colonoscopy (APC). We aimed to determine whether combining WE with CADe enhanced APC compared with WE alone. Methods This randomized controlled trial was conducted at hospitals in Italy (ENDO-AID; Olympus) and Taiwan (CAD-EYE; Fujifilm) using different CADe devices.

Incidence, risk and protective factors of symptoms after colonoscopy.

Background: Few studies focused on minor adverse events which may develop after colonoscopy.

Aims: To investigate the incidence and factors associated to post-colonoscopy symptoms.

Methods: This is a prospective study conducted in 10 Italian hospitals.

Determinants of symptom burden related to bowel preparation for colonoscopy.

Background: Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure.

Aims: We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy.

Methods: This is a prospective multicenter study conducted in 10 Italian hospitals.

Impact of colonoscopy on working productivity: a prospective multicenter observational study.

Background And Aims: Patients undergoing colonoscopy are often in the workforce. Therefore, colonoscopy may affect patients' work productivity in terms of missed working days and/or reduced working efficiency. We aimed to investigate the impact of colonoscopy on work productivity and factors influencing this impact.

Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations.

Background And Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy. We reviewed and graded the research evidence with potential clinical application. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR.

Insertion water exchange increases right colon adenoma and hyperplastic polyp detection rates during withdrawal.

Background: Single site studies in male Veterans in the U.S. reported increased detection of presumptive cancer precursors (adenomas, hyperplastic polyps) in the proximal colon (cecum-splenic flexure) by water exchange.

Impact of Colonoscopy Insertion Techniques on Adenoma Detection.

Background: Low adenoma detection rate (ADR) predicts development of interval cancers, found mainly in the right (cecum-ascending) colon, where poor bowel preparation is an associated factor. Single-site studies reported increased detection of adenomas in the proximal colon segments by water exchange (WE). Data about colon cleansing revealed that WE had the greatest impact in the right colon.

Evidence to suggest adoption of water exchange deserves broader consideration: Its pain alleviating impact occurs in 90% of investigators.

Aim: To determine whether observations were reproducible among investigators.

Methods: From March 2013 through June 2014, 18-85-year-old diagnostic and 50-70-year-old screening patients were enrolled at each center to on-demand sedation colonoscopy with water exchange (WE), water immersion (WI) and insufflation with air or CO2 for insertion and withdrawal [air or carbon dioxide (AICD)]. Data were aggregated for analysis.

Water Exchange Is the Least Painful Colonoscope Insertion Technique and Increases Completion of Unsedated Colonoscopy.

Background & Aims: Unsedated colonoscopy is acceptable for diagnostic, surveillance, and screening indications worldwide. However, insertion of the colonoscope can be painful; it is not clear which technique is least painful and thereby increases the likelihood of colonoscopy completion. We performed a head-to-head comparison of air insufflation (AI), carbon dioxide (CO2) insufflation, water immersion (WI), and water exchange (WE) to determine which combination of insertion techniques produces the least amount of pain.