Endoscopy International Open最新文献

{"title":"Novel water-based automated endoscope cleaning process vs conventional manual cleaning for reducing duodenoscope contamination.","authors":"Koen van der Ploeg, Juliëtte A Severin, Margreet C Vos, Nicole S Erler, Adriana J C Bulkmans, Marco Bruno, Bibi C G C Mason-Slingerland","doi":"10.1055/a-2536-8061","DOIUrl":"10.1055/a-2536-8061","url":null,"abstract":"<p><strong>Background and study aims: </strong>Duodenoscope contamination remains a persistent problem, exposing patients to infection risks. Automation in reprocessing may limit human error, reduce workload, and increase uniformity and traceability. However, its effectiveness should be evaluated before implementation. This study assessed the impact of implementing a novel water-based automated endoscope cleaning process on duodenoscope contamination.</p><p><strong>Methods: </strong>This before-and-after intervention study compared duodenoscope cleaning methods. From January 2022 to December 2023, conventional manual cleaning was used. From January 2024 to June 2024, the AquaTYPHOON system (AT) replaced manual cleaning. Cultures from Pentax ED34-i10T2 patient-ready duodenoscopes were collected. The main outcome was the contamination rate with microorganisms of gut or oral origin (MGO). Secondary outcomes included contamination with solely gut bacteria. Non-inferiority of the AT was tested using a generalized estimating equation with a non-inferiority margin of 5%.</p><p><strong>Results: </strong>During the manual cleaning period, 333 duodenoscope cultures of eight duodenoscopes were collected; during the AT period, 100 cultures were collected. Pre-introduction of the AT, the contamination rate with MGO was 21.6%, which fell to 16% post-introduction (risk difference: -5.6%, upper bound 90% confidence interval [CI] 6.8%). For gut bacteria, the contamination rate decreased from 14.4% to 9% (risk difference: -5.4%, upper bound 90% CI 3.9%), indicating non-inferiority.</p><p><strong>Conclusions: </strong>AT reduced the contamination rate with MGO, but non-inferiority was not demonstrated. For gut bacteria, AT was non-inferior to manual cleaning. These results are promising. However, future studies should confirm these findings in larger samples and explore other advantages of using the AT in duodenoscope cleaning.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25368061"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orally peppermint oil in small bowel capsule endoscopy: Novel approach to improve completion rates in patients at risk of delayed gastric transit.","authors":"Fintan John O'Hara, Conor Costigan, Deirdre Mc Namara","doi":"10.1055/a-2465-6918","DOIUrl":"10.1055/a-2465-6918","url":null,"abstract":"<p><strong>Background and study aims: </strong>Small bowel capsule endoscopy (SBCE) is crucial in diagnosing small bowel diseases, yet incomplete examinations often result from prolonged gastric transit time. This study aimed to assess the efficacy of orally administered peppermint oil solution as a prokinetic agent to improve SBCE completion rates in patients with delayed gastric transit risk factors.</p><p><strong>Patients and methods: </strong>Conducted as a single-center, prospective, open-label, non-inferiority trial, the study involved 132 patients identified as at risk for delayed gastric transit. Participants were divided into three groups: peppermint oil solution group (n = 57), real-time monitoring and intravenous prokinetics group (n = 75), and control group without risk factors (n = 193). Primary outcomes included SBCE completion rates, gastric transit time (GTT), small bowel transit time (SBTT), diagnostic yield, and bowel preparation quality.</p><p><strong>Results: </strong>Completion rates were high and comparable among groups, with 94.7% in the peppermint group, 90.7% in the real-time monitoring group, and 95.3% in the control group. The peppermint group exhibited a significantly shorter mean GTT of 42.3 minutes compared with 57.0 minutes in the real-time monitoring group ( <i>P</i> = 0.0423). However, SBTT was longer in the peppermint group at 246 minutes versus 193 minutes in the real-time monitoring group ( <i>P</i> = 0.0081), although similar to the control group at 228.3 minutes ( <i>P</i> = 0.2612). Diagnostic yield and bowel preparation quality were consistent across all groups.</p><p><strong>Conclusions: </strong>Oral peppermint oil solution is a safe and effective alternative to traditional prokinetics, enhancing SBCE completion rates while reducing time and resource use in the endoscopy unit.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24656918"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional small-bowel capsule endoscopy reading vs proprietary artificial intelligence auxiliary systems: Systematic review and meta-analysis.","authors":"Pablo Cortegoso Valdivia, Stefano Fantasia, Stefano Kayali, Ulrik Deding, Noemi Gualandi, Mauro Manno, Ervin Toth, Xavier Dray, Shiming Yang, Anastasios Koulaouzidis","doi":"10.1055/a-2544-2863","DOIUrl":"10.1055/a-2544-2863","url":null,"abstract":"<p><strong>Background and study aims: </strong>Small-bowel capsule endoscopy (SBCE) is the gold standard for diagnosing small bowel (SB) pathologies, but its time-consuming nature and potential for human error make it challenging. Several proprietary artificial intelligence (AI) auxiliary systems based on convolutional neural networks (CNNs) that are integrated into SBCE reading platforms are available on the market and offer the opportunity to improve lesion detection and reduce reading times. This meta-analysis aimed to evaluate performance of proprietary AI auxiliary platforms in SBCE compared with conventional, human-only reading.</p><p><strong>Methods: </strong>A systematic literature search was conducted to identify studies comparing AI-assisted SBCE readings with conventional readings by gastroenterologists. Performance measures such as accuracy, sensitivity, specificity, and reading times were extracted and analyzed. Methodological transparency was assessed using the Methodological Index for Non-randomized Studies (MINORS) assessment tool.</p><p><strong>Results: </strong>Of 669 identified studies, 104 met the inclusion criteria and six were included in the analysis. Quality assessment revealed high methodological transparency for all included studies. Pooled analysis showed that AI-assisted reading achieved significantly higher sensitivity and comparable specificity to conventional reading, with a higher log diagnostic odds ratio and no substantial heterogeneity. In addition, AI integration substantially reduced reading times, with a mean decrease of 12-fold compared with conventional reading.</p><p><strong>Conclusions: </strong>AI-assisted SBCE reading outperforms conventional human review in terms of detection accuracy and sensitivity, remarkably reducing reading times. AI in this setting could be a game-changer in reducing endoscopy service workload and supporting novice reader training.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25442863"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peroral endoscopic myotomy with fundoplication (POEM-F) for achalasia: Systematic review and meta-analysis.","authors":"Harishankar Gopakumar, Eugene Annor, Ishaan Vohra, Iman Andalib, Amy Tyberg, Avik Sarkar, Haroon Shahid, Mine Carames, Juan Carlos Carames, Giovanna Porfilio Gularte, Abed Al-Lehibi, Resheed Alkhiari, Amol Bapaye, Carlos Robles-Medranda, Michel Kahaleh","doi":"10.1055/a-2536-8132","DOIUrl":"10.1055/a-2536-8132","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroesophageal reflux (GER) and its long-term sequelae remain a concern following peroral endoscopic myotomy (POEM). POEM with fundoplication (POEM-F) is simultaneous fundoplication via pure natural orifice transluminal endoscopic surgery (NOTES). In this study, we evaluated the efficacy and safety of POEM-F in mitigating post-POEM GER.</p><p><strong>Methods: </strong>We performed a comprehensive electronic database search from January 2008 through June 2024 for studies evaluating outcomes of POEM-F performed for managing post-POEM GER. Pooled proportions were calculated using random-effects models. Heterogeneity was assessed using I ² and Q statistics.</p><p><strong>Results: </strong>We included seven studies comprising 127 patients. Pooled technical success for POEM was 96.90%; 95% confidence interval [CI] 91.40-98.90. Pooled technical success of fundoplication was 92.30%; 95% CI 85.20-96.10. Clinical success in treating achalasia was 96.40%; 95% CI 90.70-98.60. Rate of wrap integrity on follow-up was 84.00%; 95% CI 66.00-93.40. Composite clinical success of POEM-F in mitigating post-POEM GER was 86.20%; 95% CI 73.80-93.20. Mean total procedure duration and fundoplication time was 115.74 minutes; 95% CI 103.53-126.96 and 55.28 minutes; 95% CI 47.35-63.20, respectively. The overall pooled major adverse events (AE) rate was 3.60%; 95% CI 1.40-9.40.</p><p><strong>Conclusions: </strong>POEM-F is an effective procedure with an acceptable AE rate in expert hands. It appears to offer clinical benefit in mitigating post-POEM GER. However, further standardization for evaluating clinically significant post-POEM GER and long-term benefit of POEM-F is warranted.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25368132"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermal changes in guidewires used during endoscopic retrograde cholangiopancreatography during electrical conductance: Ex-vivo safety experiment.","authors":"Rahul Karna, Nicholas M McDonald, Jacob Weiner, Théodon I Netoff, Stuart K Amateau","doi":"10.1055/a-2536-7997","DOIUrl":"10.1055/a-2536-7997","url":null,"abstract":"<p><p>Risks of pancreaticobiliary tissue damage secondary to electrical conduction along cannulation wires in the vicinity of electrocautery have rarely been independently studied and remain mostly a theoretical issue. We aimed to evaluate heat generated by commercially available guidewires in the setting of currents used for sphincterotomy to assess their safety during endoscopic procedures. We tested heat generation from 11 common guidewires used in endoscopic retrograde cholangiopancreatography using an electrosurgical generator in combination with a thermocouple temperature probe in an ex vivo model. Thermal changes during electrical conductance were nominal except for minimally wrapped 0.018\" wires where the maximum changes in temperature were 4.9°C with ENDO CUT Q settings and 6.8°C with ENDO CUT I settings. Also, the Glidewire 0.018\" and the Visiglide 0.025\" produced visible sparks along their distal ends with defects in insulation found later under microscopic evaluation. In our ex-vivo study, minimal heat was generated via electrical conductivity despite direct current, suggesting negligible risk of thermal injury during sphincterotomy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25367997"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a training intervention on upper gastrointestinal endoscopy quality over time: Multicenter comparative cohort study.","authors":"Lieke Maria Koggel, Jole P E van Berlo, Fleur A Indemans, Ruud W M Schrauwen, Marten A Lantinga, Peter D Siersema","doi":"10.1055/a-2526-0240","DOIUrl":"10.1055/a-2526-0240","url":null,"abstract":"<p><strong>Background and study aims: </strong>The European Society of Gastrointestinal Endoscopy (ESGE) and British Society of Gastroenterology (BSG) formulated performance measures to improve the detection rate for upper gastrointestinal (UGI) endoscopy. We aimed to assess adherence to and impact of training on adherence to performance measures for UGI endoscopy.</p><p><strong>Methods: </strong>In this multicenter, prospective, cohort study, endoscopists at three centers underwent 1-hour face-to-face training based on ESGE and BSG procedure performance measures (≥ 7-minute inspection time; photodocumentation of ≥ 10 anatomical landmarks + abnormalities; standardized terminology; biopsy protocols). A self-developed quality assessment score was used to assess diagnostic UGI endoscopies before (control group) and after (intervention group) training. The primary endpoint was improvement in overall quality score (percentage of the maximum score).</p><p><strong>Results: </strong>Of 1,733 consecutive UGI endoscopies, 570 were eligible for inclusion (mean patient age 60 years [standard deviation 15]; male 47%): 285 in the control group and 285 in the intervention group. Overall quality score increased from 60% before to 67% after the training intervention (difference 7%, 95% confidence interval [CI] 5-10, <i>P</i> < 0.001). Male patients (3.2%, 95% CI 0.7-5.7), alarming features (-3.1%, 95% CI -5.6 to -0.5), and endoscopist age (-0.4% increment per year, 95% CI -0.8 to -0.1) were associated with higher quality scores.</p><p><strong>Conclusions: </strong>Adherence to the ESGE and BSG procedure performance measures for UGI endoscopy persistently increased after a 1-hour face-to-face training intervention, suggesting that a simple training intervention tool can improve the quality of UGI endoscopy and potentially could prevent missed lesions.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25260240"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel technology for automated cleaning of flexible endoscopes.","authors":"Michelle J Alfa","doi":"10.1055/a-2527-4224","DOIUrl":"10.1055/a-2527-4224","url":null,"abstract":"<p><p>Reprocessing of flexible endoscopes is a multi-stage system with many sequential stages. Errors in any one of the stages can result in microbial contamination that persists in patient ready endoscopes despite full reprocessing. One stage that is especially prone to errors is the manual cleaning of channels and exterior surfaces of flexible endoscopes. This editorial discusses the current factors in manual cleaning that lead to errors in cleaning adequacy. It also reviews novel technologies that provide improvements in cleaning of flexible endoscope channels.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25274224"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and endoscopic-histological correlation of premalignant gastric lesions at a university hospital in Uruguay.","authors":"Ignacio Moratorio, Adrian Canavesi, Carolina Olano, Klaus Mönkemüller","doi":"10.1055/a-2542-0880","DOIUrl":"10.1055/a-2542-0880","url":null,"abstract":"<p><strong>Background and study aims: </strong>Although chronic atrophic gastritis (CAG), intestinal metaplasia (IM), and dysplasia constitute gastric pre-neoplastic conditions of gastric cancer (GC), data on endoscopic correlation and the prevalence in many South American countries are scarce. The aims of this study were to establish prevalence and perform endoscopic-histological correlation of gastric pre-neoplastic conditions using high-definition white light endoscopy (WLE) and to determine interobserver agreement for endoscopic findings for CAG and IM.</p><p><strong>Patients and methods: </strong>A prospective, observational, descriptive, cross-sectional study was carried out at a Uruguayan hospital during a 6-month period. Risk was stratified according to Operative Link for Gastritis Assessment and Operative Link for Gastric Intestinal Metaplasia stage for CAG and IM, respectively. An independent and blinded second observer was included to determine interobserver endoscopic and histologic agreement.</p><p><strong>Results: </strong>A total of 102 patients (mean age 57 years ± 1.6 years, 68.6% woman) were included. Prevalence of histological CAG and IM were 38.2% and IM 31.4%, respectively. Endoscopic-histological correlation for CAG had kappa index 0.063, sensitivity 46%, and specificity 60%. For endoscopic IM, the kappa index was 0.216, sensitivity 22%, and specificity 96%. Interobserver variability was good for gastric fold flattening and very good in the presence of whitish-greyish plaques for CAG and IM, respectively.</p><p><strong>Conclusions: </strong>The endoscopic-histological correlation of both CAG and IM was low, raising the need for biopsy for diagnosis in all cases, regardless of HD-WLE findings. Although prevalence of gastric pre-neoplastic conditions in this group of Uruguayan patients was comparable to those described in countries with a high incidence of GC, a low proportion of high-risk stages (III and IV) was identified.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25420880"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of artificial intelligence-aided colonoscopy for adenoma detection and characterization in Spain.","authors":"Marco Bustamante-Balén, Beatriz Merino Rodríguez, Luis Barranco, Julen Monje, María Álvarez, Sofía de Pedro, Itziar Oyagüez, Nancy Van Lent, María Mareque","doi":"10.1055/a-2509-7278","DOIUrl":"10.1055/a-2509-7278","url":null,"abstract":"<p><strong>Background and study aims: </strong>The aim of this study was to assess the cost-effectiveness of an intelligent endoscopy module for computer-assisted detection and characterization (CADe/CADx) compared with standard practice, from a Spanish National Health System perspective.</p><p><strong>Methods: </strong>A Markov model was designed to estimate total costs, life years gained (LYG), and quality-adjusted life years (QALYs) over a lifetime horizon with annual cycles. A hypothetical cohort of 1,000 patients eligible for colonoscopy (mean age 61.32 years) was distributed between Markov states according to polyp size, location, and histology based on national screening program data. CADe/CADx efficacy was determined based on adenoma miss rates and natural disease evolution was simulated according to annual transition probabilities. Detected polyp management involved polypectomy and histopathology in standard practice, whereas with CADe/CADx leave-in-situ strategy was applied for ≤ 5 mm rectosigmoid non-adenomas and resect-and-discard strategy for the rest of ≤ 5mm polyps. Unit costs (€,2024) included the diagnostic procedure and polyp and colorectal cancer (CRC) management. A 3% annual discount rate was applied to costs and outcomes. Model inputs were validated by an expert panel.</p><p><strong>Results: </strong>CADe/CADx was more effective (16.37 LYG and 14.32 QALYs) than standard practice (16.33 LYG and 14.27 QALYs) over a lifetime horizon. Total cost per patient was €2,300.76 with CADe/CADx and €2,508.75 with colonoscopy alone. In a hypothetical cohort of 1,000 patients, CADe/CADx avoided 173 polypectomies, 370 histopathologies, and 7 CRC cases. Sensitivity analyses confirmed model robustness.</p><p><strong>Conclusions: </strong>The results of this analysis suggest that CADe/CADx would result in a dominant strategy versus standard practice in patients undergoing colonoscopy in Spain.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097278"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of virtual reality distraction during colonoscopy vs intravenous deep sedation: Results of a single-center randomized controlled trial.","authors":"Anastasia Pavlidi, Lotfi Triki, Julien Mortier, Jacques Deviere, Arnaud Lemmers, Vincent Huberty, Patrice Forget, Mark Hannen, Caroline Quolin, Turgay Tuna, Daniel Blero, Marianna Arvanitakis","doi":"10.1055/a-2520-9768","DOIUrl":"10.1055/a-2520-9768","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colonoscopy is associated with discomfort that requires intravenous sedation (IVS). The aim of this randomized controlled trial (RCT) was to explore the feasibility of virtual reality distraction (VRD) for colonoscopy using two primary endpoints: cecal intubation rate and the rate of rescue with IVS.</p><p><strong>Patients and methods: </strong>Patients scheduled for elective colonoscopy with IVS were randomized in a 2:1 ratio in favor of VRD, with rescue IVS by propofol if needed. VRD involved use of a device providing a visual and auditive experience similar to clinical hypnosis.</p><p><strong>Results: </strong>Ninety patients were included (VRD:60, IVS: 30). Cecal intubation rate was similar in both groups (92.8% for VRD vs 100% for IVS, <i>P</i> =0.3). The rate of rescue IVS in the VRD group was 63.6%. There was a decrease in median total dose of propofol per patient in the VRD group (1.15 mg/kg for VRD and 4.41 mg/kg for IVS, <i>P</i> <0.001) and in the subgroup of VRD patients who received IVS rescue (3.17 mg/kg for VRD and 4.41 mg/kg for IVS, <i>P</i> =0.003). The median level of pain was higher and the median level of comfort was lower in the VRD group (respectively 3 vs 0, <i>P</i> <0.001 and 7 vs 10, <i>P</i> <0.001).</p><p><strong>Conclusions: </strong>This RCT provides preliminary data to better understand the feasibility of VRD for colonoscopy. We have not identified differences in procedure outcomes compared with conventional IVS, but nevertheless, higher pain and lower comfort scores were reported.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25209768"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}