Miroslaw Szura, MD PhD, Krzysztof Bucki, MD, Andrzej Matyja, MD PhD. MEDICINA Specialist Diagnostic & Therapeutic Centre
Colorectal cancer is the most common cancer in Europe. Early diagnosis and treatment gives a chance for complete recovery of the patients. Screening colonoscopies in the symptom-free patients are currently performed on wide scale. The examinations are performed under local anesthesia which does not eliminate all discomfort and pain related to the examination.
The aim of the study is evaluation of magnetic scope navigation in screening endoscopic examination performed to detect early stage of colorectal cancer.
METHODS AND PROCEDURES
A study group consisted of 200 patients, aged 40-65 years, who were free from colon cancer symptoms. All patients underwent complete colonoscopy under local anesthesia. The equipment was fitted with the option allowing three dimensions observation of instrument localization in the bowel. The examination was performed by three experiences endoscopists, each of whom performed alone over 5000 colonoscopies. The patients were assigned to two groups with or without 3D navigation. Each group consisted of 100 cases matched by gender, age, and BMI. The authors compared the duration of introducing instrument to cecum, pulse rate before the examination and at the time of reaching cecum by the instrument, and subjective pain evaluation by the patient on the Visual and Analogue Scale.
Group I consisted of 54 women and 46 men at the mean age of 54,6 years, mean BMI 27.8, and group II of 58 women and 42 men, mean age 55.1 years and mean BMI 26.4. The average time until reaching cecum by the instrument was 216 sec. in group I and 181 sec. in group II.
Pain measured on the 10-point VAS scale was at the level 2,44 in group I and 1.85 in group II.
The results shown significantly shorter time until reaching cecum by the instrument in group II and significantly lower pain intensity during the examination reported by the patients. No significant differences were found between both groups for the pulse measurements.
3D navigation during colonoscopy allows to reduce time until reaching cecum by the instrument and to lower pain intensity subjectively reported by the patients. The use of 3D and the possibility to observe instrument localization and manouvers brings more comfort to the patients.
Program Number: S057