Patient-posture and Ileal-intubation during colonoscopy (PIC): a randomized controlled open-label trial

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Procedures

Background:

• Patient posture is frequently adjusted by colonoscopists to ensure complete examination.
• The impact of patient positioning on the success rate of ileal intubation remains an area of investigation.

Purpose of the Study:

• To investigate whether patient posture (left-lateral decubitus vs. supine) affects the success rate of ileal intubation during colonoscopy.

Main Methods:

• A prospective, open-label, randomized study involving adult outpatients undergoing colonoscopy.
• Patients achieving cecal intubation were randomized to ileal intubation in either left-lateral decubitus or supine posture.
• Success was defined as visualization of ileal mucosa or villi, confirmed by photography.

Main Results:

• Successful ileal intubation was achieved in 66.8% of 217 randomized patients.
• The supine posture group demonstrated a significantly higher success rate (74.8%) compared to the left-lateral decubitus group (58.5%).
• Independent predictors of success included supine posture, good bowel preparation, a non-thin-lipped ileocecal valve, and younger age.

Conclusions:

• Ileoscopy is more successful when performed with the patient in the supine position.
• Patient age, quality of bowel preparation, and the characteristics of the ileocecal valve are significant determinants of ileal intubation success.