Prone or Left for Colonoscopy? A Randomized Controlled Trial of Prone Versus Left-sided Starting Position for...

Area of Science:

• Gastroenterology
• Endoscopy

Background:

• Previous data suggested right-lateral positioning improves colonoscopy efficiency.
• The current study investigated the efficacy of the prone starting position for colonoscopy.

Purpose of the Study:

• To evaluate if the prone starting position offers advantages in procedure time and patient comfort for minimally sedated colonoscopy.
• To compare the prone starting position against the traditional left-lateral starting position.

Main Methods:

• A randomized controlled trial involving 181 adult patients undergoing colonoscopy.
• Patients were randomized to start in either the prone or left-lateral (LL) position.
• Primary outcome: time to cecal intubation; Secondary outcome: patient comfort (visual analog scale).

Main Results:

• No significant benefit was observed for the prone starting position compared to the left-lateral position.
• The prone position increased the mean time to reach the cecum (701 vs. 511 seconds; P=0.01).
• Patient comfort levels were similar, but the prone position was more technically challenging for endoscopists.

Conclusions:

• The prone starting position does not enhance cecal intubation time or patient comfort in minimally sedated colonoscopy.
• The left-lateral position remains a more efficient and less challenging starting position for colonoscopy.