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P253. Effectiveness of a new type ultrathin colonoscope in colonoscopy of patients with active ulcerative colitis

T. Ogawa1, Y. Ohda1, K. Nagase1, Y. Yokoyama1, K. Tozawa1, K. Hori1, S. Nakamura1, H. Miwa2, T. Matumoto1, 1Hyogo College of Medicine, Division of Lower Gastroenterology, Nishinomiya, Hyogo, Japan, 2Hyogo College of Medicine, Division of Upper Gastroenterology, Nishinomiya, Hyogo, Japan

Background

Repeat colonoscopies are required in patients with active ulcerative colitis (UC) to evaluate the efficacy of therapy. However, such patients often suffer from abdominal pain caused by mucosal inflammation during endoscopic procedures. Therefore, the administration of sedatives is needed, but these mask the pain, which is a warning sign of a perforation. Recently, a new type of ultrathin colonoscope, the PCF-PQ260 (OLYMPUS MEDICAL SYSTEM CORP.), with passive bending and high force transmission, was developed to pass through tortuous and narrow lesions of the colon easily with less abdominal pain. Therefore, in this study, we investigated the efficacy of the newly developed PCF-PQ260 by comparing its performance with the convention thin colonoscope (PCF-Q260A) during colonoscopy in patients with UC.

Methods

This was a single-center randomized comparative study of 84 patients with UC. They were randomized into one of two arms; patients examined by the new scope (PQ group; n = 42) or those examined using the conventional scope (QA group; n = 42). In this study, five experienced endoscopists performed the colonoscopies without sedation. In order to compare the performances of the scopes, we investigated the ratio of cecal intubation, time to cecal intubation, and the patient rating for pain, which was assessed by a visual analogue scale (VAS) (0 = none, 100 = extremely painful). Clinical UC activity was assessed by the DAI (disease activity index), and remission was defined as a score <2.

Results

The patient demographic characteristics were similar between these two study arms. There were no significant differences in the cecal intubation rate and time between the PQ and the QA group. However, the VAS score was significantly lower in the PQ group than the QA group (19.3±16.9 vs 32.0±21.6, p = 0.005). Interestingly, the VAS score for the patients in the PQ group was significantly lower (16.8±12.4) than that in the QA group (35.9±17.2) (p = 0.002) only in patients with active UC (n = 49), while no difference was noted in the patients in remission (n = 35).

Conclusion

The new type ultrathin PCF-PQ260 colonoscope reduced the pain during colonoscopy in patients, especially those with active UC, without any decrease in the performance compared to that of a conventional thin colonoscope. This new scope would improve the tolerability of the procedure, which may contribute to establishing a better treatment strategy for patients with active UC.