Esophagoduodenoscopy or colonoscopy: which should be done first?

Pınar Sayın; Özgür Bostancı; Hacer Şebnem Türk; Canan Tülay Işıl; Sibel Oba; Mehmet Mihmanlı

doi:10.5578/turkjsurg.4275

Esophagoduodenoscopy or colonoscopy: which should be done first?

Turk J Surg. 2020 Jun 8;36(2):172-179. doi: 10.5578/turkjsurg.4275. eCollection 2020 Jun.

Authors

Pınar Sayın¹, Özgür Bostancı², Hacer Şebnem Türk¹, Canan Tülay Işıl¹, Sibel Oba¹, Mehmet Mihmanlı²

Affiliations

¹ Department of Anestesiology and Reanimation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
² Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Abstract

Objectives: Esophagoduodenoscopy and colonoscopy can be done as bidirectional endoscopy in the same session. The aim of this study was to compare anesthetic requirements and hemodynamic effects in esophagoduodenoscopy or colonoscopy done first for bidirectional endoscopy.

Material and methods: Eighty patients, aged 18-70 years with an American Society of Anesthesiologists Classification (ASA) as I-III, were included randomly into this study. The patients were allocated into two groups: Group C: first colonoscopy followed by esophagoduodenoscopy. Group E: first esophagoduodenoscopy followed by colonoscopy. All patients received standard anesthesia with 1 µg/kg fentanyl and 1 mg/kg propofol. Demographical variables, Heart rate SpO₂, Ramsey Sedation Score were recorded every 10 minutes. Total propofol consumption, retching during esophagoduodenoscopy and time to reach cecum were also recorded. Endoscopist and patient satisfaction were questioned.

Results: Retching during esophagoduodenoscopy was not statistically significantly different in both groups. Total procedure duration and esophagoduodenoscopy duration were statistically significant longer in Group E. Complication frequency was higher in Group E. Endoscopist and patient satisfaction were lower in Group E. There was no difference in time to reach the cecum and the recovering period. Additional propofol dose was increased in Group E.

Conclusion: Regarding shorter procedural duration, lower consumption amount of propofol and fewer complications, it could be a better choice to start bidirectional procedure with colonoscopy first.