Does one-man method better than two-man method for colonoscopy insertion in children

Abstract

Background/purpose: One-man method had shown several advantages over two-man method in adult colonoscopy insertion. However, whether this advantage can be extended to children is largely unknown. The aim of this study is to test the hypothesis that one-man method is the preferred method to two-man method in pediatric colonoscopy.

Methods: In this retrospective study, from July 2010 to June 2014, colonoscopy examinations in children were recruited. These colonoscopy examinations were performed by second-year pediatric GI fellows under the supervision of an experienced attending physician. Colonoscopy indicators such as cecal intubation rate (CIR), cecal intubation time (CIT), and terminal ileum (TI) intubation rate between one-man and two-man method group were recorded. The primary outcome is CIR.

Results: Total 72 colonoscopy examinations by one-man method and 162 examinations by two-man method were studied. Univariate logistic regression showed two patient factors: poor preparation and underweight were associated with lower CIR. (Odds ratio, OR: 0.46 and 0.40, P = 0.046 and 0.01, respectively) The CIR was higher in one-man than in two-man method group (81.9% vs 69.1%, OR = 2.03, P = 0.04). One-man method had a higher TI intubation rate than that of two-man method. (66.7% vs 44.4%, OR = 2.51, P = 0.002) The mean CIT was 27.1 ± 11.7 min in one-man method and 26.9 ± 13.3 min in two-man method. (P = 0.93) No significant difference in complications was noted.

Conclusion: One-man method colonoscopy is safe and has higher CIR and TI intubation rate than two-man method colonoscopy in children, even performed by second-year GI fellows.

Keywords: Colonoscopy; One-man method; Pediatrics.