Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations

Cadoni, Sergio ; Thorlacius, Henrik LU and Leung, Felix W. (2021) In Gastrointestinal Endoscopy 93(6). p.1411-1420
Abstract
Background and Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy. We reviewed and graded the research evidence with potential clinical application. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR. Methods: Major databases were searched to obtain research reports that could potentially shape clinical practice related to WAC and UWR. Pertinent references were graded (Grading of Recommendations, Assessment, Development and Evaluation). Extracted data supporting evidence-based statements were... (More)
Background and Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy. We reviewed and graded the research evidence with potential clinical application. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR. Methods: Major databases were searched to obtain research reports that could potentially shape clinical practice related to WAC and UWR. Pertinent references were graded (Grading of Recommendations, Assessment, Development and Evaluation). Extracted data supporting evidence-based statements were tabulated and provided to respondents. We received responses from 55 (85% surveyed) experienced colonoscopists (37 experts and 18 nonexperts in WAC) from 16 countries in 3 rounds. Voting was conducted anonymously in the second and third round, with ≥80% agreement defined as consensus. We aimed to obtain consensus in all statements. Results: In the first and the second modified Delphi rounds, 20 proposed statements were decreased to 14 and then 11 statements. After the third round, the combined responses from all respondents depicted the consensus in 11 statements (S): definitions of WI (S1) and WE (S2), procedural features (S3-S5), impact on bowel cleanliness (S6), adenoma detection (S7), pain score (S8), and UWR (S9-S11). Conclusions: The most important consensus statements are that WI and WE are not the same in implementation and outcomes. Because studies that could potentially shape clinical practice of WAC and UWR were chosen for review, this modified Delphi consensus supports recommendations for the use of WAC in clinical practice. © 2020 American Society for Gastrointestinal Endoscopy (Less)
Please use this url to cite or link to this publication:
author
; and
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gastrointestinal Endoscopy
volume
93
issue
6
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:85099123178
  • pmid:33069706
ISSN
1097-6779
DOI
10.1016/j.gie.2020.10.011
language
English
LU publication?
yes
id
95ed936d-6fe7-4fce-91fc-14bb51345041
date added to LUP
2021-01-21 10:02:34
date last changed
2022-10-07 11:08:22
@article{95ed936d-6fe7-4fce-91fc-14bb51345041,
  abstract     = {{Background and Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy. We reviewed and graded the research evidence with potential clinical application. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR. Methods: Major databases were searched to obtain research reports that could potentially shape clinical practice related to WAC and UWR. Pertinent references were graded (Grading of Recommendations, Assessment, Development and Evaluation). Extracted data supporting evidence-based statements were tabulated and provided to respondents. We received responses from 55 (85% surveyed) experienced colonoscopists (37 experts and 18 nonexperts in WAC) from 16 countries in 3 rounds. Voting was conducted anonymously in the second and third round, with ≥80% agreement defined as consensus. We aimed to obtain consensus in all statements. Results: In the first and the second modified Delphi rounds, 20 proposed statements were decreased to 14 and then 11 statements. After the third round, the combined responses from all respondents depicted the consensus in 11 statements (S): definitions of WI (S1) and WE (S2), procedural features (S3-S5), impact on bowel cleanliness (S6), adenoma detection (S7), pain score (S8), and UWR (S9-S11). Conclusions: The most important consensus statements are that WI and WE are not the same in implementation and outcomes. Because studies that could potentially shape clinical practice of WAC and UWR were chosen for review, this modified Delphi consensus supports recommendations for the use of WAC in clinical practice. © 2020 American Society for Gastrointestinal Endoscopy}},
  author       = {{Cadoni, Sergio and Thorlacius, Henrik and Leung, Felix W.}},
  issn         = {{1097-6779}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{1411--1420}},
  publisher    = {{Elsevier}},
  series       = {{Gastrointestinal Endoscopy}},
  title        = {{Water-assisted colonoscopy: an international modified Delphi review on definitions and practice recommendations}},
  url          = {{http://dx.doi.org/10.1016/j.gie.2020.10.011}},
  doi          = {{10.1016/j.gie.2020.10.011}},
  volume       = {{93}},
  year         = {{2021}},
}