Introduction Studies suggest that modifying a patient’s position during colonoscope withdrawal may improve luminal distension and polyp detection. It is unclear whether this practice is widely adopted by endoscopists.
Methods Colonoscopists within the English Bowel Cancer Screening Programme (BCSP) were invited to participate in a web-based survey assessing the use of position change during colonoscope withdrawal. Free text responses were assessed using thematic analysis.
Results The survey was completed by 204/298 (68%) of English BCSP colonoscopists. 64.7% of respondents indicated that they almost always change a patient’s position, 16.7% usually, 13.7% sometimes, 3.4% occasionally and 1.5% rarely do so.
77% of those who almost always or usually changed a patient’s position did so as part of their routine, but 75.3% were less likely to change position in those with poor mobility and 75.3% would not change position if luminal distension was adequate. 93% of these respondents most often positioned patients supine while examining the transverse colon and nearly half examined the right and descending colon in a sub-optimal position (Table 1).
Of those respondents who sometimes, occasionally or rarely changed a patient’s position, 42% were unconvinced that routine position change was beneficial. A further 21.1% felt it took too long, 7.8% felt it was inconvenient for the patient and 7.8% felt it was inconvenient for the endoscopist. These respondents were most likely to examine segments without changing patient position.
Free text responses revealed that some endoscopists position patients differently during insertion and withdrawal and also use position change to optimise access during therapy.
Conclusion Most BCSP colonoscopists change patients’ position during most colonoscope withdrawals, but the patient position is often sub-optimal. Increased awareness of the existing literature and further research assessing positioning strategy is warranted.
Reference East JE et al. Gastrointest Endosc. 2011 Mar;73(3):456–63
Disclosure of Interest None Declared.
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