The effectiveness of using an abdominal binder during colonoscopy: a randomized, double-blind, sham-controlled trial

Abstract

Background

Prolongation of cecal intubation time (CIT) directly affects the comfort of the patient and the colonoscopist. In this study, the effectiveness of using an abdominal binder (AB) during colonoscopy on procedure time and colonoscopy outcomes was investigated.

Methods

We conducted a parallel randomized double-blind sham-device-controlled study of patients who underwent elective outpatient colonoscopy between 1 May 2020, and 31 August 2020. Participants were randomly assigned to AB (n = 173) and sham binder (SB) (n = 173) groups. The primary outcome was CIT. Secondary outcomes were the need for auxiliary maneuvers, the cecum intubation length (CIL) of the colonoscope, visual analog scale (VAS) score, narcotic analgesic dose, and colonoscopy results. Moreover, subgroup analysis was performed in terms of age and obesity indices.

Results

A total of 346 patients were enrolled in the study. The mean CIT was similar between groups (AB group 240 secs, control group 250 secs, p > .05). Manual pressure requirement was less in the AB group (27 vs. 36%, p = .069). VAS score and the need for extra narcotic analgesic drugs were prominently lower in the AB group (p < .001, p = .016, respectively). In the subgroup analyses, in participants at the age of <60 and waist-to-height ratio (WHtR) ≥0.5, manual pressure requirements were significantly shorter in the AB group (p = .017, p = .032, respectively).

Conclusion

AB use in selected patients may be advantageous during colonoscopy because it reduces the need for analgesics and post-procedure pain, and reduces the need for auxiliary maneuvers in relatively young and obese patients.

Keywords:

• Abdominal binder
• colonoscopy
• ancillary maneuvers
• cecal intubation time
• colorectal screening

Acknowledgements

We would like to thank the nurses and other healthcare professionals of the Endoscopy Unit of the Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital where the study was conducted. We would also like to express our gratefulness to Mr. Yaman Tekant (Hepatopancreatobiliary Surgery Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University), who reviewed the study. The authors declared that this study has received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Süreyyapaşa Chest Diseases and Chest Surgery Training and Research Hospital (Protocol Number: 074). Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

Author contributions

Beslen Goksoy and Mevlut Kiyak contributed to the study conception and design. Material preparation, data collection and analysis were performed by Beslen Goksoy and Mevlut Kiyak. The first draft of the manuscript was written by Beslen Goksoy and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Software application and codes are available to access