A study published in Endoscopy expanded on single-case studies which explored how water exchange increased adenoma detection rate.
Iglesias, Italy-based St. Barbara Hospital physician Sergio Cadoni, MD, and colleagues examined how water exchange, water immersion and air insufflation affected adenoma detection rate in 1,224 patients. Patients received one of the three options in a one-to-one to one ratio.
Researchers initially used a split-dose bowel preparation. Researchers then used a second colonoscopist blind to the insertion technique performed the withdrawal after the patients reached a cecum. The primary outcome was overall adenoma detection rate.
Here's what they found.
1. The three groups had similar baseline characteristics.
2. Water exchange achieved a 49.3 percent ADR to air insufflation's 40.4 percent ADR.
3. Water exchange was comparable to water immersion (44.3 percent to 43.4 percent, respectively.)
4. In the right colon, water exchange had a 24 percent ADR to air insufflation's 16.9 percent. Water exchange also had a 6.1 percent advanced ADR 6.1 percent to air insufflation's 2.5 percent ADR.
5. Water exchange had the highest overall and right colon cleanliness scores.
Researchers concluded, "That water exchange, but not water immersion, can achieve significantly higher adenoma detection than air insufflation."