Skip to main content
Top
Published in: Japanese Journal of Radiology 5/2014

01-05-2014 | Original Article

A comparative study of degree of colorectal distention with manual air insufflation or automated CO2 insufflation at CT colonography as a preoperative examination

Authors: Hidenori Kanazawa, Kenichi Utano, Shigeyoshi Kijima, Takahiro Sasaki, Yasuyuki Miyakura, Hisanaga Horie, Yoshikazu Nakamura, Hideharu Sugimoto

Published in: Japanese Journal of Radiology | Issue 5/2014

Login to get access

Abstract

Objectives

The purpose of this study was to compare the degree of colorectal distention between manual insufflation using room air and automatic insufflation using carbon dioxide for computed tomography colonography performed as a preoperative examination for patients with colon cancer.

Materials and methods

Participants comprised 200 patients who underwent computed tomography colonography immediately after colonoscopy from October 2011–2012. The first 100 patients were examined using manual insufflation, and the remaining 100 patients were examined using automated insufflation. Two radiologists independently assessed colorectal distention using a 4-point scale in six segments: cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. Mean scores of the two radiologists were used to analyze whether any differences existed between techniques in terms of the degree of distention per segment.

Results

Mean distention values for the colonic lumen were better using the automated technique than with the manual technique in both positions (p < 0.05). In segments, distention was significantly better using the automated technique than using the manual technique in the sigmoid and descending colon for prone patients, and in all segments for supine patients.

Conclusions

Automated carbon dioxide insufflation offered significantly improved colorectal distention scores compared to manual room air insufflation.
Literature
1.
go back to reference Leung WK, Ho KY, Kim WH, Lau JY, Ong E, Hilmi I, et al. Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients. Gastrointest Endosc. 2006;64:751–9.PubMedCrossRef Leung WK, Ho KY, Kim WH, Lau JY, Ong E, Hilmi I, et al. Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients. Gastrointest Endosc. 2006;64:751–9.PubMedCrossRef
2.
go back to reference Yiu HY, Whittemore AS, Shibata A. Increasing colorectal cancer incidence rates in Japan. Int J Cancer. 2004;109:777–81.PubMedCrossRef Yiu HY, Whittemore AS, Shibata A. Increasing colorectal cancer incidence rates in Japan. Int J Cancer. 2004;109:777–81.PubMedCrossRef
3.
go back to reference The Editorial Board of Cancer Statistics in Japan. Cancer statistics in Japan 2010. Tokyo: Foundation for Promotion of Cancer Research (FPCR); 2010. The Editorial Board of Cancer Statistics in Japan. Cancer statistics in Japan 2010. Tokyo: Foundation for Promotion of Cancer Research (FPCR); 2010.
4.
go back to reference Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.PubMedCrossRef Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.PubMedCrossRef
5.
go back to reference Royster AP, Gupta AK, Fenlon HM, Ferrucci JT. Virtual colonoscopy: current status and future implications. Acad Radiol. 1998;5:282–8.PubMedCrossRef Royster AP, Gupta AK, Fenlon HM, Ferrucci JT. Virtual colonoscopy: current status and future implications. Acad Radiol. 1998;5:282–8.PubMedCrossRef
6.
go back to reference Vining DJ. Virtual endoscopy: is it really? Radiology. 1996;200:30–1.PubMed Vining DJ. Virtual endoscopy: is it really? Radiology. 1996;200:30–1.PubMed
7.
go back to reference Leksowski K, Rudzinska M, Rudzinski J. Computed tomographic colonography in preoperative evaluation of colorectal tumors: a prospective study. Surg Endosc. 2011;25:2344–9.PubMedCentralPubMedCrossRef Leksowski K, Rudzinska M, Rudzinski J. Computed tomographic colonography in preoperative evaluation of colorectal tumors: a prospective study. Surg Endosc. 2011;25:2344–9.PubMedCentralPubMedCrossRef
8.
go back to reference Ferrucci JT. Colon cancer screening with virtual colonoscopy: promise, polyps, politics. AJR Am J Roentgenol. 2001;177:975–88.PubMedCrossRef Ferrucci JT. Colon cancer screening with virtual colonoscopy: promise, polyps, politics. AJR Am J Roentgenol. 2001;177:975–88.PubMedCrossRef
9.
go back to reference Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, et al. Computed tomography virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–200.PubMedCrossRef Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, et al. Computed tomography virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–200.PubMedCrossRef
10.
go back to reference Utano K, Endo K, Togashi K, Sasaki J, Kawamura HJ, Horie H, et al. Preoperative T staging of colorectal cancer by CT colonography. Dis Colon Rectum. 2008;51:875–81.PubMedCrossRef Utano K, Endo K, Togashi K, Sasaki J, Kawamura HJ, Horie H, et al. Preoperative T staging of colorectal cancer by CT colonography. Dis Colon Rectum. 2008;51:875–81.PubMedCrossRef
11.
go back to reference Nagata K, Endo S, Kudo SE, Kitanosono T, Kushihashi T. CT air-contrast enema as a preoperative examination for colorectal cancer. Dig Surg. 2004;21:352–8.PubMedCrossRef Nagata K, Endo S, Kudo SE, Kitanosono T, Kushihashi T. CT air-contrast enema as a preoperative examination for colorectal cancer. Dig Surg. 2004;21:352–8.PubMedCrossRef
12.
go back to reference Inomata M, Yasuda K, Shiraishi N, Kitano S. Clinical evidence of laparoscopic versus open surgery for colorectal cancer. Jpn J Clin Oncol. 2009;39:471–7.PubMedCrossRef Inomata M, Yasuda K, Shiraishi N, Kitano S. Clinical evidence of laparoscopic versus open surgery for colorectal cancer. Jpn J Clin Oncol. 2009;39:471–7.PubMedCrossRef
13.
go back to reference Cho YB, Lee WY, Yun HR, Lee WS, Yun SH, Chun HK. Tumor localization for laparoscopic colorectal surgery. World J Surg. 2007;31:1491–5.PubMedCrossRef Cho YB, Lee WY, Yun HR, Lee WS, Yun SH, Chun HK. Tumor localization for laparoscopic colorectal surgery. World J Surg. 2007;31:1491–5.PubMedCrossRef
14.
go back to reference Mulder SA, Kranse R, Damhuis RA, de Wilt JH, Ouwendijk RJ, Kuipers EJ, et al. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study. Cancer Epidemiol. 2011;35:442–7.PubMedCrossRef Mulder SA, Kranse R, Damhuis RA, de Wilt JH, Ouwendijk RJ, Kuipers EJ, et al. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study. Cancer Epidemiol. 2011;35:442–7.PubMedCrossRef
15.
go back to reference Neri E, Turini F, Cerri F, Faggioni L, Vagli P, Naldini G, et al. Comparison of CT colonography vs. conventional colonoscopy in mapping the segmental location of colon cancer before surgery. Abdom Imaging. 2010;35:589–95.PubMedCrossRef Neri E, Turini F, Cerri F, Faggioni L, Vagli P, Naldini G, et al. Comparison of CT colonography vs. conventional colonoscopy in mapping the segmental location of colon cancer before surgery. Abdom Imaging. 2010;35:589–95.PubMedCrossRef
16.
go back to reference Burling D, Taylor SA, Halligan S, Gartner L, Paliwalla M, Peiris C, et al. Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation. AJR Am Roentgenol. 2006;186:96–103.CrossRef Burling D, Taylor SA, Halligan S, Gartner L, Paliwalla M, Peiris C, et al. Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation. AJR Am Roentgenol. 2006;186:96–103.CrossRef
17.
go back to reference Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation vs. automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol. 2006;186:1491–6.PubMedCrossRef Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation vs. automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol. 2006;186:1491–6.PubMedCrossRef
18.
go back to reference Nagata K, Iyama A, Hanazuka B, Kato H, Yamada R. CT colonography with and without butyl scopolamine. JSCP. 2010;63:127–33. Nagata K, Iyama A, Hanazuka B, Kato H, Yamada R. CT colonography with and without butyl scopolamine. JSCP. 2010;63:127–33.
19.
go back to reference Owakii K, Kitano H, Fujinami T. The efficacy of polyethylene glycol electrolyte lavage solution (PEG) with sodium picosulfate at the same time. Therap Res. 1990;11:304–7. Owakii K, Kitano H, Fujinami T. The efficacy of polyethylene glycol electrolyte lavage solution (PEG) with sodium picosulfate at the same time. Therap Res. 1990;11:304–7.
20.
go back to reference The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58:S3–43. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58:S3–43.
21.
go back to reference Sosna J, Bar-Ziv J, Libson E, Eligulashvili M, Blachar A. CT colonography: positioning order and intracolonic pressure. AJR Am J Roentgenol. 2008;191:1100.PubMedCrossRef Sosna J, Bar-Ziv J, Libson E, Eligulashvili M, Blachar A. CT colonography: positioning order and intracolonic pressure. AJR Am J Roentgenol. 2008;191:1100.PubMedCrossRef
22.
go back to reference Taylor SA, Halligan S, Goh V, Morley S, Bassett P, Atkin W, et al. Optimizing colonic distension for multi-detector row CT colonography: effect of hyoscine hydrobromide and rectal balloon catheter. Radiology. 2003;229:99–108.PubMedCrossRef Taylor SA, Halligan S, Goh V, Morley S, Bassett P, Atkin W, et al. Optimizing colonic distension for multi-detector row CT colonography: effect of hyoscine hydrobromide and rectal balloon catheter. Radiology. 2003;229:99–108.PubMedCrossRef
23.
go back to reference Pooler BD, Baumel MJ, Cash BD, Moawad FJ, Riddle MS, Patrick AM, et al. Screening CT colonography: multicenter survey of patient experience, preference, and potential impact on adherence. AJR Am J Roentgenol. 2012;198:1361–6.PubMedCentralPubMedCrossRef Pooler BD, Baumel MJ, Cash BD, Moawad FJ, Riddle MS, Patrick AM, et al. Screening CT colonography: multicenter survey of patient experience, preference, and potential impact on adherence. AJR Am J Roentgenol. 2012;198:1361–6.PubMedCentralPubMedCrossRef
24.
go back to reference Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol. 1999;173:561–4.PubMedCrossRef Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol. 1999;173:561–4.PubMedCrossRef
25.
go back to reference Fenlon HM, McAneny DB, Nunes DP, Clarke PD, Ferrucci JT. Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology. 1999;210:423–8.PubMedCrossRef Fenlon HM, McAneny DB, Nunes DP, Clarke PD, Ferrucci JT. Occlusive colon carcinoma: virtual colonoscopy in the preoperative evaluation of the proximal colon. Radiology. 1999;210:423–8.PubMedCrossRef
26.
go back to reference Neri E, Giusti P, Battolla L, Boraschi P, Lencioni R, Caramella D, et al. Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology. 2002;223:615–9.PubMedCrossRef Neri E, Giusti P, Battolla L, Boraschi P, Lencioni R, Caramella D, et al. Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology. 2002;223:615–9.PubMedCrossRef
27.
go back to reference Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, McGee JB, Raptopoulos V. Endoluminal CT colonography after an incomplete endoscopic colonoscopy. AJR Am J Roentgenol. 1999;172:913–8.PubMedCrossRef Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, McGee JB, Raptopoulos V. Endoluminal CT colonography after an incomplete endoscopic colonoscopy. AJR Am J Roentgenol. 1999;172:913–8.PubMedCrossRef
28.
go back to reference Gatta G, Ciccolallo L, Capocaccia R, Coleman MP, Hakulinen T, Møller H, et al. Differences in colorectal cancer survival between European and US populations: the importance of sub-site and morphology. Eur J Cancer. 2003;39:2214–22.PubMedCrossRef Gatta G, Ciccolallo L, Capocaccia R, Coleman MP, Hakulinen T, Møller H, et al. Differences in colorectal cancer survival between European and US populations: the importance of sub-site and morphology. Eur J Cancer. 2003;39:2214–22.PubMedCrossRef
29.
go back to reference Lee SJ, Kim SA, Ku BH, Kim HY, Kim JY, Chang DK, et al. Association between colorectal cancer and colonic diverticulosis: case–control study based on computed tomographic colonography. Abdom Imaging. 2012;37:70–3.PubMedCrossRef Lee SJ, Kim SA, Ku BH, Kim HY, Kim JY, Chang DK, et al. Association between colorectal cancer and colonic diverticulosis: case–control study based on computed tomographic colonography. Abdom Imaging. 2012;37:70–3.PubMedCrossRef
30.
go back to reference Faivre J, Bédenne L, Boutron MC, Milan C, Collonges R, Arveux P. Epidemiological evidence for distinguishing subsites of colorectal cancer. J Epidemiol Community Health. 1989;43:356–61.PubMedCentralPubMedCrossRef Faivre J, Bédenne L, Boutron MC, Milan C, Collonges R, Arveux P. Epidemiological evidence for distinguishing subsites of colorectal cancer. J Epidemiol Community Health. 1989;43:356–61.PubMedCentralPubMedCrossRef
31.
go back to reference Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, et al. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009;58:241–8.PubMedCrossRef Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, et al. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009;58:241–8.PubMedCrossRef
32.
go back to reference Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP. Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol. 2003;98:578–85.PubMedCrossRef Ristvedt SL, McFarland EG, Weinstock LB, Thyssen EP. Patient preferences for CT colonography, conventional colonoscopy, and bowel preparation. Am J Gastroenterol. 2003;98:578–85.PubMedCrossRef
33.
go back to reference Dachman AH. Advice for optimizing colonic distention and minimizing risk of perforation during CT colonography. Radiology. 2006;239:317–21.PubMedCrossRef Dachman AH. Advice for optimizing colonic distention and minimizing risk of perforation during CT colonography. Radiology. 2006;239:317–21.PubMedCrossRef
Metadata
Title
A comparative study of degree of colorectal distention with manual air insufflation or automated CO2 insufflation at CT colonography as a preoperative examination
Authors
Hidenori Kanazawa
Kenichi Utano
Shigeyoshi Kijima
Takahiro Sasaki
Yasuyuki Miyakura
Hisanaga Horie
Yoshikazu Nakamura
Hideharu Sugimoto
Publication date
01-05-2014
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 5/2014
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-014-0306-0

Other articles of this Issue 5/2014

Japanese Journal of Radiology 5/2014 Go to the issue