Colonoscopy using back brace support belt: A randomized, prospective trial

Osamu Toyoshima; Toshihiro Nishizawa; Kosuke Sakitani; Tadahiro Yamakawa; Shuntaro Yoshida; Kazushi Fukagawa; Keisuke Hata; Soichiro Ishihara; Hidekazu Suzuki

doi:10.1002/jgh3.12276

Colonoscopy using back brace support belt: A randomized, prospective trial

JGH Open. 2019 Nov 7;4(3):441-445. doi: 10.1002/jgh3.12276. eCollection 2020 Jun.

Authors

Osamu Toyoshima¹, Toshihiro Nishizawa^{1

2}, Kosuke Sakitani^{1

3}, Tadahiro Yamakawa¹, Shuntaro Yoshida^{1

4}, Kazushi Fukagawa^{1

4}, Keisuke Hata^{1

5}, Soichiro Ishihara⁵, Hidekazu Suzuki⁶

Affiliations

¹ Department of Gastroenterology Graduate School of Medicine, The University of Tokyo, Toyoshima Endoscopy Clinic Tokyo Japan.
² Department of Gastroenterology and Hepatology International University of Health and Welfare, Mita Hospital Tokyo Japan.
³ Department of Gastroenterology Sakitani Endoscopy Clinic Chiba-Tsudanuma Japan.
⁴ Department of Gastroenterology, Graduate School of Medicine The University of Tokyo.
⁵ Department of Surgical Oncology, Graduate School of Medicine The University of Tokyo Tokyo Japan.
⁶ Department of Gastroenterology and Hepatology Tokai University School of Medicine Tokyo Japan.

Abstract

Background and aim: Looping is a major problem in colonoscopy, and it prolongs procedure time. We evaluated the efficacy and safety of an external abdominal compression device (back brace support belt; Maxbelt) with respect to cecal insertion time and other outcomes.

Methods: We performed a prospective study on outpatients undergoing elective colonoscopy in Toyoshima Endoscopy Clinic. Subjects were randomly assigned to groups and were subjected to either Maxbelt (n = 39) or no device (control, n = 38) during colonoscopy. The colonoscopist was blinded to the study. The primary outcome that was observed was insertion time.

Results: The intubation time of the Maxbelt group was shorter than that of the no device group, but the difference was not significant (3.29 vs 4.49 min, P = 0.069). After stratifying by age, the use of Maxbelt significantly decreased cecal intubation time in elderly participants (age ≥ 45) compared to no device group (3.27 vs 5.00 min, P = 0.032). The use of the Maxbelt significantly decreased insertion difficulty encountered by the colonoscopist (P = 0.01). There was no difference in adenoma detection rate, manual pressure, position change, and adverse event.

Conclusions: The use of a back brace support belt could be a viable approach for colonoscopy in elderly patients. (University Hospital Medical Information Network: UMIN000029361).

Keywords: back brace support belt; colonoscopy; randomized, prospective trial.