http://hdl.handle.net/2282/32 http://www.sthf.no/SectionPage.aspx?id=513 http://teora.hit.no/dspace/retrieve/616 http://hdl.handle.net/2282/32 Search the Channel search http://teora.hit.no/dspace/simple-search http://hdl.handle.net/2282/506 Title: Evaluation of a novel colonoscope designed for easier passage of flexures : a randomised study <br/> <br/>Authors: Hoff, Geir; Bretthauer, Michael; Huppertz-Hauss, Gerd; Sauar, Jostein; Paulsen, Jørn; Dahler, Stein; Kjellevold, Øystein <br/> <br/>Abstract: Background and Study Aims: A new colonoscope (XCF-Q160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and Methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCF-Q160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’ grading of pain in a questionnaire. Results: Cecal intubation rates were 85 % and 87 % for standard and prototype endoscopes, respectively (P = 0.57). On-demand sedation was given to nine (7 %) and 15 (11 %) of the patients, respectively (P = 0.17). Of the patients, 256 (85 %) returned their questionnaire, with 87 (63 %) in the standard group and 109 (77 %) in the prototype group reporting that they had experienced ‘no pain/slight pain’ (P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation. http://hdl.handle.net/2282/505 Title: Colonoscopy without sedation <br/> <br/>Authors: Hoff, Geir http://hdl.handle.net/2282/484 Title: Use of a disposable sheath system for flexible sigmoidoscopy in decentralized colorectal cancer screening <br/> <br/>Authors: Bretthauer, Michael; Hoff, Geir; Thiis-Evensen, Espen; Grotmol, Tom; Larsen, Inger K.; Kjellevold, Øystein; Skovlund, Eva <br/> <br/>Abstract: Background and Study Aims: To prevent transmission of infectious agents and to reduce instrument reprocessing time, the use of disposable sheath systems instead of conventionally reprocessed endoscopes has been promoted for flexible sigmoidoscopy. This trial primarily investigated the feasibility of a disposable sheath system for flexible sigmoidoscopy in decentralized colorectal cancer screening.Patients and Methods: In an ongoing colorectal cancer screening trial, 226 consecutive participants were randomly allocated to have their flexible sigmoidoscopy performed with either a fiberoptic sigmoidoscope covered with a disposable sheath (“EndoSheath group”) or a conventional video colonoscope (“standard colonoscope group”). All examinations were performed at a temporary screening center. The patients' experience was documented using a questionnaire. The feasibility of running temporary screening units was evaluated.Results: Examinations beyond the 60-cm level were excluded. Thus, 113 patients (examined with the disposable instrument) and 87 (standard instrument) were eligible for analysis. When the sheathed system was used, all the devices needed could be satisfactorily transported. A screening center could be set up within a few hours. No differences were observed in patient discomfort. Fewer patients with polyps were observed in the EndoSheath group (48 [42 %]), compared with 55 (63 %) in the standard colonoscope group; P = 0.005). No significant differences were observed for polyps larger than 5 mm (14 [12 %] in the EndoSheath group, 13 [15 %] in the standard colonoscope group; P = 0.6).Conclusions: Using the disposable system, decentralized colorectal cancer screening was easily established. However, fewer polyps were found, possibly due to the fiberoptic nature of the instrument. Sheathed video instruments are desirable and may increase the diagnostic yield. http://hdl.handle.net/2282/483 Title: Med åpent blikk utenfor egen institusjon <br/> <br/>Authors: Hoff, Geir <br/> <br/>Abstract: Even in a country like Norway, with a poor reputation for investment in medical research, some studies may materialise against all odds. This is the story about the difficult start and first few years of flexible sigmoidoscopy screening studies in Norway. It started in the peripheral county of Telemark with the Telemark Polyp Study no. I (TPS-I) in 1983. We now see the success of the Norwegian Colorectal Cancer Prevention (NORCCAP) study, which is an on-going large-scale version of the TPS-I study comprising 21,000 men and women to be offered flexible sigmoidoscopy screening in Oslo and Telemark after randomised invitation from the population registry.