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OpenTrials
Completed

NCT Number: NCT07772648

Supine Starting Position Shortens Cecal Intubation Time But Reduces Endoscopist Comfort: a Prospective Comparative Study of Colonoscopy Positioning Strategies

The main questions it aims to answer are:

Does starting colonoscopy in the supine position compared with the left lateral position affect the time required to reach the cecum? Does the starting position affect endoscopist comfort, patient comfort, procedure duration, polyp and adenoma detection, or the need to change the patient's position during the procedure?

Participants will be randomly assigned to undergo colonoscopy starting either in the supine position or in the left lateral position. The colonoscopy will otherwise be performed according to standard clinical practice.

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Key information

Conditions

Colonoscopy (Procedure)

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Şişli Hamidiye Etfal Training and Research Hospital

Istanbul, 34371, Turkey (Türkiye)

About this study

Colonoscopy is widely used for the diagnosis, screening, and surveillance of colorectal diseases. The left lateral position is conventionally used as the initial patient position during colonoscopy; however, alternative starting positions may influence colonoscope advancement, procedure efficiency, and the comfort of both the patient and the endoscopist.

This single-center, randomized controlled trial was designed to evaluate the effect of the starting position on colonoscopy efficiency. Adult participants undergoing elective colonoscopy were randomly assigned in a 1:1 ratio to begin the procedure either in the supine position or in the left lateral position.

The primary focus of the study was endoscopist comfort during the procedure. Additional assessments included patient comfort, cecal intubation time, withdrawal time, adenoma and polyp detection, the need for patient repositioning during colonoscopy, and procedure-related complications.

The study aimed to determine whether the supine starting position provides advantages over the conventional left lateral starting position and whether the initial patient position may represent a simple and readily applicable factor for improving colonoscopy efficiency.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Adults aged 18 years or older. Scheduled to undergo screening colonoscopy. No history of colorectal cancer. No history of colorectal surgery.

Exclusion criteria

Failure to achieve cecal intubation. Inflammatory bowel disease. Inadequate bowel preparation, defined as a Boston Bowel Preparation Scale (BBPS) score <2.

Treatment and study plan

Colonoscopy Starting Position

Procedure

Participants were assigned to undergo colonoscopy starting either in the supine position or in the left lateral position according to randomization. The assigned position was used at the beginning of the procedure. Patient repositioning during colonoscopy was permitted when clinically required to facilitate colonoscope advancement or completion of the procedure.

Primary outcomes

  1. Endoscopist Comfort Score (ECS)

    Time frame: Immediately after completion of the colonoscopy

    Endoscopist comfort was assessed using a 100-mm visual analog scale (VAS), converted to a 0-10 numeric score, with higher scores indicating greater comfort.

  2. Patient Comfort Score (PCS)

    Time frame: After recovery from anesthesia on the day of the colonoscopy

    Patient comfort was assessed using a 100-mm visual analog scale (VAS), converted to a 0-10 numeric score, with higher scores indicating greater comfort.

Secondary outcomes

  1. Cecal Intubation Time (CIT)

    Time frame: During the colonoscopy, from colonoscope insertion to cecal intubation

    Cecal intubation time was defined as the time from insertion of the colonoscope at the anal verge to visualization of characteristic cecal landmarks, such as the appendiceal orifice or ileocecal valve. Time was measured using a chronometer and recorded in minutes.

  2. Withdrawal Time (WT)

    Time frame: During the colonoscopy

    Withdrawal time was defined as the time from the start of colonoscope withdrawal at the cecum to withdrawal of the colonoscope at the rectum. The durations of polypectomy and other therapeutic interventions performed during withdrawal were included in the withdrawal time. Time was measured using a chronometer and recorded in minutes.

  3. Adenoma Detection Rate (ADR)

    Time frame: Up to 30 days after colonoscopy

    Adenoma detection rate was defined as the percentage of participants in whom at least one histologically confirmed adenoma was detected during colonoscopy. Histological confirmation was based on pathology reports.

  4. Polyp Detection Rate (PDR)

    Time frame: During the colonoscopy

    Polyp detection rate was defined as the percentage of participants in whom at least one polyp was detected during colonoscopy.

  5. Requirement for Patient Repositioning

    Time frame: During the colonoscopy

    Patient repositioning was defined as the requirement for an assisted transition from the assigned initial starting position to a different patient position during colonoscopy. The outcome was recorded as whether repositioning was required or not required.

  6. Requirement for Abdominal Compression

    Time frame: During the colonoscopy

    Abdominal compression was defined as the requirement for manual pressure applied to the abdominal wall to facilitate advancement of the colonoscope. The outcome was recorded as whether abdominal compression was required or not required.

  7. Procedure-Related Complications

    Time frame: During and after the colonoscopy on the day of the procedure

    Procedure-related complications included perforation, clinically significant bleeding or abdominal pain requiring hospitalization, and hypoxemia or hypotension requiring hospitalization. The outcome was assessed as the proportion of participants experiencing at least one of these complications.

Sponsors and collaborators

Lead sponsor

Sisli Hamidiye Etfal Training and Research Hospital

Other

Registry information

Official study title

The Effect of Colonoscopy Starting Position on Procedural Efficiency

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Aug 19, 2026
Registry last updated
Aug 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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