Adequate mucosal visualisation in the right colon remains a limitation of colonoscopy despite standard oral bowel preparation, and residual debris in the caecum and ascending colon is associated with reduced adenoma detection and shortened surveillance intervals.
RIGHT-CLEAN is an investigator-initiated, multi-centre, randomised controlled trial conducted at Westmead Hospital and Auburn Hospital within Western Sydney Local Health District. Adults undergoing colonoscopy for [indication] will be randomised [1:1] to intraprocedural right colon enema or to standard colonoscopy without enema. Randomisation will be [method, stratified by site].
The primary outcome is [right-sided Boston Bowel Preparation Scale segment score]. Secondary outcomes include [adenoma detection rate, caecal intubation and withdrawal times, need for additional washing, and participant-reported tolerability]. Assessment of cleanliness will be performed [by blinded assessors / from recorded still images]. A sample size of [n] participants provides [x]% power to detect [effect size] at a two-sided alpha of 0.05.
All participants will provide written informed consent. No investigational drug or device is used; the enema comprises [water/saline] administered through the colonoscope during the procedure.
