Comparison of the Left-Lateral Horizontal and Supine Positions for Colonoscopy Intervention: A Randomized Controlled Study

NCT07517848 | Completed

• 1 other identifier: CelalBayarU
• Study Type: interventional
• Target: 198
• Locations: 1 country
• Sites: 1

Brief Summary

Objective: One of the most common technical difficulties during colonoscopy is passing through the fold of the sigmoid colon. Colonoscopy is commonly performed by endoscopists with the patient in the left lateral position. When the procedure is initiated in the left lateral position, insufflation of the bowel may result in a sharper angulation of the sigmoid colon, making advancement of the colonoscope more difficult. This study aimed to compare colonoscopic procedures initiated in the left lateral position and the supine position. Materials and Methods: Colonoscopy was performed on 198 participants who had an indication for colonoscopy at the General Surgery clinic and met the study inclusion criteria. All procedures were conducted by the same endoscopist (Dr. Semra Tutcu Şahin) in the Endoscopy Unit during working hours. Participants were randomly assigned to two groups: Group 1: Participants whose starting position for colonoscopy was supine (n=97) Group 2: Participants whose starting position for colonoscopy was left lateral (n=101) During colonoscopy, participants' demographic data, vital signs, and the time required for the endoscopist to reach the cecum were recorded. At the end of the procedure, participants completed a pain scale, and the endoscopist completed an observation scale. The data were entered into the SPSS program and analyzed.

Conditions

Colorectal Disorders; Colorectal Neoplasms; Colorectal Polyp; Colo-rectal Cancer

Keywords

colonoscopy; endoscopy; colorectal cancer; colon polyps

Outcome Measures

Primary Outcomes (1)

• Cecal intubation time

  Time (in seconds) from insertion of the colonoscope at the anal verge to successful cecal intubation, defined by visualization of the appendiceal orifice and ileocecal valve, recorded by the endoscopist.

  During the colonoscopy procedure

Secondary Outcomes (3)

• Pain score during colonoscopy

  Immediately after colonoscopy

• Endoscopist-rated procedure difficulty

  Immediately after colonoscopy

• Changes in vital signs during colonoscopy

  During the colonoscopy procedure

Study Arms (2)

Supine position (SP)

OTHER

The first group consisted of patients assigned to the supine position (SP) as the initial position for colonoscopy

Procedure: Colonoscopy after bowel cleansing; Device: Colonoscopy after bowel cleansing

Lateral Left Horizontal Position (LLP)

OTHER

The second group consisted of patients assigned to the left lateral horizontal position (LLP) as the initial position for colonoscopy

Procedure: Colonoscopy after bowel cleansing; Device: Colonoscopy after bowel cleansing

Interventions

Colonoscopy after bowel cleansing PROCEDURE

Colonoscopy after bowel cleansing

Lateral Left Horizontal Position (LLP); Supine position (SP)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Female and male patients over 18 years of age who have been medically indicated for colonoscopy and have signed the voluntary consent form.

You may not qualify if:

• Patients under 18 years of age
• Patients who do not give informed consent
• Pregnant women
• Patients requesting sedation
• Patients with an indication for emergency colonoscopy
• Patients with a history of colon resection
• Major psychiatric disorders

Sponsors & Collaborators

• Celal Bayar University: lead

Study Sites (1)

Manisa Celal Bayar University

Manisa, Turkey (Türkiye)

Location

Related Publications (4)

• McKechnie T, Heimann L, Kazi T, Jessani G, Lee Y, Sne N, et al. Starting position during colonoscopy: a systematic review and meta-analysis of randomized controlled trials. Tech Coloproctol [Internet]. 2024;28.

  BACKGROUND

• Watanabe J. Comparison of left versus right lateral starting position on colonoscopy: A systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol. 2021;34:699-704.

  BACKGROUND

• Watanabe J, Park D, Kakehi E, Inoue K, Ishikawa S, Kataoka Y. Efficacy and safety of the starting position during colonoscopy: a systematic review and meta-analysis. Endosc Int Open. 2020;08:848-60.

  BACKGROUND

• 1. Li N, Lu B, Luo C, Cai J, Lu M, Zhang Y, et al. Incidence, mortality, survival, risk factor and screening of colorectal cancer: A comparison among China, Europe, and northern America. Cancer Lett. 2021;522:255-68.

  BACKGROUND

MeSH Terms

Conditions

Colorectal Neoplasms; Colonic Neoplasms; Colonic Polyps

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases; Intestinal Polyps; Polyps; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 6, 2025
• First Posted: April 8, 2026
• Study Start: February 1, 2021
• Primary Completion: October 1, 2023
• Study Completion: August 15, 2024
• Last Updated: April 8, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Beginning 1 month after publication with no end date

Locations

TU (1)