The Impact of Image-Assisted Colonoscope on Patient Experience, Physician Workload, and Examination Quality

Summary

Colonoscopy is the cornerstone for colorectal cancer screening, diagnosis, and post-treatment surveillance. Procedural quality is influenced by patient anatomy, particularly variations in colonic configuration such as sigmoid redundancy, looping, and low-lying transverse colon. These features prolong insertion time, increase patient discomfort, and elevate physician workload. Evidence suggests that prior CT imaging can provide objective and individualized information on colonic anatomy-such as redundancy, angulation, and tortuosity-potentially predicting procedural difficulty. However, existing studies are mainly retrospective or descriptive, lacking prospective randomized evidence on clinical utility. This single-blind, randomized controlled trial evaluates whether image-assisted colonoscope insertion, based on pre-existing abdominal/pelvic CT scans, can improve cecal intubation time, enhance patient experience, reduce operator workload, and improve overall examination quality compared with standard colonoscopy.

Eligibility

Inclusion Criteria:

* Age 18-80 years, or expected natural survival \>3 years
* Undergoing colonoscopy at Peking Union Medical College Hospital
* Presence of an abdominal/pelvic CT scan performed within ≤5 years and no - - - major abdominal surgery afterward
* Patient or legal guardian able to understand the study and provide written consent

Exclusion Criteria:

* No available CT or CT quality insufficient for anatomical evaluation
* Prior colonic surgery affecting anatomy (e.g., right hemicolectomy, transverse colectomy)
* Severe cardiopulmonary dysfunction or coagulopathy
* Pregnancy
* Refusal to participate or inability to complete questionnaires
* Patient or guardian unable to understand study requirements

Conditions5

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