CHICAGO — Patients do not necessarily prefer virtual colonoscopy to standard colonoscopy, probably because they are not given sedation to ease them through the virtual procedure, Nighat Ullah, M.D., said at the annual Digestive Disease Week.
In a survey of 55 patients who underwent both procedures, 43% preferred virtual colonoscopy, 31% preferred standard colonoscopy, and 26% had no preference, Dr. Ullah said in a poster presentation.
Overall, the survey found no significant differences between the procedures in the patients' experience of pain or embarrassment. The patients' willingness to recommend the two procedures to others and their satisfaction with the experience also did not differ significantly.
However, among those who said they preferred standard colonoscopy, the most common objection to virtual colonoscopy was the discomfort and subsequent bloating that the patients experienced as a result of the procedure, which entails insufflation of the colon, said Dr. Ullah of the division of gastroenterology at Stanford (Calif.) University.
Their survey found that about 50% of the patients reported pain associated with virtual colonoscopy, a figure consistent with other studies, Dr. Ullah said.
Obese patients tend to experience more discomfort, and the elderly, less, she added.
Patients who liked virtual colonoscopy said they preferred it because it was more convenient, mainly because there was no sedation. The exam took less time (15 minutes, compared with 40 minutes), and then the patients were up and out the door with no wait for sedation to wear off and no feeling groggy for the rest of the day, Dr. Ullah said.
In related study, conventional colonoscopy was more sensitive than virtual colonoscopy as a method of examining patients at risk for colon cancer, and was more cost effective as well, in part because if the physician finds a lesion on virtual colonoscopy, the patient still needs a conventional colonoscopy to remove it.
In that study, the sensitivity of conventional colonoscopy for large lesions (10 mm or greater) was 98%, while that of virtual colonoscopy was 59%, said Gillian D. Sanders, Ph.D., of Duke University, Durham, N.C.