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Colorectal Cancer ScreeningNCT06664762

Left Lateral Position Versus Supine Position in Colonoscopy

A study testing Left lateral position intervention and Supine position intervention in people with Colorectal Cancer Screening, run by Hospital Civil de Guadalajara at 3 sites in Mexico.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Currently, colonoscopy is a minimally invasive method that can be used as a diagnostic and therapeutic method by endoscopists, gastroenterologists and coloproctologists. Due to the importance and big impact this method has, it is necessary to both optimize its efficiency, and improve its quality, which is one of the… Read more about this study

Who is it for?
Ages 18 to 79 yearsHealthy volunteers can take part
Conditions the study is for
Colorectal Cancer Screening
What is being tested?
Left lateral position intervention and Supine position intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
144 participants
Where
3 sitesMexico
Study dates
27 Aug 2024to 6 Aug 2025
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 79 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patients with indication for colonoscopy in our coloproctology service
  • Both women and men
  • Patients within an age range of 18-79 years
  • Patients who agree having a colonoscopy and who sign the informed consent to participate in the protocol

Who cannot join

  • Patients under 18 or over 80 years old
  • All patients that won´t like to participate in the protocol or won´t sign the informed consent
  • Pregnant women
  • Patients with a medical record of colonic resection, ostomy status, severe cardiopulmonary and renal diseases, major psychiatric disorders, therapeutic colonoscopy or any contraindications for colonoscopy
  • Non compliance with the colonic preparation regimen
  • Active bleeding during the procedure
Show all 15Show fewer
  • Patients with a known diagnosis of colorectal cancer
  • Patients with class III obesity
  • Elimination criteria:
  • Boston score <6 for colonic preparation
  • Patients with a colonic lesion that makes it difficult to pass the colonoscope
  • Patients with insufficient sedation that requires the procedure to stop temporarily
  • Bowel perforation during colonoscopy
  • Inability to reach the cecum despite loop reduction maneuvers
  • Indication to suspend the study given by the anesthesiologist

Trial locations and contacts

3 sites in 1 country.

Mexico3 sites
  • Antigüo Hospital Civil de Guadalajara "Fray Antonio Alcalde"

    Guadalajara, Jalisco, 44200

  • Nuevo Hospital Civil de Guadalajara "Juan I. Menchaca"

    Guadalajara, Jalisco, 44340

  • IMSS Hospital General Regional 220 "José Vicente Villada"

    México, Toluca de Lerdo, 50150

Other trials in Mexico

About this study

Official title: Left Lateral Position Versus Supine Position in Colonoscopy, a Multicenter Single-blind Randomized Clinical Trial Study

Currently, colonoscopy is a minimally invasive method that can be used as a diagnostic and therapeutic method by endoscopists, gastroenterologists and coloproctologists. Due to the importance and big impact this method has, it is necessary to both optimize its efficiency, and improve its quality, which is one of the main objectives of this protocol.

By observing which position its faster and which one also results in fewer complications when performing a colonoscopy without reducing its performance and following all the internationally established quality standards regarding colonoscoscopy.

The risk of this protocol implies a risk no greater than the minumum the procedure itself has, and does not generate extra cost for all of the patients subjected to this protocol.

Read the detailed description

Currently, colonoscopy is one of the most used procedures when it comes to the study and treatment of patients with gastrointestinal conditions, including colorectal cancer, inflammatory bowel disease, etc.

In the area of colorectal neoplasia, colonoscopy has three main functions, which are to diagnose the desease itself and prevent its development by detecting and eliminating potentially premalignant lesions, as well as providing a diagnosis of cancer at an early stage.

The effectiveness of colonoscopy is crucial to carry out an accurate examination of the entire colorectal mucosa, which is why the quality of the procedure has been a subject of study in recent years. Among multiple factors that influence the quality of colonoscopies, the investigators can mention intestinal preparation, which is essential for an accurate procedure, because if patients have an inadequate preparation, it could impair the detection of lesions, since usually, in patients with little or no preparation, colonoscopy can be either incomplete, which requires the study to be repeated, or in case the study continues despite poor intestinal preparation, the presence of feces implies poor visualization of the colonic mucosa, which reduces the ability to detect lesions such as polyps, especially if they are <5 mm. Therefore, the type of solution and tolerability, the preparation regimen and the moment in which the intestinal preparation is performed are considerations to evaluate when performing a colonoscopy.

The position during the colonoscopy is another factor that can influence colonoscopy´s effectiveness, and also, the main focus for the investigators to study. Traditionally, if no position changes occur during colonoscopy, it begins and ends in the left lateral position. However, recent evidence suggests that supine position may reduce the disadvantages of the left lateral position, through decreased frequency of position changes and decreased abdominal pressure, which may result in an easier endoscope insertion in supine position when comparing it to left lateral position, however, there is very few information on the optimal insertion technique in colonoscopy, but it has been observed that in left lateral position, the air leaves the left colon causing it to collapse and also creating sharp curves that can be difficult to overcome during the procedure.

As previously mentioned, colonoscopy insertion is technically challenging, and one of the few clinical trials available that targeted the determination of optimal patient positioning during colonoscopy insertion compared the supine starting position with the left lateral starting position, and the investigators found that cecal intubation times decreased and patient comfort scores improved when using the supine position.

Therefore, patient positioning in colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distension and improve navigation through the colon. Based on what has been mentioned before, using the initial supine position could be a convenient method to reduce cecal intubation time, reduce pain, and improve acceptance of colonoscopy among patients. However, more research is necessary in this area to stablish the advantages of the initial supine position over other positions thar are classically used.

Based on everything that has been described above, the investigators asked themselves the following research question to start this clinical trial: Is there a significant difference in the effectiveness and comfort of performing colonoscopy, when comparing the left lateral position with the supine position?

The institutes where this clinical trial will take place have subjects for study that are ellegible to enroll as participants, infraestructure and health care providers trained to perform colonoscopies and a complete investigators team to collect and analyze the data for this protocol.

The protocol will be limited only to patients who are beneficiaries of each of the hospitals involved. Furthermore, as it is a single-blind randomized clinical trial, the endoscopists in the study cannot be blinded, so investigator bias will not be excluded.

Being tested
Left lateral position intervention, Supine position intervention

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Left lateral position interventionBehavioural

    Patients will be randomized and asigned to start and remain in left lateral position during the colonoscopy

  • Supine position interventionBehavioural

    Patients will be randomized and asigned to start and remain in supine position during the colonoscopy

Study groups in NCT06664762
Study groupRoleWhat they receive
Left lateral position during colonoscopyActive comparatorNot described
Receives: Behavioral: Left lateral position intervention
Supine position during colonoscopyActive comparatorNot described
Receives: Behavioral: Supine position intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to Cecal Intubation.

    Time since insertion to cecal intubation despite the position for colonoscopy

    Measured: 4-10 minutes, which is approximately 240-600 seconds

Secondary outcomes (1)
  1. Number of Participants With at Least One Adenoma Detected During Colonoscopy

    Adenoma detection was defined as the identification of at least one histologically confirmed adenomatous polyp during the procedure. The percentage was calculated based on the total number of participants analyzed in each group.

    Measured: During colonoscopy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Oct 2024
  2. Study start27 Aug 2024
  3. Primary completion30 Jul 2025
  4. Study completion6 Aug 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Model description
multicenter single-blind randomized clinical trial study
Masking
Single blind
Who is masked
Care provider
Enrolment
144 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06664762
Sponsor's protocol ID
150/24
Status last verified
Apr 2026
First submitted
25 Oct 2024
Last updated
29 Apr 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • de la Torre Bravo A. [The astonishing evolution of endoscopy]. Rev Gastroenterol Mex. 2001 Jan-Mar;66(1):58-9. No abstract available. Spanish.

    PubMed 11464632
  • Spaner SJ, Warnock GL. A brief history of endoscopy, laparoscopy, and laparoscopic surgery. J Laparoendosc Adv Surg Tech A. 1997 Dec;7(6):369-73. doi: 10.1089/lap.1997.7.369.

    PubMed 9449087
  • Antoniou SA, Antoniou GA, Koutras C, Antoniou AI. Endoscopy and laparoscopy: a historical aspect of medical terminology. Surg Endosc. 2012 Dec;26(12):3650-4. doi: 10.1007/s00464-012-2389-y. Epub 2012 Jun 21.

    PubMed 22717798
  • Irving MH, Catchpole B. ABC of colorectal diseases. Anatomy and physiology of the colon, rectum, and anus. BMJ. 1992 Apr 25;304(6834):1106-8. doi: 10.1136/bmj.304.6834.1106. No abstract available.

    PubMed 1586826
  • van Rijn JC, Reitsma JB, Stoker J, Bossuyt PM, van Deventer SJ, Dekker E. Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol. 2006 Feb;101(2):343-50. doi: 10.1111/j.1572-0241.2006.00390.x.

    PubMed 16454841
  • Neilson LJ, Bevan R, Panter S, Thomas-Gibson S, Rees CJ. Terminal ileal intubation and biopsy in routine colonoscopy practice. Expert Rev Gastroenterol Hepatol. 2015 May;9(5):567-74. doi: 10.1586/17474124.2015.1001744. Epub 2015 Jan 12.

    PubMed 25582839
  • Vergis N, McGrath AK, Stoddart CH, Hoare JM. Right Or Left in COLonoscopy (ROLCOL)? A Randomized Controlled Trial of Right- versus Left-Sided Starting Position in Colonoscopy. Am J Gastroenterol. 2015 Nov;110(11):1576-81. doi: 10.1038/ajg.2015.298. Epub 2015 Sep 29.

    PubMed 26416195
  • Vergis N, Scarborough AJ, Morris JA, Hoare JM. Prone or Left for Colonoscopy? A Randomized Controlled Trial of Prone Versus Left-sided Starting Position for Colonoscopy. J Clin Gastroenterol. 2018 Nov/Dec;52(10):e82-e86. doi: 10.1097/MCG.0000000000000871.

    PubMed 28644314
  • Zhao S, Yang X, Meng Q, Wang S, Fang J, Qian W, Xia T, Pan P, Wang Z, Gu L, Chang X, Zou D, Li Z, Bai Y. Impact of the supine position versus left horizontal position on colonoscopy insertion: a 2-center, randomized controlled trial. Gastrointest Endosc. 2019 Jun;89(6):1193-1201.e1. doi: 10.1016/j.gie.2019.01.009. Epub 2019 Jan 18.

    PubMed 30660634
  • Chokshi RV, Hovis CE, Hollander T, Early DS, Wang JS. Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy. Gastrointest Endosc. 2012 Jun;75(6):1197-203. doi: 10.1016/j.gie.2012.01.005. Epub 2012 Feb 28.

    PubMed 22381531
  • Cappell MS, Friedel D. The role of sigmoidoscopy and colonoscopy in the diagnosis and management of lower gastrointestinal disorders: technique, indications, and contraindications. Med Clin North Am. 2002 Nov;86(6):1217-52. doi: 10.1016/s0025-7125(02)00076-7.

    PubMed 12510453
  • Gangwani MK, Aziz A, Dahiya DS, Nawras M, Aziz M, Inamdar S. History of colonoscopy and technological advances: a narrative review. Transl Gastroenterol Hepatol. 2023 Apr 20;8:18. doi: 10.21037/tgh-23-4. eCollection 2023.

    PubMed 37197258
  • Church J. Colonoscopy: what are we missing? Surg Oncol Clin N Am. 2014 Jan;23(1):1-9. doi: 10.1016/j.soc.2013.09.001. Epub 2013 Nov 1.

    PubMed 24267161
  • Greene A, Borgoankar M, Hodgkinson K, Garland C, Bacque L, Pace D. A randomized controlled trial comparing right and left lateral decubitus starting position on outcomes in colonoscopy. Surg Endosc. 2020 Aug;34(8):3656-3662. doi: 10.1007/s00464-020-07661-x. Epub 2020 May 26.

    PubMed 32458286

Questions about this trial

What is this clinical trial studying?

A study testing Left lateral position intervention and Supine position intervention in people with Colorectal Cancer Screening, run by Hospital Civil de Guadalajara at 3 sites in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Apr 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to Cecal Intubation. (time frame: 4-10 minutes, which is approximately 240-600 seconds). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06664762, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2026.

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