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.
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
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
DONG WU
Lead sponsor
Peking Union Medical College Hospital
Sponsor institution