Pınar Sayın1, Özgür Bostancı2, Hacer Şebnem Türk1, Canan Tülay Işıl1, Sibel Oba1, Mehmet Mihmanlı2

1Department of Anestesiology and Reanimation, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
2Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey


Objective: Esophagoduodenoscopy and colonoscopy can be done as bidirectional endoscopy in the same session. The aim of this study was to compare anesthetic requirements and hemodynamic effects in esophagoduodenoscopy or colonoscopy done first for bidirectional endoscopy.

Material and Methods: Eighty patients, aged 18-70 years with an American Society of Anesthesiologists Classification (ASA) as I-III, were included randomly into this study. The patients were allocated into two groups: Group C: first colonoscopy followed by esophagoduodenoscopy. Group E: first esophagoduodenoscopy followed by colonoscopy. All patients received standard anesthesia with 1 µg/kg fentanyl and 1 mg/kg propofol. Demographical variables, Heart rate SpO2, Ramsey Sedation Score were recorded every 10 minutes. Total propofol consumption, retching during esophagoduodenoscopy and time to reach cecum were also recorded. Endoscopist and patient satisfaction were questioned.

Results: Retching during esophagoduodenoscopy was not statistically significantly different in both groups. Total procedure duration and esophagoduodenoscopy duration were statistically significant longer in Group E. Complication frequency was higher in Group E. Endoscopist and patient satisfaction were lower in Group E. There was no difference in time to reach the cecum and the recovering period. Additional propofol dose was increased in Group E.

Conclusion: Regarding shorter procedural duration, lower consumption amount of propofol and fewer complications, it could be a better choice to start bidirectional procedure with colonoscopy first.

Cite this article as: Sayın P, Bostancı Ö, Türk HŞ, Işıl CT, Oba S, Mihmanlı M. Esophagoduodenoscopy or colonoscopy: which should be done first?. Turk J Surg 2020; 36 (2): 172-179.


Ethics Committee Approval

Local ethics committee approval (28.05.2013/197) was obtained for this study.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept – P.S., Ö.B., H.Ş.T; Design – P.S., C.T.I.; Supervision – S.O., M.M.; Resource – P.S., Ö.B.; Materials – P.S., H.Ş.T.; Data Collection and/or Pro-cessing – C.T.I., P.S.; Analysis and Interpretation – C.T.I., S.O.; Literature Review – S.O., M.M.; Writing Manuscript – H.Ş.T., Ö.B.; Critical Reviews – M.M., S.O.

Conflict of Interest

The authors have no conflicts of interest.

Financial Disclosure

Financial support was provided by departmental sources.