Colonoscopic decompression, decompression colonoscopy (+ occasional other variations - see below)
Explanation:
Colonoscopic decompression (or decompression colonoscopy), as well other occasional variations on the same theme (enumerated below) are the correct term in English.
Colonoscopic exsufflation or exsufflation colonoscopy are medical Franglais terms, i.e., used exclusively as a result of literal translation from the French medical language by francophone authors who, then, translate themselves to English their abstracts.
I am an infrequent contributor to this forum but I get occasionally compelled to combat fallacies transpiring from its pages whenever students of mine in English medical writing (mostly MDs, working in the field of drug and medical instrument development in Quebec, France, and Belgium, who use this website) draw my attention to posts that are seemingly authoritative but, in fact, inadequately anchored in proper documentation and evidence. Exsufflation colonoscopy is one of these.
Insufflation and exsufflation are the integral yin and yang of pressure and flow control systems in modern endoscopy, such as the topic of the link (http://www.patentgenius.com/patent/7335159.html), provided in one of the posts on this page, to an English–language text that uses extensively those terms. Nonetheless, that link is irrelevant to the issue of translating colonoscopie d’exsufflation. The technical English terms insufflation and exsufflation refer to the underlying technological underpinnings of modern endoscopes, whereas the latter is the commonly used French term for what the English medical literature recognizes as colonoscopic decompression. Admittedly, the decompression of a distended bowel is made feasible via the valves, pressure regulators, and other control devices of the colonoscope, whereby the decrease in intraluminal bowel pressure is the result of the physical process of exsufflation, but this doesn’t legitimize turning the ingrained medical English concept of decompression colonoscopy into exsufflation colonoscopy.
The proof to my contention is offered by the peer-reviewed published English-language literature that uses decompression extensively, but virtually never exsufflation.
As of the time of this writing (Sep-2013), 205 hits are yielded by a PubMed search with the term “decompression colonoscopy”, of which 161 are articles in English. Of the latter, 86 were authored by MDs from English speaking countries [1-86]. Various terms and phrases transpire from those published works, e.g.,
• colonoscopic decompression of ….
• colonoscopic decompression for …,
• decompressive colonoscopy,
• endoscopic decompression for ….,
• colonic decompression via colonoscopy,
• endoscopic management of colonic distension / obstruction / pseudo-obstruction,
• endoscopic fixation of rectal decompression tube,
• colonic stents as treatment of colonic obstruction,
• endoluminal insertion of colonic stents,
• endoscopic placement of flatus tube,
• decompression tube placement,
• therapeutic colonoscopy,
• colonic decompression (notwithstanding that the latter may also be surgical, not necessarily colonoscopic),
• colonoscopically guided tube decompression,
• decompression with a colonoscopically placed drainage tube,
• etc, etc,
yet none of them uses or even mentions colonoscopic exsufflation.
In conclusion, the English speaking author does not write or publish anything using exsufflation colonoscopy or colonoscopic exsufflation in a medical narrative, unless referring to the technical structure and functional substratum of the endoscope itself (as in the above-mentioned patent).
In sharp counter distinction, only two hits are retrieved by a PubMed search using colonoscopic exsufflation or exsufflation colonoscopy: both of them are written in French, by French authors, published in France-based journals [87,88].
Additional material on insufflation / exsufflation versus compression / decompression:
Since the advent of colonoscopy in the second half of the 20th century, decompressing acute colon obstructions and pseudo-obstructions by means of the endoscopic techniques became possible (as opposed to celiotomy or cecostomy). Decompression refers to relieving the gas that becomes built up within the lumen of the colon, which is rendered possible by the modern endoscopes that provide a conduit for the delivery of an inert gas to insufflate the colon to facilitate examination. The colon, which collapses upon itself when empty, must be inflated to create a space, thereby creating a clear field of view for visualization. In order to insufflate the colon, conventional endoscopic systems utilize an air compressor or other similar gas supply sources. Insufflation creates a space for visualization and keeps the gas pressure constant within the colon by controlling the pressure of the gas supply by means of valves, pressure regulators, and other control devices.
However, air pressure in the colon is a cause of pain for the patient, both during the procedure and afterwards, due to distension of the bowel if the pressure is not abated. Furthermore, excess insufflation pressure can potentially stress, or even rupture, the colon during the colonoscopy or may cause the development of late perforations if the pressure and volume of the insufflating gas is not accurately controlled and promptly released. Moreover, in pathological conditions such as colon obstruction / pseudo-obstruction that cause its dilation and distension, properly relieving the extra pressure in the colon is the indication for colonoscopy in the first place. Therefore, modern endoscope shafts are fitted with gas ports that can be connected to a vacuum source so that the field of interest be exsufflated (collapsed). Thus, colonoscopists control insufflation and exsufflation parameters based on different operating modes of the system and/or based on body cavity characteristics viewed by the endoscope, and /or based on the underlying pathology being visualized or treated.
Sincerely,
Chris B. Teszler, MD
Associate professor of otolaryngology, H & N surgery - Bruce Rappaport (Technion) School of Medicine (Israel) & University of British Columbia (Canada)
Pharmacologist, author, editor, lecturer of English medical writing – For Drug Consulting, Paris (France)
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Reference: http://www.ncbi.nlm.nih.gov/pubmed/21559070
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peer agreement (net): +3