TITLE

Usefulness of a Small-Caliber, Variable-Stiffness Colonoscope as a Backup in Patients with Difficult or Incomplete Colonoscopy

AUTHOR(S)
Horiuchi, Akira; Nakayama, Yoshiko; Kajiyama, Masashi; Fujii, Hideyasu; Tanaka, Naoki
PUB. DATE
October 2004
SOURCE
American Journal of Gastroenterology;Oct2004, Vol. 99 Issue 10, p1936
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: Although variable-stiffness colonoscopes have been developed, difficult or incomplete colonoscopies occasionally occur. The aim of this study was to evaluate the usefulness of a small-caliber, variable-stiffness colonoscope (scVSC) as a backup in patients with difficult or incomplete colonoscopies.METHODS: First, we retrospectively reviewed the cecal intubation rate of colonoscopies in which an adult standard colonoscope (AC) was immediately switched to an scVSC in all patients in whom a colonoscopy with an AC was incomplete. Second, 374 consecutive patients were randomized to undergo colonoscopy with a pediatric variable-stiffness colonoscope (PVSC, n= 123), AC (n= 125), or scVSC (n= 126). The scVSC was used by the same endoscopist to reattempt colonoscopy immediately after colonoscopy with a PVSC or an AC had been assessed as difficult or incomplete. The cecal intubation rate and time and the ancillary maneuvers used were evaluated.RESULTS: Fifty-two (2.5%) of the 2,056 attempted colonoscopies with an AC did not reach the cecum. Fifty-one of the 52 patients (98.1%) had complete colonoscopies after the switch from the AC to the scVSC. The initial intubation rate and time were not statistically different among the groups: PVSC, 95% and 6.8 min; AC, 91% and 7.5 min; and scVSC, 98% and 8.2 min. Cecal intubation was achieved in all five patients (100%) and in 10 out of 11 (91%) patients, respectively, after the PVSC or AC was switched to the scVSC.CONCLUSIONS: The completion rate markedly improved after switching from an AC or PVSC to an scVSC in difficult or incomplete colonoscopies, although the scVSC does not appear to offer any distinct advantage over the AC or PVSC for routine colonoscopies.(Am J Gastroenterol 2004;99:1936-1940)
ACCESSION #
14816491

 

Related Articles

  • Colorectal Cancer Screening on Stronger Footing. Fletcher, Robert H. // New England Journal of Medicine;9/18/2008, Vol. 359 Issue 12, p1285 

    The author reflects on colorectal cancer screening. He suggests that screening for colorectal cancer has lagged behind other cancer screening but is presently in a dynamic phase. He argues that new screening tests have been developed for colorectal cancer and that research indicates that they...

  • Measuring Medical Quality: Is a Slower Colonoscopy Really Better? Kirsch, Michael // American Journal of Gastroenterology;Apr2008, Vol. 103 Issue 4, p823 

    The author reflects on the quality of medical care, particularly on the performance of colonoscopists in performing colonoscopy. He cites the conclusion of a study, which states that the longer the colonoscopists spend time in the examination the more they find polyps, which means that the...

  • Clinical Experiences with Colonoscopy. Dagradi, Angelo E.; Alaama, Abdulmouti; Ruiz, Ricardo // American Journal of Gastroenterology;May1975, Vol. 63 Issue 5, p408 

    Our experiences with 100 colonoscopic examinations are described. The clinical value of the procedure is outlined and the minimal degree of attendant morbidity, when performed by a competent endoscopist, are emphasized. The indications and contraindications for this relatively recently devised...

  • Delayed ("Blow-out") Perforation of Sigmoid Following Diagnostic Colonoscopy. Dagradi, Angelo E.; Norris, Mary E.; Weingarten, Zelman G. // American Journal of Gastroenterology;Sep1978, Vol. 70 Issue 3, p317 

    A case has been described in which perforation of the sigmoid colon occurred three days following simple diagnostic colonoscopic examination. The desirability is indicated for including the possibility of this occurrence in the informed consent. Administration of stool softener and use of...

  • SHOULD A NORMAL-APPEARING COLORECTAL MUCOSA BE BIOPSIED? Thompson, W. Grant // American Journal of Gastroenterology;Mar1995, Vol. 90 Issue 3, p336 

    Questions whether a normal-appearing colorectal mucosa be biopsied. Likelihood of a positive biospy; Influence of a positive biopsy on management; Histological features that constitute a positive result.

  • Flexible Sigmoidoscopy--Why, Where and When? Christie, John P.; Jacobs, Walter Harvey // American Journal of Gastroenterology;Jan1980, Vol. 73 Issue 1, p70 

    Deals with issues related to flexible fiberoptic sigmoidoscopy. Popularity of sigmoidoscopy; Conduct of flexible sigmoidoscopy in the office setting; Instances where flexible sigmoidoscopy cannot be performed.

  • COLONOSCOPY  // Davis's Comprehensive Handbook of Laboratory & Diagnostic Tests ;Jan2006, p398 

    Colonoscopy allows inspection of the mucosa of the entire colon, ileocecal valve, and terminal ileum using a flexible fiberoptic colonoscope inserted through the anus and advanced to the terminal ileum. The colonoscope is a multichannel instrument that allows viewing of the gastrointestinal (GI)...

  • Meeting My Friend the Colon. Gaby, Alan R. // Townsend Letter;Jan2007, Issue 282, p106 

    The author reflects on unsedated process of colonoscopy. He questions the risk of an idiosyncratic toxic reaction or memory loss if ever he would go under the operation. He shares that the procedure was rough in the first curve, traverse colon, but was all in all it was just periodic mild...

  • Rationale for and clinical benefits of colonoscopy with narrow band imaging: pathological prediction and colorectal screening. Aihara, Hiroyuki; Saito, Shoichi; Tajiri, Hisao // International Journal of Colorectal Disease;Jan2013, Vol. 28 Issue 1, p1 

    Introduction: Narrow-band imaging (NBI), an emerging imaging technology, allows direct visualization of capillaries on the gastrointestinal mucosal surface. The combination of NBI and magnifying endoscopy can be used to identify morphological changes in these capillaries during the process of...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics