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Double‐balloon colonoscopy carried out by a trainee after incomplete conventional colonoscopy
Author(s) -
Nemoto Daiki,
Isohata Noriyuki,
Utano Kenichi,
Endo Shungo,
Hewett David G.,
Togashi Kazutomo
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12195
Subject(s) - colonoscopy , medicine , cecum , sedation , intubation , visual analogue scale , balloon , surgery , anesthesia , colorectal cancer , cancer
Background and Aim It has been reported that double‐balloon colonoscopy ( DBC ) is useful for patients after failed colonoscopy. In most cases previously reported, expert colonoscopists have carried out DBC . However, DBC may not require significant expertise. The objective of the present study is to assess DBC carried out by an inexperienced colonoscopist in patients referred after previously incomplete colonoscopy. Methods In a single center between J une 2011 and S eptember 2012, we enrolled 28 consecutive patients referred following incomplete conventional colonoscopy. The reported reasons for previous failed colonoscopy were severe pain during the procedure in 15, long redundant colon in 13 and sigmoid fixation in eight. Under instruction by an experienced colonoscopist, all procedures were carried out by a gastroenterology trainee with little colonoscopy experience. A double‐balloon instrument with carbon dioxide insufflation was used under fluoroscopicguidance, with i.v. sedation. Cecal intubation rate, time to cecum and patient‐reported pain using a visual analog scale (0 to 10) were evaluated. Results The trainee achieved a cecal intubation in all patients (100%) without primary involvement by the experienced colonoscopist. Time to cecum ranged from 6 min to 66 min (median time to cecum 15 min 55 s). No patients required additional sedation. Visual analogue pain scores ranged from 0/10 to 10/10 (median score 2.5/10). There were no complications. Conclusion DBC may enable inexperienced colonoscopists to achieve total colonoscopy after previously incomplete conventional colonoscopy.