Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 11/2013

01-11-2013

Colonoscopy using a small-caliber colonoscope with passive-bending after incomplete colonoscopy due to sharp angulation or pain

Authors: Koichiro Sato, Fumiko Shigiyama, Sayo Ito, Tomoyuki Kitagawa, Kenji Tominaga, Takeshi Suzuki, Iruru Maetani

Published in: Surgical Endoscopy | Issue 11/2013

Login to get access

Abstract

Background

We evaluated the performance of a newly developed small-caliber (SC) colonoscope (PCF-PQ260L). This colonoscope (diameter 9.2 mm) is designed with passive-bending and high-force transmission. The SC colonoscope was used for rescue colonoscopy following incomplete colonoscopy with a standard (SD) colonoscope caused by sharp angulation, loop formation, or pain.

Methods

Records of SC colonoscopy given to patients following an incomplete colonoscopy with the SD colonoscope and in the same session were analyzed. Cecal intubation rate, pain using a visual analog scale (0 = none, 100 = extremely painful) in the first and second colonoscopy, total time, new lesions detected with the SC colonoscopy, dosage of sedation used, and any complications were assessed. Examinations that could not be completed, because the colonoscope was not long enough to reach the cecum due to a redundant colon were excluded.

Results

The records of 43 patients who were given SC colonoscopy following incomplete examinations using the SD colonoscope were reviewed. In 97.7 % of cases (42/43), cecal intubation was achieved with the SC colonoscope in the same session. The mean pain score during colonoscopy was significantly lower for the second SC colonoscopy than for the first SD colonoscopy (40.6 ± 14.1 vs. 74.5 ± 10.8, P < 0.001). Lesions were detected with the SC colonoscope in 41.8 % of cases (18/43).

Conclusions

When a colonoscopy with SD colonoscope failed due to sharp angulations, loop formation, or pain, subsequent colonoscopy with a SC colonoscope increased cecal intubation and lesion detection rates and decreased severity of reported pain.
Literature
1.
Rex DK, Goodwine BW (2002) Method of colonoscopy in 42 consecutive patients presenting after prior incomplete colonoscopy. Am J Gastroenterol 97:1148–1151PubMedCrossRef
2.
Rex DK, Bond JH, Winawer S, Levin TR, Burt RW, Johnson DA, Kirk LM, Litlin S, Lieberman DA, Waye JD, Church J, Marshall JB, Riddell RH (2002) Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the US multi-society task force on colorectal cancer. Am J Gastroenterol 97:1296–1308PubMedCrossRef
3.
Saifuddin T, Trivedi M, King PD, Madsen R, Marshall JB (2000) Usefulness of a pediatric colonoscope for colonoscopy in adults. Gastrointest Endosc 51:314–317PubMedCrossRef
4.
Marshall JB (1996) Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients. Gastrointest Endosc 44:675–678PubMedCrossRef
5.
Coppola F, Gaia S, Cosimato M, Recchia S (2011) Enteroscope without overtube for cecal intubation after an incomplete colonoscopy. Dig Liver Dis 43:475–477PubMedCrossRef
6.
Cirocco WC, Rusin LC (1995) Factors that predict incomplete colonoscopy. Dis Colon Rectum 38:964–968PubMedCrossRef
7.
Lichtenstein GR, Park PD, Long WB, Ginsberg GG, Kochman ML (1999) Use of a push enteroscope improves ability to perform total colonoscopy in previously unsuccessful attempts at colonoscopy in adult patients. Am J Gastroenterol 94:187–190PubMedCrossRef
8.
Rex DK, Chen SC, Overhiser AJ (2007) Colonoscopy technique in consecutive patients referred for prior incomplete colonoscopy. Clin Gastroenterol Hepatol 5:879–883PubMedCrossRef
9.
Morini S, Zullo A, Hassan C, Lorenzetti R, Campo SM (2011) Endoscopic management of failed colonoscopy in clinical practice: to change endoscopist, instrument, or both? Int J Colorectal Dis 26:103–108PubMedCrossRef
10.
Kaffes AJ, Mishra A, Ding SL, Hope R, Williams SJ, Gillespie PE, Bourke MJ (2003) A prospective trial of variable stiffness pediatric vs. standard instrument colonoscopy. Gastrointest Endosc 58:685–689PubMedCrossRef
11.
Pasha SF, Harrison ME, Das A, Corrado CM, Arnell KN, Leighton JA (2007) Utility of double-balloon colonoscopy for completion of colon examination after incomplete colonoscopy with conventional colonoscope. Gastrointest Endosc 65:848–853PubMedCrossRef
12.
Friedland S, Soetikno RM (2007) Small caliber overtube-assisted colonoscopy. World J Gastroenterol 13:5933–5937PubMed
13.
May A, Nachbar L, Ell C (2006) Push-and-pull enteroscopy using a single-balloon technique for difficult colonoscopy. Endoscopy 38:395–398PubMedCrossRef
14.
Lee YT, Hui AJ, Wong VW, Hung LC, Sung JJ (2006) Improved colonoscopy success rate with a distally attached mucosectomy cap. Endoscopy 38:739–742PubMedCrossRef
15.
Sato K, Ito S, Shigiyama F, Kitagawa T, Hirahata K, Tominaga K, Maetani I (2012) A prospective randomized study on the benefits of a new small-caliber colonoscope. Endoscopy 44:746–753PubMedCrossRef
16.
Luo DJ, Hui AJ, Yan KK, Ng SC, Wong VW, Chan FK, Cheong JP, Lam PP, Tse YK, Lau JY (2012) A randomized comparison of ultrathin and standard colonoscope in cecal intubation rate and patient tolerance. Gastrointest Endosc 75:484–490PubMedCrossRef
17.
18.
Garborg KK, Loberg M, Matre J, Holme O, Kalager M, Hoff G, Bretthauer M (2012) Reduced pain during screening colonoscopy with an ultrathin colonoscope: a randomized controlled trial. Endoscopy 44:740–746PubMedCrossRef
19.
Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13:227–236PubMedCrossRef
20.
Wehrmann T, Lechowicz I, Martchenko K, Riphaus A (2008) Routine colonoscopy with a standard gastroscope. A randomized comparative trial in a western population. Int J Colorectal Dis 23:443–446PubMedCrossRef
21.
Park CH, Lee WS, Joo YE, Kim HS, Choi SK, Rew JS, Kim SJ (2006) Sedation-free colonoscopy using an upper endoscope is tolerable and effective in patients with low body mass index: a prospective randomized study. Am J Gastroenterol 101:2504–2510PubMedCrossRef
22.
Marshall JB, Perez RA, Madsen RW (2002) Usefulness of a pediatric colonoscope for routine colonoscopy in women who have undergone hysterectomy. Gastrointest Endosc 55:838–841PubMedCrossRef
23.
Horiuchi A, Nakayama Y, Kajiyama M, Fujii H, Tanaka N (2004) Usefulness of a small-caliber, variable-stiffness colonoscope as a backup in patients with difficult or incomplete colonoscopy. Am J Gastroenterol 99:1936–1940PubMedCrossRef
24.
Suzuki T, Matsushima M, Tsukune Y, Fujisawa M, Yazaki T, Uchida T, Gocyo S, Okita I, Shirakura K, Sasao K, Saito T, Sakamoto I, Igarashi M, Koike J, Takagi A, Mine T (2012) Double-balloon endoscopy versus magnet-imaging enhanced colonoscopy for difficult colonoscopies, a randomized study. Endoscopy 44:38–42PubMedCrossRef
25.
Farraye FA, Horton K, Hersey H, Trnka Y, Heeren T, Provenzale D (2004) Screening flexible sigmoidoscopy using an upper endoscope is better tolerated by women. Am J Gastroenterol 99:1074–1080PubMedCrossRef
26.
Han Y, Uno Y, Munakata A (2000) Does flexible small-diameter colonoscope reduce insertion pain during colonoscopy? World J Gastroenterol 6:659–663PubMed
27.
Hoff G, Bretthauer M, Huppertz-Hauss G, Sauar J, Paulsen J, Dahler S, Kjellevold O (2005) Evaluation of a novel colonoscope designed for easier passage through flexures: a randomized study. Endoscopy 37:1123–1126PubMedCrossRef
28.
Okamoto M, Kawabe T, Kato J, Yamaji Y, Ikenoue T, Omata M (2005) Ultrathin colonoscope with a diameter of 9.8 mm for total colonoscopy. J Clin Gastroenterol 39:679–683PubMedCrossRef
29.
Anderson JC, Walker G, Birk JW, Alpern Z, Von Althen I (2007) Tapered colonoscope performs better than the pediatric colonoscope in female patients: a direct comparison through tandem colonoscopy. Gastrointest Endosc 65:1042–1047PubMedCrossRef
Metadata
Title
Colonoscopy using a small-caliber colonoscope with passive-bending after incomplete colonoscopy due to sharp angulation or pain
Authors
Koichiro Sato
Fumiko Shigiyama
Sayo Ito
Tomoyuki Kitagawa
Kenji Tominaga
Takeshi Suzuki
Iruru Maetani
Publication date
01-11-2013
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3016-2

Other articles of this Issue 11/2013

Surgical Endoscopy 11/2013 Go to the issue

OriginalPaper

Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a single-center experience

OriginalPaper

Simulated Colonoscopy Objective Performance Evaluation (SCOPE): a non-computer-based tool for assessment of endoscopic skills

OriginalPaper

Disease-based mortality after percutaneous endoscopic gastrostomy: utility of the enterprise data warehouse

OriginalPaper

Endoluminal surgical triangulation: overcoming challenges of colonic endoscopic submucosal dissections using a novel flexible endoscopic surgical platform: feasibility study in a porcine model

OriginalPaper

Laparoscopic resection of paraaortic or paracaval lesions: feasibility and outcome

OriginalPaper

High serum CA19-9 levels are associated with an increased risk of cholangiocarcinoma in patients with intrahepatic duct stones: a case–control study