Use of a push enteroscope improves ability to perform total colonoscopy in previously unsuccessful attempts at colonoscopy in adult patients |
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Authors: | Gary R Lichtenstein MD Peter D Park MD William B Long MD Gregory G Ginsberg MD Michael L Kochman MD |
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Institution: | Division of Gastroenterology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA |
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Abstract: | Objective: Total colonoscopy with use of a standard adult colonoscope can be difficult in the presence of a redundant or angulated colon. It is often possible to traverse these areas with the use of a thinner, more flexible endoscope. The objective of this study was to evaluate the efficacy of completing total colonoscopy using a push enteroscope when a standard colonoscope was unsuccessful. Methods: A prospective analysis was performed for 721 consecutive colonoscopies attempted by two gastroenterologists. Those patients in whom complete colonoscopy was unsuccessful using the standard colonoscope (Olympus CF-100L) had attempts to complete colonoscopy using the enteroscope (Olympus SIF-100). The extent of each exam was recorded. Additional pathologic findings discovered by the use of the enteroscope and therapeutic interventions performed were additionally noted. Results: Colonoscopy using an enteroscope was performed in 32 patients with successful total colonoscopy in 22 patients (68.7%). Additional pathology was noted in nine patients who had successful complete colonoscopy using the enteroscope; adenomatous polyp ( n = 5 ), adenocarcinoma ( n = 1 ), bleeding source ( n = 2 ), and extent of colitis ( n = 1 ). Total colonoscopy rate using standard adult colonoscope was 93.2% (630 of 676) when cases with poor bowel preparation ( n = 23 ) and obstructing lesions ( n = 14 ) were excluded. When the results of successful colonoscopies with the enteroscope were included, the overall completion rate of total colonoscopy improved to 96.4% (652 of 676). Conclusion: The use of the enteroscope to help evaluate patients who have had incomplete colonoscopies with the standard colonoscope increases the diagnostic yield of colonic examination. |
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