BACKGROUND AND AIMS: Caecal intubation fails up to 20% of colonoscopy in clinical practice. We aimed to assess whether (1) in patients with a prior incomplete colonoscopy with a standard adult colonoscope, a subsequent caecal intubation may be achieved with the same instrument; (2) there are factors predicting a repeated unsuccessful colonoscopy; and (3) how frequently completion can be further achieved by shifting to a standard gastroscope. MATERIALS AND METHODS: Data of patients with a previously failed bowel examination referred to our community hospital for a further colonoscopy were reviewed. When caecal intubation still failed with standard colonoscope, complete colonoscopy was usually attempted by shifting to a gastroscope. RESULTS: Overall, 451 patients with a prior colonoscopy were considered. By using a standard colonoscope, caecal intubation rate was achieved in 285 out of 296 patients with prior complete examination and in 121 out of 155 patients with a prior failed colonoscopy (96.3% vs. 78.1%, p < .001). Caecum visualization was significantly lower when prior colonoscopy was stopped in the sigmoid tract as compared to any other proximal tract (65.1% vs. 86.9%, p < .001). After a second failed examination, colonoscopy was completed in 15 (51.7%) out of 29 cases by shifting to a standard gastroscope. No procedure-related complications were observed in the study. CONCLUSIONS: After incomplete colonoscopy with a standard adult colonoscope, a further colonoscopy may be completed with same standard colonoscope or by using a gastroscope in the same session. A prior failed colonoscopy, particularly when stopped in the sigmoid tract, is significantly associated with a lower caecal intubation rate at second colonoscopy.
BACKGROUND AND AIMS: Caecal intubation fails up to 20% of colonoscopy in clinical practice. We aimed to assess whether (1) in patients with a prior incomplete colonoscopy with a standard adult colonoscope, a subsequent caecal intubation may be achieved with the same instrument; (2) there are factors predicting a repeated unsuccessful colonoscopy; and (3) how frequently completion can be further achieved by shifting to a standard gastroscope. MATERIALS AND METHODS: Data of patients with a previously failed bowel examination referred to our community hospital for a further colonoscopy were reviewed. When caecal intubation still failed with standard colonoscope, complete colonoscopy was usually attempted by shifting to a gastroscope. RESULTS: Overall, 451 patients with a prior colonoscopy were considered. By using a standard colonoscope, caecal intubation rate was achieved in 285 out of 296 patients with prior complete examination and in 121 out of 155 patients with a prior failed colonoscopy (96.3% vs. 78.1%, p < .001). Caecum visualization was significantly lower when prior colonoscopy was stopped in the sigmoid tract as compared to any other proximal tract (65.1% vs. 86.9%, p < .001). After a second failed examination, colonoscopy was completed in 15 (51.7%) out of 29 cases by shifting to a standard gastroscope. No procedure-related complications were observed in the study. CONCLUSIONS: After incomplete colonoscopy with a standard adult colonoscope, a further colonoscopy may be completed with same standard colonoscope or by using a gastroscope in the same session. A prior failed colonoscopy, particularly when stopped in the sigmoid tract, is significantly associated with a lower caecal intubation rate at second colonoscopy.
Authors: Madhusudhan R Sanaka; Nirav Shah; Kevin D Mullen; D R Ferguson; Charles Thomas; Arthur J McCullough Journal: Am J Gastroenterol Date: 2006-12 Impact factor: 10.864
Authors: Ana Ponte; Rolando Pinho; Adélia Rodrigues; Luísa Proença; Joana Silva; Jaime P Rodrigues; Mafalda Sousa; João Carlos Silva; João Carvalho Journal: GE Port J Gastroenterol Date: 2018-02-06