Clin Endosc.  2018 Jan;51(1):66-71. 10.5946/ce.2017.011.

Double-Balloon Endoscopy after Incomplete Colonoscopy and Its Comparison with Computed Tomography Colonography

• Hermans C
• van der Zee D
• Gilissen L

• KMID: 2403635
• DOI: http://doi.org/10.5946/ce.2017.011

Abstract

BACKGROUND/AIMS
Because of the national screening program for colorectal carcinoma in The Netherlands, the number of colonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-balloon colonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previously unexplored part of the colon, complication rate of DBc, and CTC results after incomplete colonoscopy.
METHODS
Retrospective observational study in a tertiary referral hospital regarding DBc and CTC reports from cases with incomplete colonoscopy.
RESULTS
Sixty-three DBcs were performed after incomplete colonoscopy. Cecal intubation rate was 95%. Detection rate was 58% (5% carcinoma and 3% high-grade dysplastic adenoma). CTC preceded 54% of DBcs and 62% of CTC findings were confirmed. In 16%, a biopsy was taken, and in 60%, an intervention (mostly polypectomy) was performed. One major complication (1.5%) occurred, i.e., arterial bleeding due to polypectomy necessitating right hemicolectomy. CTC (n=213) showed a possible lesion in 35%, and could be confirmed by follow-up endoscopy or surgery in 65%.
CONCLUSIONS
DBc is effective and safe for completion of colon inspection in incomplete colonoscopy. In patients with a high likelihood of pathology, DBc is preferred over CTC.

Keyword

Double-balloon colonoscopy; Colonography, computed tomographic; Colon carcinoma; Colon visualization; Cecum

MeSH Terms

Biopsy
Cecum
Colon
Colonography, Computed Tomographic
Colonoscopy*
Colorectal Neoplasms
Endoscopy*
Follow-Up Studies
Hemorrhage
Humans
Intubation
Mass Screening
Netherlands
Observational Study
Pathology
Retrospective Studies
Tertiary Care Centers

Figure

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  Fig. 1. Findings in double balloon colonoscopy after incomplete colonoscopy (n =63 procedures) in the unexplored part of the colon.

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