Difficult or incomplete colonoscopies occasionally occur despite the development of variable-stiffness colonoscopes.
Researchers from Japan undertook a study to evaluate how useful a small-caliber, variable-stiffness colonoscope (scVSC) is as a backup in patients with difficult or incomplete colonoscopies.
The research group retrospectively reviewed the cecal intubation rate of all patients who had had colonoscopies in which an adult standard colonoscope (AC) had been immediately switched to an scVSC.
|51 of the 52 patients (98.1%) had complete colonoscopies after the switch from the AC to the scVSC|
|American Journal of Gastroenterology|
The group also took 374 consecutive patients who were randomized to undergo colonoscopy with a pediatric variable-stiffness colonoscope (PVSC, n = 123), AC (n = 125), or scVSC (n = 126).
The scVSC was used by the same endoscopist to reattempt colonoscopy immediately after colonoscopy with a PVSC or an AC had been assessed as difficult or incomplete.
The researchers noted the cecal intubation rate and time and the ancillary maneuvers used.
They found that 52 (2.5%) of the 2,056 attempted colonoscopies with an AC did not reach the cecum.
In addition, 51 of the 52 patients (98.1%) had complete colonoscopies after the switch from the AC to the scVSC.
On analysis of the results, the researchers found that the initial intubation rate and time were not statistically different among the groups.
Cecal intubation was achieved in all five patients (100%) and in 10 out of 11 (91%) patients, respectively, after the PVSC or AC was switched to the scVSC.
Dr Horiuchi concluded, "The completion rate markedly improved after switching from an AC or PVSC to an scVSC in difficult or incomplete colonoscopies, although the scVSC does not appear to offer any distinct advantage over the AC or PVSC for routine colonoscopies."