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 23 February 2018

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News

IIeoscopy is the gold standard for completeness of colonoscopy

A study published in the American Journal of Gastroenterology shows that with practice, completeness of colonoscopy can be achieved routinely with ileoscopy in at least 85% of colonoscopies and in skilled hands, it adds only 3 minutes to the procedure time.

News image

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IIeoscopy is not routinely attempted because of its perceived technical difficulty, time constraints, and the expectation of a low diagnostic yield.

Dr Pradip Singh and colleagues from Stafford, England undertook a study in order to investigate the value of routine ileoscopy as an integral part of colonoscopy.

The researchers evaluated ileoscopy in terms of additional diagnostic information, extra time spent, and the relationship between ileoscopy rate and accumulation of colonoscopic experience.

The investigators examined colonoscopy data from September 1995 to April 2004 of a gastroenterological firm.

The research team calculated the crude and adjusted total colonoscopy rates (CTCR, ATCR) and ileoscopy rate (IR).

The researchers excluded 108 procedures in patients with previous colonic resection and 91 with unavoidable reasons for failure to reach cecum, in order to calculate ATCR and IR.

The research team analyzed time trend in ileoscopy rate with IR as a function of cumulative colonoscopy experience.

The researchers collected data on procedure times for 1,222 consecutive colonoscopies between November 2000 and April 2004.

The researchers noted that out of 2,537 colonoscopies, 1,902 were performed by a single consultant and 635 by eight trainees with or without assistance from the consultant.

The diagnostic yield from ileoscopy and ileal histology was 16.7% and 19% in patients with colonic inflammatory bowel disease
The American Journal of Gastroenterology

The researchers found that the CTCR, ATCR, and IR were 94%, 97.5%, and 71.5% respectively.

The research team found that the diagnostic yield from ileoscopy and ileal histology was 16.7% and 19% in patients with colonic inflammatory bowel disease, and 2.69% and 7.4% in other patients.

26 ileoscopies in 24 patients showed Crohn's ileitis with normal colon.

The other diagnoses that the researchers reported were NSAID related or nonspecific ileitis, ileal lipoma, ileal villous atrophy, and amyloidosis.

The team observed that the median anus to cecum and cecum to ileum times were 8.5 and 2 minutes respectively.

The American Journal of Gastroenterology; 2004: 99 (12): 2324
06 December 2004

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