A multicenter, prospective trial of total colonoscopy using a short double-balloon endoscope in patients with previous incomplete colonoscopy

BackgroundThere is no specific insertion method for patients who previously underwent an incomplete colonoscopy. No multicenter prospective study using a double-balloon endoscope (DBE) for total colonoscopy was previously performed.ObjectiveTo demonstrate the effectiveness and safety of using short DBEs in patients who previously underwent incomplete colonoscopies.DesignA multicenter, prospective trial.SettingFour tertiary care academic centers and 6 community hospitals.PatientsPatients with a history of incomplete colonoscopy, ages 20 to 79 years, were included. Exclusion criteria were colonoscopy performed by endoscopists with experience in fewer than 1000 cases, history of colectomy, poor bowel preparation, inflammatory bowel disease, active bowel obstruction, and active bleeding.InterventionTotal colonoscopies using short DBEs were attempted in all patients.Main Outcome MeasurementsPrimary endpoint was the cecal intubation rate. Secondary endpoints were time to cecal intubation, complications, and tolerability.ResultsA total of 110 patients (62 males, median age 66.5 years) were included. Fifty-four patients had a history of abdominal surgery. The cecal intubation rate was 100% (110/110). Median intubation time was 12 minutes (range 4–47 minutes). Mild mucosal tears without symptoms occurred in 1 patient. For 64.5% of patients, intravenous sedatives and/or analgesics were used during examinations. Based on questionnaires, 50.9% had no pain, 31.8% slight pain, and 17.3% tolerable pain. Moreover, 96.4% of patients answered that their examination was more comfortable than their previous colonoscopy.LimitationUncontrolled trial.ConclusionThe use of a short DBE is an effective and safe method for total colonoscopy in patients who previously underwent incomplete colonoscopies. (Clinical trial registration number: UMIN3464.)