Double-Balloon Endoscopy after Incomplete Colonoscopy and Its Comparison with Computed Tomography Colonography
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Background/Aims: Because of the national screening program for colorectal carcinoma in The Netherlands, the number ofcolonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-ballooncolonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previouslyunexplored 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 incompletecolonoscopy. 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 beconfirmed 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 likelihoodof pathology, DBc is preferred over CTC.
Abstract
Background/Aims: Because of the national screening program for colorectal carcinoma in The Netherlands, the number ofcolonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-ballooncolonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previouslyunexplored 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 incompletecolonoscopy. 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 beconfirmed 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 likelihoodof pathology, DBc is preferred over CTC.
참고문헌 (31)
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