Double-balloon endoscopy

Becx, Marco C.; Al–Toma, Abdulbaqi

doi:10.1097/meg.0000000000000067

Cited by 11 publications

(7 citation statements)

References 26 publications

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“…The DBc cecal intubation rate of 95% is comparable to that in other studies, which reported success rates of 88.6%–100% [ 11 , 12 , 17 , 19 - 23 ]. Two of the 3 incomplete DBcs were because of inadequate cleansing of the bowel, which should be avoidable in future to improve intubation rates.…”

Section: Discussionsupporting

confidence: 79%

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

2018

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Background/AimsBecause 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.MethodsRetrospective observational study in a tertiary referral hospital regarding DBc and CTC reports from cases with incomplete colonoscopy.ResultsSixty-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%.ConclusionsDBc 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.

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Section: Discussionsupporting

confidence: 79%

“…Most studies reported no or few major complications [ 21 - 23 ]. Another Dutch clinical study reported a complication rate of 1.8%, consisting of 2 cases of arterial bleeding [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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

2018

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“…Balloon-assisted enteroscopes (BAEs), both double balloon as well as single balloon, have shown to be successful as alternative techniques 7 13 14 15 16 17 18 19 20 21 . Manual version of spiral overtube-assisted colonoscopy achieved a cecal intubation rate of 92 % in 24 patients in whom conventional colonoscopy had failed 22 .…”

Section: Introductionmentioning

confidence: 99%

Prospective evaluation of the motorized spiral enteroscope for previous incomplete colonoscopy

et al. 2022

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Background and aims A significant percentage of colonoscopies remain incomplete because of failure to intubate the cecum. The motorized spiral enteroscope (MSE) technique, originally developed for deep small bowel enteroscopy, may be an effective alternative technique in cases of incomplete examination of abnormally long colons (dolichocolon). We prospectively evaluated the success rate of cecal intubation, safety and the therapeutic consequences of using MSE after incomplete conventional colonoscopy. Methods A total of 36 consecutive patients with an indication for diagnostic and/or therapeutic colonoscopy were prospectively enrolled in this multicenter trial. All patients had undergone at least one incomplete colonoscopy attributed to abnormally long colons. Patients with incomplete colonoscopy due to stenosis were excluded. Results Twenty-two men and 14 women (median age 66 years, range 35-82) were enrolled. Median procedure time was 30 min (range 16-50). Cecal intubation rate was 100% and median cecal intubation time was 10 min (range 4-30). Abnormalities, mostly neoplastic lesions, were detected in 23 of 36 patients, corresponding to a diagnostic yield of 64%. All these findings were in the right side of the colon and had not been described by the antecedent incomplete coloscopy. No adverse events occurred. Conclusion In case of a difficult and long colon, MSE is safe and effective for diagnostic and therapeutic colonoscopy. It may provide an attractive solution to accomplish completeness of previous incomplete colonoscopies in these patients.

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“…Device-assisted colonoscopy with either spiral endoscopy and double or single balloons have identical rates, similar to CCE, of complementing incomplete OC of about 90%[ 28 - 31 ]. These flexible endoscopic techniques additionally provide the possibility to directly treat detected lesions, but they require equipment and expertise, and they are restricted to specialized centres.…”

Section: Discussionmentioning

confidence: 99%

PillCamColon2 after incomplete colonoscopy - A prospective multicenter study

Baltes

Bota

Albert

et al. 2018

WJG

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AIMTo evaluate the ability of PillCamColon2 to visualize colonic segments missed by incomplete optical colonoscopy (OC) and to assess the diagnostic yield.METHODSThis prospective multicentre study included 81 patients from nine centres who underwent second-generation colon capsule endoscopy (CCE) following incomplete OC performed by an experienced gastroenterologist (> 1000 colonoscopies). Patients with stenosis were excluded. According to patient preferences, CCE was performed the following day (protocol A) after staying on clear liquids and 0.75 L Moviprep in the morning or within 30 d after new split-dose Moviprep (protocol B). Boosts consisted of 0.75 L and 0.25 L Moviprep, and phospho-soda was given as a rescue if the capsule was not excreted after seven hours.RESULTSSeventy-four patients were analysed (51% of them in group A; 49% in group B). Bowel cleansing was adequate in 67% of cases, and CCE could visualize colonic segments missed by incomplete colonoscopy in 90% of patients under protocol A and 97% of patients under protocol B (P = 0.35, n.s.). Significant polyps including adenocarcinoma were detected in 24% of cases. Detection rates for all polyps and significant polyps per patient were similar in both protocols. Polyps were found predominantly in the right colon (86%) in segments that were not reached by OC. Extracolonic findings - such as reflux esophagitis, suspected Barrett esophagus, upper GI-bleeding, gastric polyps, gastric erosions and angiectasia - were detected in eight patients. PillCamColon2 capsule was retained in the ileum of one patient (1.4%) without symptoms and removed during an uneventful resection for unknown Crohn’s disease that was diagnosed as the cause of anemia, which was the indication for colonoscopy. CCE was well tolerated. One patient suffered from self-limiting vomiting after consuming the phospho-soda.CONCLUSIONSecond-generation CCE using a low-volume preparation is useful after incomplete OC, and it allows for the detection of additional relevant findings, but cleansing efficiency could be improved.

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Double-balloon endoscopy

Abstract: Colonoscopy by DBE was useful in most patients in whom conventional colonoscopy was incomplete, irrespective of the cause of the failure. In nearly half the patients, a relevant new diagnosis was made with therapeutic consequences.

Cited by 11 publications

References 26 publications

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

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

Prospective evaluation of the motorized spiral enteroscope for previous incomplete colonoscopy

PillCamColon2 after incomplete colonoscopy - A prospective multicenter study

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