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Review
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Korean J Med. 2006;71(1):260-260.
- Is improved colonoscopy success rate with a Cap-assisted colonoscopy in failed ordinary colonoscopy for first-year trainee?
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., , , , , , , , , , , , , , ,
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- Is improved colonoscopy success rate with a Cap-assisted colonoscopy in failed ordinary colonoscopy for first-year trainee?
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, , , , , , , , , , , , , , ,
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- Background and Aims : Colonoscopy is a well-established and commonly performed endoscopic procedure. Various methods
of improving the success rate have been tried, including manual abdominal compression, changing the patient's position, using
a gastroscope, enteroscope, pediatric colonoscope, or variable-stiffness colonoscope. This report describe experience with
cap-assisted colonoscopy, a technique in which a mucosectomy cap is attached to the end of colonoscope in order to improve
the success rate in first-year trainee. Patients and Methods : From July 2006 to August 2006, The procedures were carried
out by a first-year fellow who did 300 colonoscopies during 3 months and were supervised by endoscopy instructor. In
consecutive patients with difficult colonoscopy procedures, which were defined firstly as failure to pass through the sigmoid
colon after 20 min of examination, or secondly as failure to reach the cecum at the end of the procedure. Patients with prior
surgery, poor bowel preparation, distal colonic stricture were excluded. When difficult procedures were encountered, a
mucosectomy cap (disposable distal attachment D-201-14304) was fitted to the tip of the colonoscope and the procedure was
repeated in the same session under the instruction of the supervisor. Result: During the study period, 153 patients were examined
and 3 patients were excluded due to poor bowel preparation. Up to 20% of the examinations cannot be completed due to various
patient factors and technical difficulties with an ordinary colonoscopy. A total of 30 patients met the criteria for difficult
colonoscopy during the study period. (13 men, 17 women ; median age 43.6, range 16-83) When Cap-assisted colonoscopy was
used to repeat the procedure, cecal intubation could then be achieved in 26 patients. Conclusions : CAC may be used as a rescue
method to improve the success rate of colonoscopy when failure is encountered for first-year trainee.
Keywords :
