Extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening: a pilot study.
BACKGROUND
Caecal intubation can be achieved by extended flexible sigmoidoscopy in 32% of patients.


OBJECTIVE
To assess the feasibility of extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening.


METHODS
We enrolled 41 patients referred for screening flexible sigmoidoscopy. After purging, examination was performed with a colonoscope. All patients completed sigmoidoscopy (success in meeting referral goal); 93% and 71% had examination to the transverse or ascending colon, and caecum, respectively. Overall yield and right-sided polyps was 56% and 27%, respectively. Caecal intubation and complete examination with polypectomy took 6.0 +/- 2.5 and 18.3 +/- 5.1 min, respectively; with no complications. Twelve patients requested colonoscope withdrawal because of discomfort. Although 46% reported moderate to severe discomfort, 39% and 36%, respectively, were definitely or probably willing to repeat flexible sigmoidoscopy.


RESULTS
Unsedated colonoscopy introduced as extended flexible sigmoidoscopy emphasizes the benefits of added yield rather than the negative image of withholding of discomfort relief. The patient can choose to accept the equivalent of an unsedated colonoscopy or reject the option based on perceived discomfort during extended flexible sigmoidoscopy performed by the colonoscopist.


CONCLUSIONS
Extended flexible sigmoidoscopy is a feasible option in carefully selected patients, fully prepared and by an experienced colonoscopist.
Research and Medical Services, Veterans Affairs Northern California Health Care System, University of California Davis Medical Center, Sacramento, USA.
J G
JG
Lee
D
D
Lum
S
S
Urayama
S
S
Mann
S
S
Saavedra
H
H
Vigil
C
C
Vilaysak
J W
JW
Leung
F W
FW
Leung
D002432:Cecum; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery; D008297:Male; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D012812:Sigmoidoscopy / Q000379:methods*