title: Magnifying gastroscopy using a soft black hood for difficult colonoscopy.
abstract: BACKGROUND
  Various methods are reported as aids to cecal intubation for cases in which colonoscopy is difficult. This study aimed to investigate prospectively whether a gastroscope with magnification function, narrow-band imaging (NBI), and a soft black hood can aid insertion in cases of difficult colonoscopy and facilitate both accurate diagnosis and safe treatment.
  
  
  METHODS
  This prospective study recruited 177 patients. All were examined with a magnifying gastroscope. A commercially available soft black hood was attached to the gastroscope during insertion and magnification. Difficult colonoscopy was anticipated before colonoscopy in cases of patients with at least one of the following factors: low BMI (<20 kg/m(2)), adhesion due to previous surgery, or previous colonoscopy that could not reach to the cecum. The success rate and duration of cecal intubation then were assessed. All detected lesions were evaluated by magnifying NBI and then classified as non-neoplastic or neoplastic for endoscopic diagnosis. Subsequently, all the lesions were removed and examined histologically for comparison.
  
  
  RESULTS
  The overall success rate of cecal intubation was 100% (177/177), and the mean time taken to reach the cecum was 5.9 min. A total of 156 lesions were detected endoscopically, and the overall diagnostic accuracy of NBI with magnification was 98.7%. No associated complications occurred.
  
  
  CONCLUSIONS
  Magnifying gastroscopy using a soft black hood and NBI is useful for cecal intubation in cases wherein colonoscopy is difficult, facilitating accurate diagnosis and safe treatment.
authors.affiliation: Department of Gastroenterology, Chofu Surgical Clinic, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Kuangi
authors.initials: K
authors.lastname: Fu
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yamamura
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000175:diagnosis; D002432:Cecum; D003110:Colonic Neoplasms / Q000175:diagnosis; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D020699:Gastroscopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014741:Video Recording; D055815:Young Adult