title: Double-balloon endoscopy versus magnet-imaging enhanced colonoscopy for difficult colonoscopies, a randomized study.
abstract: OBJECTIVE
  Studies have estimated that failure of cecal intubation occurs with conventional colonoscopy in up to 10 % of cases. Double-balloon endoscopy (DBE) systems, magnetic endoscope imaging (MEI), and transparent cap have been shown to improve success rates for colonoscopy. This study evaluated the utility of DBE for complete examination of the colon compared with MEI plus cap (MEI-Cap) after incomplete or technically difficult colonoscopy in a randomized comparative manner.
  
  
  METHODS
  A total of 94 patients with incomplete or technically difficult colonoscopy were randomly assigned to receive either DBE (n = 47) or colonoscopy with MEI-Cap (n = 47). The primary end point was cecal intubation rate within 30 minutes. Secondary end points included intubation time, pain score using a visual analog scale, abdominal pressure attempts, doses of sedative medication, and changes in patient position during colonoscopy.
  
  
  RESULTS
  Patient characteristics were comparable in both groups. Cecal intubation rate within 30 minutes was significantly higher for DBE (45 /47, 95.7 %) than for MEI-Cap (34 /47, 72.3 %) (P = 0.0049). Mean time to reach the cecum was significantly lower in the DBE group (13.0 ± 5.3 minutes) than in the MEI-Cap group (16.4 ± 4.8 minutes; P = 0.0003). No complications were encountered in either group.
  
  
  CONCLUSIONS
  DBE is more useful for complete examination of the colon than MEI-Cap in patients with incomplete or technically difficult colonoscopy.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan. takayosh@is.icc.u-tokai.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Matsushima
authors.forename: Y
authors.initials: Y
authors.lastname: Tsukune
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.forename: T
authors.initials: T
authors.lastname: Yazaki
authors.forename: T
authors.initials: T
authors.lastname: Uchida
authors.forename: S
authors.initials: S
authors.lastname: Gocyo
authors.forename: I
authors.initials: I
authors.lastname: Okita
authors.forename: K
authors.initials: K
authors.lastname: Shirakura
authors.forename: K
authors.initials: K
authors.lastname: Sasao
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: I
authors.initials: I
authors.lastname: Sakamoto
authors.forename: M
authors.initials: M
authors.lastname: Igarashi
authors.forename: J
authors.initials: J
authors.lastname: Koike
authors.forename: A
authors.initials: A
authors.lastname: Takagi
authors.forename: T
authors.initials: T
authors.lastname: Mine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D002432:Cecum; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000175:diagnosis* / Q000601:surgery; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D058582:Double-Balloon Enteroscopy; D005260:Female; D005445:Flunitrazepam / Q000008:administration & dosage; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D056888:Patient Positioning; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D014151:Anti-Anxiety Agents; D005445:Flunitrazepam