Utility of single and double balloon endoscopy in patients with difficult colonoscopy: a randomized controlled trial.
OBJECTIVE
To compare the utility of single-balloon colonoscopy (SBC) or double-balloon colonoscopy (DBC) for difficult colonoscopies.


METHODS
Between August 2008 and June 2010, patients in whom total colonoscopy failed within 30 min of insertion were assigned randomly to undergo either SBC or DBC. No sedatives were used. After the endoscopy, all patients were asked to evaluate pain during the procedure on a 10-point analog scale (1 = no pain; 10 = worst imaginable pain) with a questionnaire. The study outcomes were the cecal intubation rate and time, endoscopic findings, complications, and pain score.


RESULTS
The SBC and DBC groups included 11 and 10 patients, respectively. All but one SBC patient achieved total colonoscopy successfully. The cecal intubation times were 18 min (range: 10-85 min) and 12.8 min (range: 9.5-42 min) in the SBC and DBC groups, respectively (P = 0.17). No difference was observed in the prevalence of colon polyps between the SBC and DBC groups (45% vs 30%, P = 0.66). SBC showed advanced colon cancer in the ascending colon, which was inaccessible using conventional colonoscopy. The respective pain scores were 5 (1-10) [median (range)] and 5 (1-6) in the SBC and DBC groups (P = 0.64). No complications were noted in any patient.


CONCLUSIONS
The utility of single- and double-balloon endoscopy for colonoscopy seems comparable in patients with incomplete colonoscopy using a conventional colonoscope.
Department of Gastroenterology, University of Tokyo, Tokyo 113-8655, Japan. yamada-a@umin.ac.jp
Atsuo
A
Yamada
Hirotsugu
H
Watabe
Noriyuki
N
Takano
Goichi
G
Togo
Yutaka
Y
Yamaji
Haruhiko
H
Yoshida
Takao
T
Kawabe
Masao
M
Omata
Kazuhiko
K
Koike
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology; D020685:Colonoscopes; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013997:Time Factors
Difficult colonoscopy; Double-balloon colonoscopy; Double-balloon endoscopy; Single-balloon colonoscopy; Single-balloon endoscopy