title: Cap-assisted gastroscope versus cap-assisted colonoscope for examination of difficult sigmoid colons in a nonsedated Asian population: a randomized study.
abstract: BACKGROUND
  Studies have estimated that cecal intubation failure occurs with conventional colonoscopy in about 10% of cases. Various methods have been adopted to improve the cecal intubation rate, including a transparent cap and special colonoscopes.
  
  
  OBJECTIVE
  To assess the efficacy of using a cap-assisted gastroscope (E-cap) compared with a cap-assisted colonoscope (C-cap) for the complete examination of the colon in nonsedated patients with technically difficult sigmoid colons.
  
  
  METHODS
  Randomized, controlled study.
  
  
  METHODS
  Tertiary-care referral center.
  
  
  METHODS
  One hundred thirty-nine patients with technically difficult sigmoid colons were studied.
  
  
  METHODS
  Colonoscopy with either an E-cap (n = 69) or a C-cap (n = 70).
  
  
  METHODS
  Cecal intubation rate, cecal intubation time, patient-assessed pain score, and endoscopist-assessed pain score.
  
  
  RESULTS
  The cecal intubation rate was significantly higher in the E-cap (65/69, 94.2%) than in the C-cap group (50/70, 71.4%; P < .0001). Patient-assessed pain (moderate to severe) was more frequently reported in the C-cap (14/70, 20.0%) than in the E-cap group (5/69, 7.2%; P = .029). Endoscopist-assessed pain (moderate to severe) was more frequently reported in the C-cap (13/70, 18.6%) than in the E-cap group (3/69, 7.2%; P = .009). For patients with a low body mass index (≤ 22 kg/m(2)), the cecal intubation rate was significantly higher in the E-cap (37/38, 97.4%) than in the C-cap group (15/29, 51.7%; P < .0001).
  
  
  CONCLUSIONS
  Single-center experience, lack of a gastroscope control group without a cap.
  
  
  CONCLUSIONS
  The cap-assisted gastroscope is more tolerable and effective than cap-assisted colonoscope for the complete examination of the colon in patients with technically difficult sigmoid colons. (
  
  
  BACKGROUND
  KCT0000744.).
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Ho-Seok
authors.initials: HS
authors.lastname: Ki
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Jun
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D002432:Cecum; D012809:Colon, Sigmoid / Q000033:anatomy & histology*; D020685:Colonoscopes / Q000009:adverse effects; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation*; D054810:Deep Sedation; D005260:Female; D020699:Gastroscopes / Q000009:adverse effects; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010146:Pain / Q000209:etiology; D010147:Pain Measurement