title: High success rate of repeat colonoscopy with standard endoscopes in patients referred for prior incomplete colonoscopy.
abstract: BACKGROUND
  In patients with incomplete colonoscopy, cecal intubation is sometimes unsuccessful due to a redundant or tortuous colon. Repeat colonoscopy may be successful with the use of alternate endoscopes or careful attention to technique but limited outcomes data is available. The aim of this study was to describe the technique, success rate and outcomes of consecutive patients referred for previous incomplete colonoscopy.
  
  
  METHODS
  We conducted a retrospective chart review of incomplete colonoscopy procedures in patients age 18-90 at an academic teaching hospital referred to an endoscopist specializing in difficult colonoscopy.
  
  
  RESULTS
  Cecal intubation was successful in 96 of 100 repeat colonoscopies and 83 procedures were completed with a standard endoscope (adult, pediatric, or gastroscope). The adenoma detection rate was 28% for successful repeat colonoscopies; a majority of these patients had no adenomas identified on incomplete exam. In 69.4% of cases, an endoscope was used to successfully complete colonoscopy that was not used in the incomplete colonoscopy. The median insertion time was significantly less for the complete colonoscopy (10.6 min) compared to the incomplete colonoscopy (18.8 min, P = 0.004).
  
  
  CONCLUSIONS
  Repeat colonoscopy has a high success rate and identified a significant number of new adenomas. Use of all available endoscopes should be considered prior to procedure termination in patients with a tortuous colon. Repeat colonoscopy can often be accomplished using a standard endoscope and is not attributed to increased endoscope insertion time.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Gawron
authors.forename: Annapoorani
authors.initials: A
authors.lastname: Veerappan
authors.affiliation: Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. raj-keswani@northwestern.edu.
authors.forename: Rajesh N
authors.initials: RN
authors.lastname: Keswani
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002430:Cecal Neoplasms / Q000175:diagnosis; D015331:Cohort Studies; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D020699:Gastroscopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult