title: Double-Balloon Colonoscopy Has a Higher Cecal Intubation Rate Than Conventional Colonoscopy Using a Colon Simulator.
abstract: Cecal intubation using conventional colonoscopy (CC) requires substantial training. We hypothesized that double-balloon colonoscopy (DBC) facilitates cecal intubation by endoscopy naïve operators. The aim of this study is to evaluate the cecal intubation rate and learning curve of DBC compared with CC.
  
  
  
  Eighteen endoscopy naïve medical students were allocated to two groups and attempted cecal intubation within 20 min using a colon simulator. In group A, CC was performed ten times and then DBC ten times. In group B, the reverse was carried out. We evaluated the cecal intubation rate and learning curve.
  
  
  
  The overall success rate for cecal intubation using DBC was significantly superior to CC [132/180 (73%) vs. 12/180 (7%), p < 0.001]. To evaluate the success rate overtime, we divided the ten repetitions of the procedure into three time periods: first (1-3), second (4-6), and third (7-10). The success rate using CC is <20%, even during the third time period, in both groups, and one perforation occurred. The success rate using DBC is over 30% in the first period and increased to nearly 80% in the third period in both groups. Finally, we evaluated the time needed for cecal intubation using DBC. The mean cecal intubation time in the first period is 14 min and decreased to 11 min in the third period.
  
  
  
  DBC has a higher cecal intubation rate than CC performed by endoscopy naïve medical students using a colon simulator in this randomized-controlled, cross-over study.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.|Shinozaki Medical Clinic, Tochigi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shinozaki
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Sakamoto
authors.affiliation: Department of Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Alan Kawarai
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. ireef@jichi.ac.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D002432:Cecum; D002983:Clinical Competence / Q000592:standards*; D003106:Colon; D020685:Colonoscopes / Q000592:standards; D003113:Colonoscopy / Q000379:methods / Q000592:standards*; D018592:Cross-Over Studies; D058582:Double-Balloon Enteroscopy / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods / Q000592:standards*; D013337:Students, Medical; D055815:Young Adult
keywords: Colonoscopy; Double-balloon enteroscopy; Endoscopy; Training technics