Push enteroscopy has a 96% cecal intubation rate in colonoscopies that failed because of redundant colons

Abstract

Background: Performing a complete colonoscopy to the cecum is important for ruling out malignancy and other lesions, but failure rates are significant with a standard colonoscope. A previous study using a push enteroscope for failed colonoscopies had a completion rate of 68.7%.

Objective: To improve the cecal intubation rate by using a newer version of a push enteroscope.

Design: Retrospective study at first, then a prospective study.

Setting: Single-center veterans health care system.

Patients: A total of 47 patients in whom the cecum was not reached with a regular adult colonoscope between January 2007 and December 2010 were included. Those with poor bowel preparation were excluded.

Interventions: Repeat colonoscopy using a new version of a push enteroscope.

Main outcome measurements: The rate of cecal intubation and additional pathological findings.

Results: The cecum or terminal ileum was reached in 45 patients (96%). Additional significant pathological findings in the previously unexamined colon were seen in 18 patients (38%).

Limitations: Small sample size, lack of comparison with other endoscopes.

Conclusions: Colonoscopy with a push enteroscope could be advanced to either the terminal ileum or cecum in 96% of patients, which is one of the highest known completion rates in patients in whom colonoscopy failed. Clinical management changed in all patients with additional findings.