Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 7, 2013; 19(29): 4732-4736
Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4732
Utility of single and double balloon endoscopy in patients with difficult colonoscopy: A randomized controlled trial
Atsuo Yamada, Hirotsugu Watabe, Noriyuki Takano, Goichi Togo, Yutaka Yamaji, Haruhiko Yoshida, Takao Kawabe, Masao Omata, Kazuhiko Koike
Atsuo Yamada, Hirotsugu Watabe, Noriyuki Takano, Goichi Togo, Yutaka Yamaji, Haruhiko Yoshida, Takao Kawabe, Masao Omata, Kazuhiko Koike, Department of Gastroenterology, University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Togo G, Yamaji Y, Yoshida H, Kawabe T and Omata M designed the research; Yamada A, Watabe H and Takano N performed the research and analyzed the data and wrote the paper; Yoshida H and Koike K had final approval of the version to be published.
Supported by Olympus Medical Systems, Tokyo, Japan
Correspondence to: Dr. Atsuo Yamada, MD, Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yamada-a@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-38140021
Received: March 1, 2013
Revised: April 15, 2013
Accepted: May 16, 2013
Published online: August 7, 2013
Abstract

AIM: 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.

CONCLUSION: The utility of single- and double-balloon endoscopy for colonoscopy seems comparable in patients with incomplete colonoscopy using a conventional colonoscope.

Keywords: Difficult colonoscopy, Double-balloon endoscopy, Single-balloon endoscopy, Double-balloon colonoscopy, Single-balloon colonoscopy

Core tip: We compared the utility of single-balloon colonoscopy and double-balloon colonoscopy for difficult colonoscopy. Both single-balloon endoscopy (SBE) and double-balloon endoscopy (DBE) make possible performance of total colonoscopy in patients with incomplete colonoscopy using a conventional colonoscope. The utility of SBE and DBE for colonoscopy seems to be comparable. We recommend that patients with incomplete total colonoscopy undergo SBE or DBE.