Using the gastroscope for incomplete colonoscopy.

Purpose: Reports of virtual colonoscopy demonstrate sensitivity similar to that of conventional colonoscopy for polyps 5 mm or larger, suggesting the validity of its use for colorectal cancer screening. Critical to the success of either procedure is the ability to evaluate the entire colon. Cecal intubation rates during diagnostic or screening colonoscopies vary from 53 to 99 percent. We describe the added value of using a gastroscope to perform a colonoscopic examination that would otherwise result in an incomplete colonoscopy.

Methods: From January 1, 2002 to December 31, 2002 a total of 1,979 colonoscopies were performed. A gastroscope was used in 1.3 percent (n = 26) of these colonoscopies in an effort to complete the index examination initially started with a standard or pediatric colonoscope. The success rate was defined as intubating proximal to the initial area of impasse and entering the cecum.

Results: Cecal intubation was achieved in 62 percent of patients.

Conclusions: In patients with incomplete conventional colonoscopy, the gastroscope can usually advance through the initial area of impasse with a cecal intubation rate of 62 percent.