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Double-Balloon Colonoscopy Has a Higher Cecal Intubation Rate Than Conventional Colonoscopy Using a Colon Simulator

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Abstract

Background/Aim

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.

Methods

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.

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Keijiro Sunada, Satoshi Shinozaki, Tomonori Yano, Yoshikazu Hayashi, Hirotsugu Sakamoto & Hironori Yamamoto

  2. Shinozaki Medical Clinic, Tochigi, Japan

    Satoshi Shinozaki

  3. Department of Surgery, Jichi Medical University, Tochigi, Japan

    Alan Kawarai Lefor

Authors
  1. Keijiro Sunada
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  2. Satoshi Shinozaki
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  3. Tomonori Yano
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  4. Yoshikazu Hayashi
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  5. Hirotsugu Sakamoto
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  6. Alan Kawarai Lefor
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  7. Hironori Yamamoto
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Corresponding author

Correspondence to Hironori Yamamoto.

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Conflict of interest

H.Y. has a consultant relationship with FUJIFILM Corporation and has received Honoraria, Grants, and Royalties from the company. He has patents for the double-balloon endoscope produced by FUJIFILM Corporation. Y.H. has received Honoraria from FUJIFILM Corporation. The funding source had no role in the design, practice, or analysis of this study. All other authors do not have any conflict of interests.

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Sunada, K., Shinozaki, S., Yano, T. et al. Double-Balloon Colonoscopy Has a Higher Cecal Intubation Rate Than Conventional Colonoscopy Using a Colon Simulator. Dig Dis Sci 62, 979–983 (2017). https://doi.org/10.1007/s10620-017-4477-2

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  • DOI: https://doi.org/10.1007/s10620-017-4477-2

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