Résumé
Introduction: L’examen endoscopique du côlon est complet jusqu’à la valvule iléo-caecale dans près de 90% des cas. Les examens incomplets sont favorisés par des dispositions anatomiques particulières: côlon trop long, ou secondaires à des antécédents chirurgicaux responsables d’angle ou de segment colique fixé en raison d’adhérences. Dans ce contexte, il a été proposé d’appliquer le principe de l’entéroscopie double ballon développé pour l’intestin grêle au niveau du côlon en cas de coloscopie difficile en associant coloscope avec un ballonnet et surtube avec également un ballonnet.
Patients et méthodes: A partir de l’expérience acquise en entéroscopie double ballon, nous avons testé le coloscope double ballon développé par FUJINON Inc. (Saitama, Japon), basé sur la même technologie chez 12 patients dont la coloscopie initiale avait été incomplète bien que pratiquée par des endoscopistes confirmés.
Résultats: La coloscopie double ballon (CDB) a été complète chez 11 des 12 patients explorés. La procédure endoscopique a été simple sans complication.
Discussion/Conclusions: Il est possible actuellement d’utiliser le coloscope double ballon en cas d’examen incomplet réalisé avec un coloscope classique. Les procédures techniques de réalisation de cette CDB sont relativement simples en sachant qu’il conviendra de valider cette technique sur un plus grand nombre de patients de façon à préciser l’évaluation des coûts qu’elle engendre.
Summary
Introduction: Endoscopic examination of the colon is done up to the ileocaecal valve in nearly 90 % of cases. Incomplete examinations are induced by particular anatomical configurations such as an long colon, or are secondary to surgical antecedents responsible for fixed angles or segments of the colon due to adhesions. In this context, it has been proposed that the principle of double-balloon enteroscopy, developed for the small intestine, be applied to the colon in the case of difficult colonoscopy by associating a colonoscope with a balloon and an over-tube, also equipped with a balloon.
Patients and methods: From the experience acquired in double-balloon enteroscopy, we tested the double-balloon colonoscope developed by FUJINON Inc. (Saitama, Japan), based on the same technology, in 12 patients in whom the initial colonoscopy was incomplete, even though it was performed by experienced endoscopists.
Results: Double-balloon colonoscopy (DBC) was completed in 11 out of 12 patients explored. The endoscopic procedure was easy and without complication.
Discussion/Conclusions: It is currently possible to use the double-balloon colonoscope in the event of an incomplete examination performed with a classical colonoscope. The technical procedures for performing this DBC are relatively easy, although the technique should be validated on a larger number of patients for the purpose of cost-effectiveness evaluation.
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Références
Waye JD, Bashkoff E. Total colonoscopy: is it always possible? Gastrointest Endosc 1991; 37: 152–4.
Marshall JB, Barthel JS. The frequency of total colonoscopy and terminal ileal intubation in the 1990s. Gastrointest Endosc 1993; 39: 518–20.
Canard JM, Debette-Gratien M, Dumas R, Escourrou J, Gay G, Giovannini M, Greff M, Grimaud JC, Helbert T, Marchetti B, Lapuelle J, Napoleon B, Palazzo L, Ponchon T, Rey JF, Sautereau D, la Société Francaise d’Endoscopie Digestive (SFED). A prospective national study on colonoscopy and sigmoidoscopy in 2000 in France. Gastroenterol Clin Biol 2005; 29: 17–22.
Anderson JC, Gonzalez JD, Messina CR, Pollack BJ. Factors that predict incomplete colonoscopy: thinner is not always better. Am J Gastroenterol 2000; 95: 2784–7.
Anderson JC, Messina CR, Cohn W et al. Factors predictive of difficult colonoscopy. Gastrointest Endosc 2001; 54: 558–62.
Takahashi Y, Tanaka H, Kinjo M, Sakumoto K. Prospective evaluation of factors predicting difficulty and pain during sedation-free colonoscopy. Dis Colon Rectum 2005; 48: 1295–300.
Hull T, Church JM. Colonoscopy: how difficult, how painful? Surg Endosc 1994; 8: 784–7.
Anonymous. Conférence de Consensus: Prévention, dépistage et prise en charge des cancers du côlon. Gastroentérol Clin Biol 1998; 22: 205–8.
American Society for Gastrointestinal Endoscopy. Guidelines for colo-rectal cancer screening and surveillance. Gastrointest Endosc 2000; 51: 777–82.
Rex DK, Johnson DA, Lieberman DA et al. Colo-rectal cancer prevention: Screening recommendations of American College of Gastroenterology. Am J Gastroenterol 2000; 95: 868–77.
Anonymous. Recommendations on cancer screening in the European Union. Bull Cancer 2001; 88: 687–92.
Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Lino S, Ido K, Sugano K. Total enteroscopy with a non-surgical steerable double-balloon method. Gastrointest Endosc 2001; 53: 216–20.
Yamamoto H, Kita H, Sunada K et al. Colonoscopy using a double-balloon endoscope for technical difficult cases. Endoscopy 2005; 37: A53.
May A et al. Push-and-Pull Enteroscopy with Single-Balloon Technique for Difficult Colonoscopy. Endoscopy 2006; 38: 395–8.
Saifuddin T, Trivedi M, King PD, Madsen R, Marshall JB. Usefulness of a pediatric colonoscope for colonoscopy in adults. Gastrointest Endosc 2000; 51: 314–7.
Rex DK, Goodwine BW. Method of colonoscopy in 42 consecutive patients presenting after prior incomplete colonoscopy. Am J Gastroenterol 2002; 97: 1148–51.
Vucelic B, Rex D, Pulanic R, Pfefer J, Hrstic I, Levin B, Halpern Z, Arber N. The aero-scope: proof of concept of a pneumatic, skill-independent, self-propelling, self-navigating colonoscope. Gastroenterology 2006; 130: 672–7.
Bar-Meir S, Wallace MB. Diagnostic colonoscopy: The end is coming. Gastroenterology 2006; 131: 992–4.
Horiuchi A, Nakayama Y, Kajiyama M, Fujii H, Tanaka N. Usefulness of a small-caliber, variable-stiffness colonoscope as a backup in patients with difficult or incomplete colonoscopy. Am J Gastroenterol 2004; 99: 1936–40.
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Gay, G., Delvaux, M. Le coloscope double-ballon (CDB), une solution pour les coloscopies difficiles?. Acta Endosc 37, 51–61 (2007). https://doi.org/10.1007/BF02961816
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DOI: https://doi.org/10.1007/BF02961816