Despott Edward J, Murino Alberto, Nakamura Masanao, Bourikas Leonidas, Fraser Chris
Royal Free Unit for Endoscopy and Centre for Gastroenterology, UCL Institute for Liver and Digestive Health, Royal Free NHS Foundation Trust, London, United Kingdom; Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, London, United Kingdom.
Royal Free Unit for Endoscopy and Centre for Gastroenterology, UCL Institute for Liver and Digestive Health, Royal Free NHS Foundation Trust, London, United Kingdom; Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, London, United Kingdom.
Dig Liver Dis. 2017 May;49(5):507-513. doi: 10.1016/j.dld.2017.01.139. Epub 2017 Feb 14.
Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon.
We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC. Pain, sedation dose, colonoscopy completeness, time taken for cecal intubation, procedure completion, recovery time and patient satisfaction were recorded.
Forty-four patients were recruited (DBC=22; CC=22). DBC facilitated total colonoscopy in 22 cases whereas 9 CC procedures were incomplete (P=0.019). Median pre-procedure difficulty scores were equal for both groups (4.0 vs. 4.0). Mean patient discomfort, pain scores and recovery time were significantly lower for the DBC group (2.3 vs. 5.5, P=0.001; 2.0 vs. 5.9, P=0.005; 5 vs. 20min, P=0.014 respectively). Mean time taken for cecal intubation was similar (17.5 vs. 14min, P=0.18); CONCLUSION: DBC facilitates colonoscopy completion and may be a more comfortable alternative to CC for TD cases although the time taken to achieve caecal intubation was similar.
技术上“困难的”（TD）结肠镜检查与结肠镜检查不完整、不适以及操作时间延长有关。双气囊结肠镜检查（DBC）可能有助于进行TD结肠镜检查。主要结局是比较常规结肠镜检查（CC）和DBC对TD结肠患者进行盲肠插管所需的时间。
我们进行了一项前瞻性随机研究，比较DBC和CC用于TD结肠镜检查的效果。使用原始评分系统筛选预测TD结肠镜检查的参数的患者，并随机分为DBC组或CC组。记录疼痛、镇静剂量、结肠镜检查完整性、盲肠插管所需时间、操作完成情况、恢复时间和患者满意度。
招募了44例患者（DBC组=22例；CC组=22例）。DBC组22例完成了全结肠镜检查，而CC组9例未完成（P=0.019）。两组术前难度评分中位数相等（4.0对4.0）。DBC组患者的平均不适、疼痛评分和恢复时间显著更低（分别为2.3对5.5，P=0.001；2.0对5.9，P=0.005；5对20分钟，P=0.014）。盲肠插管的平均时间相似（17.5对14分钟，P=0.18）。结论：DBC有助于完成结肠镜检查，对于TD病例，DBC可能是比CC更舒适的选择，尽管盲肠插管所需时间相似。
