Robertson Alexander R, Koulaouzidis Anastasios, Yung Diana E, Fraser Christopher, Nemeth Artur, Trimble Kenneth, Toth Ervin, Plevris John N, Wurm Johansson Gabriele
Department of Gastroenterology, Western General Hospital, Edinburgh EH4 2XU, UK.
Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
J Clin Med. 2020 Sep 15;9(9):2981. doi: 10.3390/jcm9092981.
Conventional colonoscopy (CC) allows access for colonic investigation and intervention; in the small group in whom CC is unsuccessful alternative imaging is often sufficient. There remains a subset, however, requiring full colonic visualisation or intervention. Balloon-assisted colonoscopy (BAC) gives a further option when access is difficult. This study aims to present the experience with BAC of two European tertiary referral centres. Procedures were carried out under local protocol over 15-years (2006-2020). Markers of procedural quality such as caecal intubation, complications and comfort were retrospectively compiled and analysed. Published evidence was summarised for comparison. 122 procedures were undertaken, with polyps the most frequent indication and 90.2% having at least one previously incomplete CC. Features associated with difficult colonoscopy were common, including intraabdominal surgery (32.0%). 92.6% reached the caecum; completion was higher (96.3%) in those failing CC due to discomfort and lower in those failing due to anatomical difficulties (90.7%) or previous surgery (84.6%). Mean time to the caecum was 20.9 minutes and mean midazolam and fentanyl doses were 2.6 mg and 49.9 µg with low discomfort scores. Balloon-assisted colonoscopy is successful in >90% of patients, is well-tolerated, and is safe.
传统结肠镜检查（CC）可用于结肠检查和干预；在CC检查不成功的一小部分患者中，替代成像通常就足够了。然而，仍有一部分患者需要对整个结肠进行可视化检查或干预。当进入困难时，气囊辅助结肠镜检查（BAC）提供了另一种选择。本研究旨在介绍两个欧洲三级转诊中心的BAC经验。在15年（2006 - 2020年）期间按照当地方案进行了相关操作。对盲肠插管、并发症和舒适度等操作质量指标进行了回顾性整理和分析。总结已发表的证据以供比较。共进行了122例操作，息肉是最常见的适应证，90.2%的患者之前至少有一次CC检查未完成。与结肠镜检查困难相关的特征很常见，包括腹部手术史（32.0%）。92.6%的患者到达了盲肠；因不适导致CC检查失败的患者中完成率更高（96.3%），而因解剖困难（90.7%）或既往手术（84.6%）导致CC检查失败的患者中完成率较低。到达盲肠的平均时间为20.9分钟，咪达唑仑和芬太尼的平均剂量分别为2.6毫克和49.9微克，不适评分较低。气囊辅助结肠镜检查在超过90%的患者中是成功的，耐受性良好且安全。
