Utility of double-balloon colonoscopy for completion of colon examination after incomplete colonoscopy with conventional colonoscope

Background: The failure rate of cecal intubation with conventional colonoscopy is 5% to 10%. Double-balloon endoscopy is a new technique for antegrade or retrograde examination of the small intestine, with a flexible scope and a sliding overtube with a balloon at the distal end of both. The entire colon can be shortened and evaluated by the push-and-pull technique, which allows diagnostic and therapeutic interventions (eg, biopsies). Objective: To evaluate the completion rate of double-balloon endoscopy for colon evaluation (ie, double-balloon colonoscopy) and therapeutic interventions after a prior incomplete colonoscopy by conventional colonoscope. Design: Retrospective chart review. Setting: Tertiary-care academic medical center. Patients: Sixteen patients (11 women and 5 men; mean age, 69 years) had retrograde double-balloon endoscopy between April 20, 2005, and February 8, 2006, after a prior incomplete colonoscopy. Interventions: Completion of colonoscopy with therapeutic interventions, such as polypectomy and hemostasis. Main Outcome Measurements: Completion rate of double-balloon colonoscopy, therapeutic success of standard procedures, and postprocedure complications. Results: A completion rate of 88% (14 patients), successful performance of standard therapeutic procedures, and no procedure-related complications. Double-balloon colonoscopy was generally performed with the patient under conscious sedation in a mean (standard deviation) total procedure time (including therapeutics) of 50.6 minutes (SD, 15.2 minutes). Limitations: Retrospective nature of study. Conclusions: Double-balloon colonoscopy has a high rate of effectiveness for completion of colon evaluation in patients with incomplete conventional colonoscopy. It allows diagnostic and therapeutic interventions and can be performed with the patient under conscious sedation within a reasonable time.