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Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy

BACKGROUND AND STUDY AIMS:  Incomplete colonoscopy may occur as a result of colon angulation (adhesions or diverticulosis), endoscope looping, or both. Specialty endoscopes/devices have been shown to successfully complete prior incomplete colonoscopies, but may not be widely available. Radiographic...

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Autores principales: Rogers, Melinda C., Gawron, Andrew, Grande, David, Keswani, Rajesh N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2017
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595582/
https://www.ncbi.nlm.nih.gov/pubmed/28924595
http://dx.doi.org/10.1055/s-0043-114663
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author Rogers, Melinda C.
Gawron, Andrew
Grande, David
Keswani, Rajesh N.
author_facet Rogers, Melinda C.
Gawron, Andrew
Grande, David
Keswani, Rajesh N.
author_sort Rogers, Melinda C.
collection PubMed
description BACKGROUND AND STUDY AIMS:  Incomplete colonoscopy may occur as a result of colon angulation (adhesions or diverticulosis), endoscope looping, or both. Specialty endoscopes/devices have been shown to successfully complete prior incomplete colonoscopies, but may not be widely available. Radiographic or other image-based evaluations have been shown to be effective but may miss small or flat lesions, and colonoscopy is often still indicated if a large lesion is identified. The purpose of this study was to develop and validate an algorithm to determine the optimum endoscope to ensure completion of the examination in patients with prior incomplete colonoscopy. PATIENTS AND METHODS:  This was a prospective cohort study of 175 patients with prior incomplete colonoscopy who were referred to a single endoscopist at a single academic medical center over a 3-year period from 2012 through 2015. Colonoscopy outcomes from the initial 50 patients were used to develop an algorithm to determine the optimal standard endoscope and technique to achieve cecal intubation. The algorithm was validated on the subsequent 125 patients. RESULTS:  The overall repeat colonoscopy success rate using a standard endoscope was 94 %. The initial standard endoscope specified by the algorithm was used and completed the colonoscopy in 90 % of patients. CONCLUSIONS:  This study identifies an effective strategy for completing colonoscopy in patients with prior incomplete examination, using widely available standard endoscopes and an algorithm based on patient characteristics and reasons for prior incomplete colonoscopy.
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spelling pubmed-55955822017-09-18 Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy Rogers, Melinda C. Gawron, Andrew Grande, David Keswani, Rajesh N. Endosc Int Open BACKGROUND AND STUDY AIMS:  Incomplete colonoscopy may occur as a result of colon angulation (adhesions or diverticulosis), endoscope looping, or both. Specialty endoscopes/devices have been shown to successfully complete prior incomplete colonoscopies, but may not be widely available. Radiographic or other image-based evaluations have been shown to be effective but may miss small or flat lesions, and colonoscopy is often still indicated if a large lesion is identified. The purpose of this study was to develop and validate an algorithm to determine the optimum endoscope to ensure completion of the examination in patients with prior incomplete colonoscopy. PATIENTS AND METHODS:  This was a prospective cohort study of 175 patients with prior incomplete colonoscopy who were referred to a single endoscopist at a single academic medical center over a 3-year period from 2012 through 2015. Colonoscopy outcomes from the initial 50 patients were used to develop an algorithm to determine the optimal standard endoscope and technique to achieve cecal intubation. The algorithm was validated on the subsequent 125 patients. RESULTS:  The overall repeat colonoscopy success rate using a standard endoscope was 94 %. The initial standard endoscope specified by the algorithm was used and completed the colonoscopy in 90 % of patients. CONCLUSIONS:  This study identifies an effective strategy for completing colonoscopy in patients with prior incomplete examination, using widely available standard endoscopes and an algorithm based on patient characteristics and reasons for prior incomplete colonoscopy. © Georg Thieme Verlag KG 2017-09 2017-09-12 /pmc/articles/PMC5595582/ /pubmed/28924595 http://dx.doi.org/10.1055/s-0043-114663 Text en © Thieme Medical Publishers
spellingShingle Rogers, Melinda C.
Gawron, Andrew
Grande, David
Keswani, Rajesh N.
Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title_full Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title_fullStr Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title_full_unstemmed Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title_short Development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
title_sort development and validation of an algorithm to complete colonoscopy using standard endoscopes in patients with prior incomplete colonoscopy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595582/
https://www.ncbi.nlm.nih.gov/pubmed/28924595
http://dx.doi.org/10.1055/s-0043-114663
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