Transparent cap‐assisted, water‐exchange colonoscopy in previous incomplete difficult colonoscopy patients: A retrospective study

Abstract

AbstractThe reported rates of incomplete colonoscopy (IC) range from 4% to 25% for both screening and nonscreening colonoscopy. Colonic neoplasm can be found in up to 53% on successful repeat colonoscopy. Transparent cap‐assisted colonoscopy (TCAC) and water‐exchange colonoscopy (WEC) have been applied seperately for repeat colonoscopy in the setting of failed difficult colonoscopy, but combination of these two methods for previous incomplete difficult colonoscopy has not been reported. The aim of this study is to report the success rate, time‐to cecum duration, polyp detection rate, and any complications using the combined methods of TCAC and WEC for previous incomplete difficult colonoscopy. Eight cases of incomplete difficult colonoscopy were enrolled from November 2016 to October 2018. Water exchange method (air‐less colonoscopy) performed during insertion of Cap‐fitted colonoscope, and after reaching the cecum, CO2 was insufflated for examination during withdrawal. The mean age of all eight female patients was 59 years (39‐72 year). One patient had failed colonoscopy twice previously, four had previous abdominal surgery. Six cases were performed by gastroenterologists, and two by colorectal surgeons previously. The cecal intubation rate was 100% on repeat colonoscopy with the combined TCAC and WEC methods without complications. The mean duration time to reach the ceum was 12.5 minutes (6.8‐23.3 minutes). Out of the eight patients, four had colon polyps, all confined to proximal colon. Two patients have advanced colon adenoma. Combining cap‐assisted colonoscopy (TCAC), and water exchange colonoscopy (WEC) are useful in previous incomplete colonoscopy cases.