Background: Interest in effective ways to complete colon examinations in patients who had previously undergone failed colonoscopies has increased recently. Objective: To determine whether water immersion decreased the need for ancillary equipment to achieve cecal intubation in patients who had previously undergone incomplete colonoscopies. Design: Retrospective cohort study. Setting: Tertiary academic center. Patients: A total of 345 consecutive patients referred to a tertiary center for the indication of a previous incomplete colonoscopy. Interventions: Colonoscopy with or without water immersion insertion. Main Outcome Measurements: Cecal intubation rates, type of equipment, and maneuvers used. Results: Cecal intubation was achieved in 332 of 345 patients (96.2%) and was similar in those with and without water immersion (170/178, 95.5% vs 162/167, 97%, P =.58). An external straightening device was used in 6 of 178 cases with water immersion (3.4%) compared with 25 of 168 cases with air insufflation (15%) (P <.0001). Among patients with a redundant colon as the sole cause of previously incomplete examinations, water immersion required an external straightener in 7% compared with 37% with air insufflation during insertion (P <.0001), and position change was required in 5% of those with water immersion compared with 22% with air insufflation (P =.01). Limitations: Retrospective review; single-center, single-endoscopist study. Conclusion: Water immersion decreases the need for external straightening devices and position change maneuvers in patients with redundant colons and previously incomplete colonoscopies.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging