Use of a standard gastroscope for colonoscopy at a general hospital in Venezuela: A prospective randomized trial

Abstract 

Background and study aims

The use of an upper endoscope has been considered as a back-up method in case of incomplete caecal intubation. We compared caecal intubation rates between colonoscopic examinations done with a standard colonoscope and those in which a standard gastroscope was used, to determine if routine colonoscopies could be performed with a gastroscope if no colonoscope is available.

Patients and methods

A prospective comparative study, analyzing continuous data was designed to evaluate the usefulness of a standard gastroscope in a group of outpatients with indication for colonoscopy in colorectal cancer screening. A total of 170 adult patients were randomly assigned to two similar study groups. All examinations were performed by a single endoscopist. Our primary end point was to achieve caecal intubation.

Results

Successful caecal intubation was achieved in 162 patients that fulfilled our inclusion criteria, 83 patients in the colonoscope and 79 in the gastroscope group. Failure of caecal intubation was similar in male and female patients in both groups (p=0.34). Caecal intubation failure rates were similar in both study groups.

Conclusions

We used the gastroscope as a first line method for routine colonoscopies and found no statistical difference between the colonoscope and gastroscope groups. If these results can be verified in larger multicenter studies, it may be possible in the future, to work with only one endoscope for both upper and lower digestive tract examinations in small centers, particularly in developing countries.

Keywords: Gastroscope, Colonoscope, Caecal intubation, Colorectal cancer screening