FLUOROSCOPY - A VALUABLE ALLY DURING DIFFICULT COLONOSCOPY

Background: This study determines the pattern of fluoroscopy use durin g colonoscopy among a group of gastroenterologists and colon and recta l surgeons who have it readily available for each patient. Methods: On e thousand three hundred fifty-seven consecutive patients undergoing c olonoscopic examination were studied over a 16-month period. Results: Fluoroscopy was used during 34% of colonoscopic examinations. The freq uency of fluoroscopy use was significantly higher for women (41% vs 28 %, p < 0.001). Fluoroscopy was most commonly used to precisely locate the colonoscope tip (45%) or during manipulation of troublesome loops of colon (42%), thus accounting for 87% of 677 fluoroscopic checks. Th e most common location of the colonoscope tip during these fluoroscopi c checks was the hepatic flexure (23%) followed by the cecum (20%); 51 % involved the right colon. The selective use of fluoroscopy during th e more difficult cases was substantiated by the longer procedure time (36 vs 26 min) and significantly lower cecal intubation rate (74% vs 9 6%, p < 0.002) when fluoroscopy was required. Fluoroscopy also proved to be valuable when precisely locating pathology and teaching colonosc ope intubation techniques. Conclusions: Endoscopists who have fluorosc opy readily available often use it during difficult colonoscopic exami nations. Fluoroscopy is most commonly used to maneuver troublesome loo ps of colon or to precisely locate colonoscope tip position, especiall y when negotiating the right colon. Although this technology is more f requently required for women, fluoroscopic capability for all colonosc opic examinations is advantageous.