The use of the 130-cm colonoscope for screening flexible sigmoidoscopy

The 130-cm colonoscope was utilized to determine whether a deeper insertion could be accomplished after the usual enema preparation for routine flexible sigmoidoscopy and, if so, to what extent that would enhance the yield of neoplastic findings. Sixty-four patients were examined, and intubation was accomplished to the level of 69 cm compared with 48.1 cm for a matched control group that had flexible sigmoidoscopy with the 60-cm endoscope. Another 24 patients who had a barium enema prep had a significantly greater depth of insertion (81.4 cm). Only two polyps were found proximal to 60 cm. The 130-cm colonoscope does not offer any substantial advantage over the standard 60-cm sigmoidoscope unless a bowel preparation more thorough than enemas is given and then it would probably only be worthwhile using the colonoscope in patients who are above average risk for colorectal neoplasia.