Abstract
Endoscopic examination of the ileocecal region is now very difficult, even for experts. To make this easier, we investigated the insertion technique together with a fibercolonoscope designed for experiment (FCS) and an improved model. A total of 231 cases, consisting of 161 healthy cases and 70 cases with diseases in the ileocecal area, were studied. As a result, FCS-L 2, a model having a total length of 1, 866mm and an effective length of 1, 660 mm, was found to be easy to insert into the ileocecal region. Using this equipment, several patterns of insertion in to the ileocecal region were found to occur. Sufficient understanding and confirmation of these patterns are necessary to insert this FCS. Namely, 3 passageways in the region of the sigmoid colon, i. e., N-loop, Q-loop and α-loop, were observed, and there were 4 patterns of passage on the left and right sides of the colon. The passageways of the FCS inserted into the ileocecal region can be divided into 5 patterns, among which pattern No. I, a simple form, had the highest insertion success rate into the ileum. The success of insertion into the ileocecal region was found to increase only when the appropriate technique was freely, used and based on a full recognition of the patterns mentioned above. The insertion success rate of FCS into the ileocecal region was generally higher in cases with organic diseases of the ileocecal region. Of particular note is that the success rate was 100% in cases with ulcerative colitis land cancer of the colon. In cases where insertion into the ileocecal region was impossible, intestinal abhesion due to previous laparotomy was the most common (48%) cause. The insertion success rate was also low in cases with diverticulosis of the right colon. Excluding these cases, the ileocecal insertion success rate using the FCS-L 2 was 96%.
The capacity of FCS-L 2 to perform observation and biopsy of the ileocecal region was also investigated:
