Efficacy of Double-Balloon Colonoscopy in Technically Difficult Cases: Growing Evidence Favoring its Frontline Use

We read with great interest the results of the meta-analysis by Tan et al1 that highlight the usefulness of balloon overtube-assisted colonoscopy for technically difficult (TD) cases. Interestingly, among the 18 studies included in this meta-analysis,1 only 3 were prospective randomized studies; this underlines the scarcity of higher-quality data regarding this important subject.

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