Factors for cecal intubation time during colonoscopy in women: Impact of surgical history
Ji Hyung Nam1, Jung Hyeon Lee2, Jae Hak Kim2, Hyoun Woo Kang2, Dong Kee Jang2, Yun Jeoung Lim2, Moon-Soo Koh2, Hyun Soo Park3, Eun-Cheol Park4, Jun Kyu Lee2, Jin Ho Lee2
1 Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang; Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea
2 Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
3 Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
4 Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
Jun Kyu Lee,
Department of Internal Medicine, Dongguk University College of Medicine, Ilsan Hospital, Dongguk-ro 27, Ilsandong-gu, Goyang-si, Gyeonggi-do - 10326
Republic of Korea
Source of Support: None, Conflict of Interest: None
Background/Aim: Cecal intubation during colonoscopy is prone to be prolonged in women, which may be related to frequent exposure to pelvic/abdominal surgery. We evaluated the association between Cecal Intubation Time (CIT) and prior episodes of pelvic/abdominal surgery in women.
Patients and Methods: A cross-sectional study was conducted on screening participants who underwent colonoscopy. Multivariate regression with parameter estimates (β) was performed to determine the factors affecting CIT, including age, body mass index (BMI), bowel preparation, sedation, diverticulosis, experience of colonoscopists, and a surgical history. Also, subgroup analyses according to type of surgery were performed.
Results: A total of 835 women were enrolled. The mean CIT was 5.82 ± 3.40 min. 323 females (38.7%) had episodes of surgery. The CIT was prolonged in cases performed by non-experienced trainees (β = 3.61, P< 0.001) and with a history of gynecological surgery (β = 0.97, P = 0.001). In the subgroup of non-experienced trainees, lower BMI, poor preparation, and a history of cesarean section significantly prolonged the CIT. Also, the risk for difficult colonoscopy (CIT ≥ 15 min) was increased with a history of cesarean section (odds ratio = 4.43, P= 0.024).
Conclusion: A prior episode of gynecological surgery prolonged CIT. Also, cesarean section history was associated with difficult colonoscopy in the examination by non-experienced trainees.