Published: 2016-12-20

Impact of sex and body mass index on cecal intubation time. Is it a myth that colonoscopy is easier to perform in obese than lean people?

Division of Dietetic, Department of Gastroenterology and Hepatology, Wroclaw Medical University
Division of Dietetic, Department of Gastroenterology and Hepatology, Wroclaw Medical University
Department of Gastroenterology, Distric Hospital in Świdnica
colonoscopy cecal intubation time quality in colonoscopy

Abstract

Introduction. Colonoscopy is the gold standard for prevention and early diagnosis of colorectal cancer. Procedure quality is an important issue. Current quality indicators, such as cecal intubation rate, adenoma detection rate, and withdrawal time, are important, but cecum intubation time influences all of them. Factors that determine cecal intubation time (CIT) include body mass index (BMI), age, sex, history of abdominal surgery, quality of bowel preparation, and visceral adipose tissue. Among those who perform colonoscopy, it is believed that the procedure is easier to perform in obese people.
Aim. To determine whether cecal intubation time depends on body mass index and sex of patients undergoing colonoscopy.
Material and Methods. An analysis of the technical aspects of colonoscopy, such as the time required to intubate the cecum, with respect to BMI and sex in 100 patients.
Results. The average time taken to reach the cecum or ileum was slightly longer in obese people than in people with normal weight. Average CIT was almost one minute longer in men than women. Average CIT in obese men was slightly longer than in normal weight men. There was no difference in average CIT in obese and normal weight women. The differences were not statistically significant.
Conclusions. This study demonstrates that the claim that endoscopic examination of the lower gastrointestinal tract is easier to perform in obese people cannot be objectively confirmed.

Downloads

Download data is not yet available.

References

  1. Kotowski B, Kamiński MF, Rupiński M et al. Analiza jakości kolonoskopii w Ogólnopolskim Programie Badań Przesiewowych dla Wczesnego Wykrywania Raka Jelita Grubego. Gastroenterologia Kliniczna. 2009;1(1):45–53.
  2. Atia MA, Ramirez FC, Gurudu SR. Quality monitoring in colonoscopy: Time to act. World J Gastrointest Endosc. 2015 Apr 16;7(4):328–335.
  3. Ennaifer R, Elleuch N, Sabbagh S et al. Quality indicators for colonoscopy in a Tunisian endoscopy unit. Tunis Med. 2015 Mar;93(3):138–141.
  4. Allen JI. Quality measures for colonoscopy: where should we be in. 2015. Curr Gastroenterol Rep. 2015 Mar;17(3):10.
  5. Anderson JC, Butterly LF. Colonoscopy: quality indicators. Clin Transl Gastroenterol. 2015 Feb 26;6:e77.
  6. Lee TJ, Rees CJ, Blanks RG et al. Colonoscopic factors associated with adenoma detection in a national colorectal cancer screening program. Endoscopy. 2014 Mar;46(3):203–211.
  7. Brunner KT, Calderwood AH. Quality in Colonoscopy. Curr Gastroenterol Rep. 2015 Oct;17(10):401.
  8. Choung BS, Kim SH, Yoo KB et al. Should Assessment of Quality Indicator of Colonoscopy Be Varied Depending on the Colonoscopic Technique Level? Dig Dis Sci. 2015 Nov 17 [epub ahead of print].
  9. Benson ME, Reichelderfel M, Said A et al. Variation in colonoscopic technique and adenoma detection rates at anacademic gastroenterology unit. Di Dis Sci. 2010 Jan;55(1):166–171.
  10. Morini S, Hassan C, Zullo A. Detection of colonic polyps according to insertion/withdrawal phases of colonoscopy. Int J Colorectal Dis. 2009 May:24(5):527–530.
  11. Park HJ, Hong JH, Kim HS et al. Preictive factors affecting cecal intubaction failure in colonoscopy trainees. BMC Med Educ. 2013 Jan 19;13:5.
  12. Chung GE, Lim SH, Yang SY et al. Factors that determine prolonged cecal intubation time during colonoscopy: impact of visceral adipose tissue. Scand J Gastroenterrol. 2014;49:1261–1267.
  13. Park HJ, Hong JH, Kim HS et al. Predictive factors affecting cecal intubation failure in colonoscopy trainees. BMC Med Educ. 2013;13:5.
  14. Uddin FS, Iqbal R, Harford WV et al. Prone positioning of obese patients for coonoscopy results in sghortened cecal intubation time: a randomized trial. Dig Dis Sci. 2013;58(3):782–787.
  15. Bernstein C, Thorn M, Monsees K et al. A prospective study of factors that determine cecal intubation time at colonoscopy. Gastroinetest Endosc. 2005;61(1):72–75.
  16. Anderson JC, Gonzales JD, Messina CR, et. Factors that predict incomplete colonoscopy: thinner is not always better. Am J Gastroenterol. 2000;95(10):2784–2787.

How to Cite

1.
Poniewierka E, Dudkowiak R, Marczyński W. Impact of sex and body mass index on cecal intubation time. Is it a myth that colonoscopy is easier to perform in obese than lean people?. JMS [Internet]. 2016Dec.20 [cited 2020Aug.8];85(4):298. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/183