Journal of gastroenterology and hepatology · 2022
Factors associated with prolonged cecal insertion time in patients undergoing water exchange colonoscopy.
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Hsieh Yu-Hsi, Koo Malcolm, Tseng Chih-Wei
Аннотация
BACKGROUND AND AIM: Water exchange is superior to air insufflation in reducing discomfort and increasing adenoma detection during colonoscopy. However, prolonged cecal insertion time is a drawback. This study aims to investigate the factors affecting cecal insertion during water exchange colonoscopy.
METHODS: We pooled data from five randomized clinical trials that included patients undergoing water exchange colonoscopy. Logistic analysis was performed to determine the independent factors associated with prolonged cecal insertion time (> 15 min).
RESULTS: The cohort included 912 patients (493 men and 419 women) with a median age of 57 years (interquartile range, 49-64 years). The median cecal insertion time was 13.5 min (interquartile range, 10.9-17.0 min). Multivariate logistic regression analysis indicated that female sex, body mass index < 25 kg/m2 , a history of constipation, no sedation, less experienced endoscopist, Boston Bowel Preparation Scale score ≤ 6, infused water volume during insertion ≥ 1000 mL, and scope length at the cecum ≥ 85 cm were associated with prolonged cecal insertion time. With increasing volume of infused water (1000-2000 mL), the median cecal insertion time increased gradually from 11.4 to 23.0 min (P < 0.001).
CONCLUSIONS: The current study identified independent factors associated with prolonged cecal insertion time during water exchange colonoscopy. Several factors are modifiable to achieve a shorter insertion time, including better bowel preparation, the use of sedation, more experienced endoscopist, infusing less water during insertion, and maintaining a shorter scope length.
METHODS: We pooled data from five randomized clinical trials that included patients undergoing water exchange colonoscopy. Logistic analysis was performed to determine the independent factors associated with prolonged cecal insertion time (> 15 min).
RESULTS: The cohort included 912 patients (493 men and 419 women) with a median age of 57 years (interquartile range, 49-64 years). The median cecal insertion time was 13.5 min (interquartile range, 10.9-17.0 min). Multivariate logistic regression analysis indicated that female sex, body mass index < 25 kg/m2 , a history of constipation, no sedation, less experienced endoscopist, Boston Bowel Preparation Scale score ≤ 6, infused water volume during insertion ≥ 1000 mL, and scope length at the cecum ≥ 85 cm were associated with prolonged cecal insertion time. With increasing volume of infused water (1000-2000 mL), the median cecal insertion time increased gradually from 11.4 to 23.0 min (P < 0.001).
CONCLUSIONS: The current study identified independent factors associated with prolonged cecal insertion time during water exchange colonoscopy. Several factors are modifiable to achieve a shorter insertion time, including better bowel preparation, the use of sedation, more experienced endoscopist, infusing less water during insertion, and maintaining a shorter scope length.