GOALS: This large prospective study attempted to analyze the effect of various prior surgery on colonoscopy performance. BACKGROUND: It is generally presumed that colonoscopy in patients with a history of abdominal or pelvic surgery is difficult. This difficulty is apparently due to adhesions and anatomic alterations after surgery but the incidence, site, and severity of adhesions are different according to the types of surgery. STUDY: We analyzed completion rate and insertion time in 4089 consecutive colonoscopies in patients with intact colon. RESULTS: The adjusted completion rate for colonoscopy was 96.7%. The mean insertion time was 6.2+/-4.0 minutes. Not only old age [odds ratio (OR) 1.46; 95% confidence interval (CI) [1.04, 2.04]] and inadequate bowel cleansing (OR 5.82; 95% CI [4.19, 8.09]) but also a surgical history (OR 1.71; 95% CI [1.18, 2.48]) were independent factors associated with procedural incompleteness. Of surgical history, gastrectomy and hysterectomy were significantly associated with procedural incompleteness (P<0.001 and P=0.001, respectively). Old age (OR 1.48; 95% CI [1.22, 1.79]), female sex (OR 1.22; 95% CI [1.01, 1.48]), constipation as an indication (OR 1.58; 95% CI [1.24, 2.02]), and inadequate bowel cleansing (OR 1.46; 95% CI [1.13, 1.88]) were independent factors associated with prolonged insertion time (>10 min), but a surgical history lost statistical power as a predictor for prolonged insertion time in multivariate analysis. CONCLUSIONS: Although the difference in insertion time was not substantial, a history of abdominal or pelvic surgery is associated with difficulty in colonoscopy.
GOALS: This large prospective study attempted to analyze the effect of various prior surgery on colonoscopy performance. BACKGROUND: It is generally presumed that colonoscopy in patients with a history of abdominal or pelvic surgery is difficult. This difficulty is apparently due to adhesions and anatomic alterations after surgery but the incidence, site, and severity of adhesions are different according to the types of surgery. STUDY: We analyzed completion rate and insertion time in 4089 consecutive colonoscopies in patients with intact colon. RESULTS: The adjusted completion rate for colonoscopy was 96.7%. The mean insertion time was 6.2+/-4.0 minutes. Not only old age [odds ratio (OR) 1.46; 95% confidence interval (CI) [1.04, 2.04]] and inadequate bowel cleansing (OR 5.82; 95% CI [4.19, 8.09]) but also a surgical history (OR 1.71; 95% CI [1.18, 2.48]) were independent factors associated with procedural incompleteness. Of surgical history, gastrectomy and hysterectomy were significantly associated with procedural incompleteness (P<0.001 and P=0.001, respectively). Old age (OR 1.48; 95% CI [1.22, 1.79]), female sex (OR 1.22; 95% CI [1.01, 1.48]), constipation as an indication (OR 1.58; 95% CI [1.24, 2.02]), and inadequate bowel cleansing (OR 1.46; 95% CI [1.13, 1.88]) were independent factors associated with prolonged insertion time (>10 min), but a surgical history lost statistical power as a predictor for prolonged insertion time in multivariate analysis. CONCLUSIONS: Although the difference in insertion time was not substantial, a history of abdominal or pelvic surgery is associated with difficulty in colonoscopy.
Authors: Hui Won Jang; Jae Hee Cheon; Chung Mo Nam; Chang Mo Moon; Jin Ha Lee; Soung Min Jeon; Jae Jun Park; Tae Il Kim; Won Ho Kim Journal: Surg Endosc Date: 2011-02-07 Impact factor: 4.584
Authors: Ja Sung Choi; Young Hoon Youn; Sang Kil Lee; Jin Yi Choi; Hee Man Kim; Yu Jin Kim; Ki Jun Han; Hyeon Geun Cho; Si Young Song; Jae Hee Cho Journal: Surg Endosc Date: 2013-01-26 Impact factor: 4.584