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Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?

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Abstract

Background

A history of abdominal surgery is associated with difficulty in colonoscopy insertion. Few studies have reported effective colonoscopy insertion for patients who underwent abdominal surgery due to stomach cancer.

Aim

We aimed to compare the impact of supine position (SP) and left lateral position (LLP) as the starting position of colonoscopy insertion in patients who underwent abdominal surgery due to stomach cancer.

Methods

This was a prospective, randomized controlled trial. Patients undergoing colonoscopy for screening or post-polypectomy surveillance after gastrectomy due to stomach cancer were enrolled and randomized to the SP or LLP group as the starting position of colonoscopy insertion. All colonoscopic examinations were performed with a transparent cap. The primary outcome was to compare the cecal intubation time between the two groups.

Results

A total of 224 patients were enrolled. The mean cecal intubation time was not significantly different between the SP and LLP groups (364.5 s versus 306.9 s; p = 0.105). In patients with a lower body mass index (< 21 kg/m2) or who underwent gastrectomy within three years, the mean cecal intubation time of the LLP group was shorter than the SP group. In the multivariate analysis for the factors affecting to increase in the cecal intubation time (> 5 min), the starting position was not an independent factor.

Conclusion

Either the SP or LLP could serve as a possible starting position of colonoscopy insertion for patients who underwent abdominal surgery due to stomach cancer.

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Author notes

  1. Jae Hyun Kim and Youn Jung Choi contributed equally to this article.

Authors and Affiliations

  1. Department of Internal Medicine, Kosin University College of Medicine, Gamcheonro 262, Seo-gu, Busan, 49267, Korea

    Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Gyu Man Oh, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park & Seun Ja Park

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  1. Jae Hyun Kim
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Correspondence to Seun Ja Park.

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Kim, J.H., Choi, Y.J., Kwon, H.J. et al. Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?. Dig Dis Sci 67, 4533–4540 (2022). https://doi.org/10.1007/s10620-021-07325-3

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  • DOI: https://doi.org/10.1007/s10620-021-07325-3

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