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?

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.

Cecal intubation time in screening colonoscopy

“…Previous studies have identified several factors affecting prolonged CIT, including age, [ 14 ] sex, [ 15 ] BMI, [ 9 , 14 ] fat adipose tissue, waist circumference, [ 16 ] diverticulosis, [ 8 ] bowel preparation status, [ 17 ] and prior abdominal or pelvic surgery [ 14 ] ; however, these findings remain controversial. Understanding the factors affecting prolonged CIT is meaningful toward complete colonoscopy, as it will allow decreasing the burden on the colonoscopist or the fatigue of procedure, the discomfort of patients, and the risk of complications.…”