Factors that determine prolonged cecal intubation time during colonoscopy: impact of visceral adipose tissue

Abstract

Objective. Various factors including age, sex, body mass index (BMI) and history of operation have been linked to the colonoscopic intubation time. The aims of this study were to identify the factors predicting cecal intubation time (CIT) and to evaluate the effect of the visceral adipose tissue (VAT) area on CIT. Material and methods. A total of 1386 consecutive subjects who underwent colonoscopy and abdominal CT on the same day for a health checkup at a single health care center in Korea from August to December 2011 were studied prospectively. Age, sex, BMI, height, waist circumference, history of operation, symptoms of irritable bowel syndrome, bowel preparation status, experience of colonoscopists, VAT amount on abdominal CT and time required to reach the cecum were analyzed. Results. The mean age of the subjects was 53.0 ± 9.6 years, and 63.5% were male. The median CIT was 271 s. Univariate analyses showed that female gender, old age, shorter height, lower BMI, prior history of surgery and lower VAT were associated with longer CIT. To adjust for confounding effects of the gender, we investigated the genders separately in multivariate analysis. Older age and lower VAT were associated with prolonged CIT. However, the significance of association of VAT on prolonged CIT disappeared in women. Conclusion. This study demonstrates that CIT is prolonged by lower VAT area in men. This is the first study to demonstrate a direct association between VAT area and CIT.

Key Words::

• cecal intubation
• colonoscopy
• visceral adipose tissue area

Acknowledgment

We thank the Medical Research Collaborating Center of Seoul National University Hospital for the statistical analysis performed for this study. Poster presentation at the 2013 CDDW (Canadian Digestive Diseases Week) Annual meeting at Fairmont Empress, Victoria, British Columbia, Canada, during March 1-4, 2013.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.