Investigation of the relationship between colonoscopy insertion difficulty factors and endoscope shape using an endoscopic position detection unit.

ABSTRACT

In this study, we investigated the relationship between the cecal intubation time (CIT) and the form and method used for passing through the sigmoid/descending colon junction (SDJ) and the hepatic flexure using an endoscopic position detection unit (UPD), with reference to various factors [age, sex, body mass index (BMI), history of abdominal and pelvic surgery, and diverticulum]. A total of 152 patients underwent colonoscopy with UPD. The mean age was 66.9 ±â€…12.4 years, and the male to female ratio was 3.61. The average CIT time was 14.3 ±â€…8.2 min. Age, number of experienced endoscopies, history of abdominal and pelvic surgery, BMI, and diverticulum were associated with prolonged CIT; SDJ passage pattern was straight 8.6 ±â€…5.0, alpha loop 11.8 ±â€…5.6, puzzle ring-like loop 20.2 ±â€…5.0, reverse alpha loop 22.4 ±â€…9.7, and other loop 24.7 ±â€…10.5. The hepatic flexure passing method was in the following order right rotation maneuver 12.6 ±â€…6.6, push maneuver 15.1 ±â€…5.9, and right rotation with positional change maneuver 20.5 ±â€…7.2. In conclusion, colonoscopy with UPD revealed an association between CIT and SDJ passage pattern and hepatic flexure passing method.