Impact of prior different abdominal or pelvic surgery on cecal intubation time: a prospective observational study

Background: Studies investigating the effect of different abdominopelvic surgeries on cecal intubation time (CIT) are limited and their results are heterogeneous. The aim of this study was to investigate the effect of different abdominopelvic surgeries on CIT.

Methods: The study was designed as a single-center, prospective, investigator-blinded and compared patients with previous pelvic surgery, appendectomy, hepatobiliary surgery, upper abdominal region surgery, and umbilical hernioraphy with patients that had no history of surgery. Factors associated with prolonged CIT (>600 sec) were determined using both univariate and multivariate analyses.

Results: This study included a total of 1,420 consecutive colonoscopy procedures that were undertaken between October 2018 and December 2019. The patients comprised 55.1% women and the mean age was 53.05±13.9 years. Mean CIT was 361.87±192.2 sec and prolonged CIT was detected in 176 (12.4%) patients. Of all patients, 523 (36.8%) of them had a history of abdominopelvic surgery. On multivariate analysis, diabetes mellitus (p=0.032, OR 1.766, 95% CI 1.051-2.968) and previous umbilical hernioraphy (p=0.002, OR 3.614, 95% CI 1.623-8.049) were found to be significant factors for CIT and prolonged CIT.

Conclusion: Previous umbilical hernioraphy and diabetes mellitus were identified as independent factors associated with prolonged CIT and difficult colonoscopy.

Keywords: Cecal intubation time, colonoscopy, abdominopelvic surgery, umbilical hernioraphy.