Effect of Previous Gastrectomy on the Performance of Postoperative Colonoscopy
Journal of Gastric Cancer
;
: 167-176, 2016.
Article
in English
| WPRIM
| ID: wpr-216434
ABSTRACT
PURPOSE:
The purpose of this study was to determine the effect of a prior gastrectomy on the difficulty of subsequent colonoscopy, and to identify the surgical factors related to difficult colonoscopies. MATERIALS ANDMETHODS:
Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (16) to patients with no history of gastrectomy (n=2,892). Cecal insertion time, intubation failure, and bowel clearance score were compared between the gastrectomy and control groups, as was a newly generated comprehensive parameter for a difficult/incomplete colonoscopy (cecal intubation failure, cecal insertion time >12.9 minutes, or very poor bowel preparation scale). Surgical factors including surgical approach, extent of gastrectomy, extent of lymph node dissection, and reconstruction type, were analyzed to identify risk factors for colonoscopy performance.RESULTS:
A history of gastrectomy was associated with prolonged cecal insertion time (8.7±6.4 vs. 9.7±6.5 minutes; P=0.002), an increased intubation failure rate (0.1% vs. 1.9%; P<0.001), and a poor bowel preparation rate (24.7 vs. 29.0; P=0.047). Age and total gastrectomy (vs. partial gastrectomy) were found to be independent risk factors for increased insertion time, which slowly increased throughout the postoperative duration (0.35 min/yr). Total gastrectomy was the only independent risk factor for the comprehensive parameter of difficult/incomplete colonoscopy.CONCLUSIONS:
History of gastrectomy is related to difficult/incomplete colonoscopy performance, especially in cases of total gastrectomy. In any case, it may be that a pre-operative colonoscopy is desirable in selected patients scheduled for gastrectomy; however, it should be performed by an expert endoscopist each time.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Period
/
Risk Factors
/
Colonoscopy
/
Gastrectomy
/
Intubation
/
Lymph Node Excision
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Journal of Gastric Cancer
Year:
2016
Type:
Article
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