Predictors for Cecal Insertion Time: The Impact of Abdominal Visceral Fat Measured by Computed Tomography
BACKGROUND:Several factors affect the risk for longer cecal insertion time. OBJECTIVE:The aim of this study was to identify the predictors of longer insertion time and to evaluate the effect of visceral fat measured by CT. DESIGN:This is a retrospective observational study. PATIENTS:Outpatients for...
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| Veröffentlicht in: | Diseases of the colon & rectum 2014-10, Vol.57 (10), p.1213-1219 |
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| container_title | Diseases of the colon & rectum |
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| creator | Nagata, Naoyoshi Sakamoto, Kayo Arai, Tomohiro Niikura, Ryota Shimbo, Takuro Shinozaki, Masafumi Noda, Mitsuhiko Uemura, Naomi |
| description | BACKGROUND:Several factors affect the risk for longer cecal insertion time.
OBJECTIVE:The aim of this study was to identify the predictors of longer insertion time and to evaluate the effect of visceral fat measured by CT.
DESIGN:This is a retrospective observational study.
PATIENTS:Outpatients for colorectal cancer screening who underwent colonoscopies and CT were enrolled. Computed tomography was performed in individuals who requested cancer screening and in those with GI bleeding.
MAIN OUTCOME MEASURES:Information on obesity indices (BMI, visceral adipose tissue, and subcutaneous adipose tissue area), constipation score, history of abdominal surgery, poor preparation, fellow involvement, diverticulosis, patient discomfort, and the amount of sedation used was collected.
RESULTS:The cecal insertion rate was 95.2% (899/944), and 899 patients were analyzed. Multiple regression analysis showed that female sex, lower BMI, lower visceral adipose tissue area, lower subcutaneous adipose tissue area, higher constipation score, history of surgery, poor bowel preparation, and fellow involvement were independently associated with longer insertion time. When obesity indices were considered simultaneously, smaller subcutaneous adipose tissue area (p = 0.038), but not lower BMI (p = 0.802) or smaller visceral adipose tissue area (p = 0.856), was associated with longer insertion time; the other aforementioned factors remained associated with longer insertion time. In the subanalysis of normal-weight patients (BMI |
| doi_str_mv | 10.1097/DCR.0000000000000203 |
| format | Article |
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OBJECTIVE:The aim of this study was to identify the predictors of longer insertion time and to evaluate the effect of visceral fat measured by CT.
DESIGN:This is a retrospective observational study.
PATIENTS:Outpatients for colorectal cancer screening who underwent colonoscopies and CT were enrolled. Computed tomography was performed in individuals who requested cancer screening and in those with GI bleeding.
MAIN OUTCOME MEASURES:Information on obesity indices (BMI, visceral adipose tissue, and subcutaneous adipose tissue area), constipation score, history of abdominal surgery, poor preparation, fellow involvement, diverticulosis, patient discomfort, and the amount of sedation used was collected.
RESULTS:The cecal insertion rate was 95.2% (899/944), and 899 patients were analyzed. Multiple regression analysis showed that female sex, lower BMI, lower visceral adipose tissue area, lower subcutaneous adipose tissue area, higher constipation score, history of surgery, poor bowel preparation, and fellow involvement were independently associated with longer insertion time. When obesity indices were considered simultaneously, smaller subcutaneous adipose tissue area (p = 0.038), but not lower BMI (p = 0.802) or smaller visceral adipose tissue area (p = 0.856), was associated with longer insertion time; the other aforementioned factors remained associated with longer insertion time. In the subanalysis of normal-weight patients (BMI <25 kg/m), a smaller subcutaneous adipose tissue area (p = 0.002), but not a lower BMI (p = 0.782), was independently associated with a longer insertion time. Longer insertion time had a positive correlation with a higher patient discomfort score (ρ = 0.51, p < 0.001) and a greater amount of midazolam use (ρ = 0.32, p < 0.001).
LIMITATIONS:This single-center retrospective study includes a potential selection bias.
CONCLUSIONS:In addition to BMI and intra-abdominal fat, female sex, constipation, history of abdominal surgery, poor preparation, and fellow involvement were predictors of longer cecal insertion time. Among the obesity indices, high subcutaneous fat accumulation was the best predictive factor for easier passage of the colonoscope, even when body weight was normal.</description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1097/DCR.0000000000000203</identifier><identifier>PMID: 25203379</identifier><language>eng</language><publisher>United States: The American Society of Colon and Rectal Surgeons</publisher><subject>Abdomen - surgery ; Aged ; Body Mass Index ; Cecum ; Colonoscopy ; Constipation - complications ; Fellowships and Scholarships ; Female ; Humans ; Hypnotics and Sedatives - administration & dosage ; Intra-Abdominal Fat - anatomy & histology ; Intra-Abdominal Fat - diagnostic imaging ; Intubation, Gastrointestinal ; Male ; Midazolam - administration & dosage ; Middle Aged ; Multidetector Computed Tomography ; Predictive Value of Tests ; Retrospective Studies ; Sex Factors ; Subcutaneous Fat ; Time Factors</subject><ispartof>Diseases of the colon & rectum, 2014-10, Vol.57 (10), p.1213-1219</ispartof><rights>2014 The American Society of Colon and Rectal Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3010-345f2c77f558de8cdb02af24de40295b9a58df1e429be022e68c8eae479c773b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25203379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nagata, Naoyoshi</creatorcontrib><creatorcontrib>Sakamoto, Kayo</creatorcontrib><creatorcontrib>Arai, Tomohiro</creatorcontrib><creatorcontrib>Niikura, Ryota</creatorcontrib><creatorcontrib>Shimbo, Takuro</creatorcontrib><creatorcontrib>Shinozaki, Masafumi</creatorcontrib><creatorcontrib>Noda, Mitsuhiko</creatorcontrib><creatorcontrib>Uemura, Naomi</creatorcontrib><title>Predictors for Cecal Insertion Time: The Impact of Abdominal Visceral Fat Measured by Computed Tomography</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description>BACKGROUND:Several factors affect the risk for longer cecal insertion time.
OBJECTIVE:The aim of this study was to identify the predictors of longer insertion time and to evaluate the effect of visceral fat measured by CT.
DESIGN:This is a retrospective observational study.
PATIENTS:Outpatients for colorectal cancer screening who underwent colonoscopies and CT were enrolled. Computed tomography was performed in individuals who requested cancer screening and in those with GI bleeding.
MAIN OUTCOME MEASURES:Information on obesity indices (BMI, visceral adipose tissue, and subcutaneous adipose tissue area), constipation score, history of abdominal surgery, poor preparation, fellow involvement, diverticulosis, patient discomfort, and the amount of sedation used was collected.
RESULTS:The cecal insertion rate was 95.2% (899/944), and 899 patients were analyzed. Multiple regression analysis showed that female sex, lower BMI, lower visceral adipose tissue area, lower subcutaneous adipose tissue area, higher constipation score, history of surgery, poor bowel preparation, and fellow involvement were independently associated with longer insertion time. When obesity indices were considered simultaneously, smaller subcutaneous adipose tissue area (p = 0.038), but not lower BMI (p = 0.802) or smaller visceral adipose tissue area (p = 0.856), was associated with longer insertion time; the other aforementioned factors remained associated with longer insertion time. In the subanalysis of normal-weight patients (BMI <25 kg/m), a smaller subcutaneous adipose tissue area (p = 0.002), but not a lower BMI (p = 0.782), was independently associated with a longer insertion time. Longer insertion time had a positive correlation with a higher patient discomfort score (ρ = 0.51, p < 0.001) and a greater amount of midazolam use (ρ = 0.32, p < 0.001).
LIMITATIONS:This single-center retrospective study includes a potential selection bias.
CONCLUSIONS:In addition to BMI and intra-abdominal fat, female sex, constipation, history of abdominal surgery, poor preparation, and fellow involvement were predictors of longer cecal insertion time. Among the obesity indices, high subcutaneous fat accumulation was the best predictive factor for easier passage of the colonoscope, even when body weight was normal.</description><subject>Abdomen - surgery</subject><subject>Aged</subject><subject>Body Mass Index</subject><subject>Cecum</subject><subject>Colonoscopy</subject><subject>Constipation - complications</subject><subject>Fellowships and Scholarships</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - administration & dosage</subject><subject>Intra-Abdominal Fat - anatomy & histology</subject><subject>Intra-Abdominal Fat - diagnostic imaging</subject><subject>Intubation, Gastrointestinal</subject><subject>Male</subject><subject>Midazolam - administration & dosage</subject><subject>Middle Aged</subject><subject>Multidetector Computed Tomography</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Subcutaneous Fat</subject><subject>Time Factors</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1PgzAUhhujcfPjHxjTS2-Y_YAVvFvQ6ZIZjUFvSSkHQWHFFrLs31vc_Ii96TnN8749fYvQGSUTSiJxeR0_TcjfxQjfQ2MacOIRHoT7aEwIZR4XZDpCR9a-udZB4hCNWOBgLqIxqh4N5JXqtLG40AbHoGSNFysLpqv0CidVA1c4KQEvmlaqDusCz7JcN9XKcS-VVWBcMZcdvgdpe-eGsw2OddP2nasT3ehXI9tyc4IOCllbON3tx-h5fpPEd97y4XYRz5ae4m4-j_tBwZQQRRCEOYQqzwiTBfNz8AmLgiyS7ryg4LMoA8IYTEMVggRfRE7FM36MLra-rdEfPdgubYYp61quQPc2pcGU-oKKKHSov0WV0dYaKNLWVI00m5SSdAg5dSGn_0N2svPdDX3WQP4j-k7113et6w6Mfa_7NZi0BFl35ZefeyX3GKE-HTqPDF_DPwGrb4aj</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Nagata, Naoyoshi</creator><creator>Sakamoto, Kayo</creator><creator>Arai, Tomohiro</creator><creator>Niikura, Ryota</creator><creator>Shimbo, Takuro</creator><creator>Shinozaki, Masafumi</creator><creator>Noda, Mitsuhiko</creator><creator>Uemura, Naomi</creator><general>The American Society of Colon and Rectal Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201410</creationdate><title>Predictors for Cecal Insertion Time: The Impact of Abdominal Visceral Fat Measured by Computed Tomography</title><author>Nagata, Naoyoshi ; Sakamoto, Kayo ; Arai, Tomohiro ; Niikura, Ryota ; Shimbo, Takuro ; Shinozaki, Masafumi ; Noda, Mitsuhiko ; Uemura, Naomi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3010-345f2c77f558de8cdb02af24de40295b9a58df1e429be022e68c8eae479c773b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abdomen - surgery</topic><topic>Aged</topic><topic>Body Mass Index</topic><topic>Cecum</topic><topic>Colonoscopy</topic><topic>Constipation - complications</topic><topic>Fellowships and Scholarships</topic><topic>Female</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - administration & dosage</topic><topic>Intra-Abdominal Fat - anatomy & histology</topic><topic>Intra-Abdominal Fat - diagnostic imaging</topic><topic>Intubation, Gastrointestinal</topic><topic>Male</topic><topic>Midazolam - administration & dosage</topic><topic>Middle Aged</topic><topic>Multidetector Computed Tomography</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Sex Factors</topic><topic>Subcutaneous Fat</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nagata, Naoyoshi</creatorcontrib><creatorcontrib>Sakamoto, Kayo</creatorcontrib><creatorcontrib>Arai, Tomohiro</creatorcontrib><creatorcontrib>Niikura, Ryota</creatorcontrib><creatorcontrib>Shimbo, Takuro</creatorcontrib><creatorcontrib>Shinozaki, Masafumi</creatorcontrib><creatorcontrib>Noda, Mitsuhiko</creatorcontrib><creatorcontrib>Uemura, Naomi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagata, Naoyoshi</au><au>Sakamoto, Kayo</au><au>Arai, Tomohiro</au><au>Niikura, Ryota</au><au>Shimbo, Takuro</au><au>Shinozaki, Masafumi</au><au>Noda, Mitsuhiko</au><au>Uemura, Naomi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors for Cecal Insertion Time: The Impact of Abdominal Visceral Fat Measured by Computed Tomography</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2014-10</date><risdate>2014</risdate><volume>57</volume><issue>10</issue><spage>1213</spage><epage>1219</epage><pages>1213-1219</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><abstract>BACKGROUND:Several factors affect the risk for longer cecal insertion time.
OBJECTIVE:The aim of this study was to identify the predictors of longer insertion time and to evaluate the effect of visceral fat measured by CT.
DESIGN:This is a retrospective observational study.
PATIENTS:Outpatients for colorectal cancer screening who underwent colonoscopies and CT were enrolled. Computed tomography was performed in individuals who requested cancer screening and in those with GI bleeding.
MAIN OUTCOME MEASURES:Information on obesity indices (BMI, visceral adipose tissue, and subcutaneous adipose tissue area), constipation score, history of abdominal surgery, poor preparation, fellow involvement, diverticulosis, patient discomfort, and the amount of sedation used was collected.
RESULTS:The cecal insertion rate was 95.2% (899/944), and 899 patients were analyzed. Multiple regression analysis showed that female sex, lower BMI, lower visceral adipose tissue area, lower subcutaneous adipose tissue area, higher constipation score, history of surgery, poor bowel preparation, and fellow involvement were independently associated with longer insertion time. When obesity indices were considered simultaneously, smaller subcutaneous adipose tissue area (p = 0.038), but not lower BMI (p = 0.802) or smaller visceral adipose tissue area (p = 0.856), was associated with longer insertion time; the other aforementioned factors remained associated with longer insertion time. In the subanalysis of normal-weight patients (BMI <25 kg/m), a smaller subcutaneous adipose tissue area (p = 0.002), but not a lower BMI (p = 0.782), was independently associated with a longer insertion time. Longer insertion time had a positive correlation with a higher patient discomfort score (ρ = 0.51, p < 0.001) and a greater amount of midazolam use (ρ = 0.32, p < 0.001).
LIMITATIONS:This single-center retrospective study includes a potential selection bias.
CONCLUSIONS:In addition to BMI and intra-abdominal fat, female sex, constipation, history of abdominal surgery, poor preparation, and fellow involvement were predictors of longer cecal insertion time. Among the obesity indices, high subcutaneous fat accumulation was the best predictive factor for easier passage of the colonoscope, even when body weight was normal.</abstract><cop>United States</cop><pub>The American Society of Colon and Rectal Surgeons</pub><pmid>25203379</pmid><doi>10.1097/DCR.0000000000000203</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0012-3706 |
| ispartof | Diseases of the colon & rectum, 2014-10, Vol.57 (10), p.1213-1219 |
| issn | 0012-3706 1530-0358 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Abdomen - surgery Aged Body Mass Index Cecum Colonoscopy Constipation - complications Fellowships and Scholarships Female Humans Hypnotics and Sedatives - administration & dosage Intra-Abdominal Fat - anatomy & histology Intra-Abdominal Fat - diagnostic imaging Intubation, Gastrointestinal Male Midazolam - administration & dosage Middle Aged Multidetector Computed Tomography Predictive Value of Tests Retrospective Studies Sex Factors Subcutaneous Fat Time Factors |
| title | Predictors for Cecal Insertion Time: The Impact of Abdominal Visceral Fat Measured by Computed Tomography |
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