Factors associated with prolonged cecal insertion time in patients undergoing water exchange colonoscopy

Background and Aim Water exchange is superior to air insufflation in reducing discomfort and increasing adenoma detection during colonoscopy. However, prolonged cecal insertion time is a drawback. This study aims to investigate the factors affecting cecal insertion during water exchange colonoscopy. Methods We pooled data from five randomized clinical trials that included patients undergoing water exchange colonoscopy. Logistic analysis was performed to determine the independent factors associated with prolonged cecal insertion time (> 15 min). Results The cohort included 912 patients (493 men and 419 women) with a median age of 57 years (interquartile range, 49–64 years). The median cecal insertion time was 13.5 min (interquartile range, 10.9–17.0 min). Multivariate logistic regression analysis indicated that female sex, body mass index