Factors Associated with Difficulty Maintaining Insufflation of the Colon During Endoscopy
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: Insufflation of the colon allows for adequate visualization of the mucosal tissue and advancement of the endoscope during colonoscopy. Most colonoscopies are performed with sedation to mitigate discomfort and enhance the colonoscopy experience for both the patient and the endoscopist.
AIM: We aimed to evaluate factors associated with difficulty maintaining insufflation.
METHODS: A cross-sectional study of individuals undergoing colonoscopy at the Oklahoma City Veterans Affairs Medical Center was performed. Experiencing difficulty maintaining air insufflation during colonoscopy was assessed with a questionnaire completed by the performing endoscopist at the end of procedure. Information regarding procedure times, sedation used, demographics, comorbidities, surgical history, and medications used was extracted from the medical record. A multivariate regression analysis was performed to identify factors associated with difficulty maintaining air insufflation. A P value < 0.05 was considered significant.
RESULTS: 996 Patients were included for the analysis. Difficulty with insufflation was reported in 240 (24%) colonoscopies; mean age of 63.8 ± 10.4 years old and 13% were female. Fellow trainees were involved in 669 (67%) colonoscopies. Older age (OR 1.02, P 0.03, CI [1.00-1.04]), diabetes (OR 1.5, 95% CI [1.03, 2.05]), fellow's involvement (OR 2.6. (95% CI [1.68, 4.09]), total procedure time (OR 1.02, 95% CI [1.00, 1.03]), mean number of adenomas (OR 1.05, 95% CI [1.00, 1.09]), and MAC use (OR 2.6, 95% CI [1.80, 3.85]) were independent predictors for difficulty in maintaining air insufflation.
CONCLUSION: Our findings suggest that endoscopists should be cognizant of colon insufflation issues in older, diabetic patients undergoing colonoscopies under deep sedation, particularly if prolonged procedure is anticipated or encountered.
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Medienart: |
E-Artikel |
Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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Enthalten in: |
Digestive diseases and sciences - 68(2023), 1 vom: 27. Jan., Seite 202-207 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Madhoun, Mohammad F [VerfasserIn] |
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Air |
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Date Completed 31.01.2023 Date Revised 13.03.2023 published: Print-Electronic CommentIn: Dig Dis Sci. 2023 Jan;68(1):7-8. - PMID 35759157 Citation Status MEDLINE |
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doi: |
10.1007/s10620-022-07592-8 |
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funding: |
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PPN (Katalog-ID): |
NLM342801538 |
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520 | |a © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
520 | |a BACKGROUND: Insufflation of the colon allows for adequate visualization of the mucosal tissue and advancement of the endoscope during colonoscopy. Most colonoscopies are performed with sedation to mitigate discomfort and enhance the colonoscopy experience for both the patient and the endoscopist | ||
520 | |a AIM: We aimed to evaluate factors associated with difficulty maintaining insufflation | ||
520 | |a METHODS: A cross-sectional study of individuals undergoing colonoscopy at the Oklahoma City Veterans Affairs Medical Center was performed. Experiencing difficulty maintaining air insufflation during colonoscopy was assessed with a questionnaire completed by the performing endoscopist at the end of procedure. Information regarding procedure times, sedation used, demographics, comorbidities, surgical history, and medications used was extracted from the medical record. A multivariate regression analysis was performed to identify factors associated with difficulty maintaining air insufflation. A P value < 0.05 was considered significant | ||
520 | |a RESULTS: 996 Patients were included for the analysis. Difficulty with insufflation was reported in 240 (24%) colonoscopies; mean age of 63.8 ± 10.4 years old and 13% were female. Fellow trainees were involved in 669 (67%) colonoscopies. Older age (OR 1.02, P 0.03, CI [1.00-1.04]), diabetes (OR 1.5, 95% CI [1.03, 2.05]), fellow's involvement (OR 2.6. (95% CI [1.68, 4.09]), total procedure time (OR 1.02, 95% CI [1.00, 1.03]), mean number of adenomas (OR 1.05, 95% CI [1.00, 1.09]), and MAC use (OR 2.6, 95% CI [1.80, 3.85]) were independent predictors for difficulty in maintaining air insufflation | ||
520 | |a CONCLUSION: Our findings suggest that endoscopists should be cognizant of colon insufflation issues in older, diabetic patients undergoing colonoscopies under deep sedation, particularly if prolonged procedure is anticipated or encountered | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Air | |
650 | 4 | |a Colonoscopy | |
650 | 4 | |a Insufflation | |
650 | 4 | |a Monitored anesthesia care | |
650 | 4 | |a Sedation | |
700 | 1 | |a Bader, Nimrah |e verfasserin |4 aut | |
700 | 1 | |a Ali, Ijlal |e verfasserin |4 aut | |
700 | 1 | |a Yohannan, Bryce |e verfasserin |4 aut | |
700 | 1 | |a Grossen, Alyssa |e verfasserin |4 aut | |
700 | 1 | |a Nadeem, Mahum |e verfasserin |4 aut | |
700 | 1 | |a Corredine, Thomas J |e verfasserin |4 aut | |
700 | 1 | |a Harty, Richard |e verfasserin |4 aut | |
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