Fahad Alasfarq, MD1, Yousef Almuhanna, MD2, Fatema Alotaibi1. 1Department of Surgery – Faculty of Medicine – Kuwait, 2General Surgery Resident – State of Kuwait
Colonoscopy is a common non-invasive procedure, widely conducted for a diagnostic and therapeutic reasons. It is defined as a lower gastrointestinal endoscopy, passing the scope through the anal verge, all to the way to the cecum, thus it allows thorough examination of the rectum, colon, and distal part of the ileum, with the privilege of taking biopsies when needed. The aim of this study is to find a correlation between the procedure and the factors that may affect its completion.
A prospective study was conducted of 500 patients who have visited the clinics for colonoscopy. A complete colonoscopy was defined as a scope capable of reaching the cecum. Incomplete colonoscopy was defined as inability to reach the cecum or poor visualization of the colon/ ileocecal valve. All of these patients had a colonoscopy as an elective procedure. Preprocedure factors that were tested include BMI, co-morbid diseases, and history of abdominal surgery. Intraprocedure factors include bowel preparation, heart rate and oxygen saturation.
Those 500 patients were studied over a period of 12 months, January to December 2013. The median age of patients was 44 (15-85) and 57% were males. Factors affecting procedure completion were categorized into pre-procedure and intra-procedure factors. History of abdominal surgeries, co-morbid conditions, and body mass index were used as pre-procedure factors. Whereas oxygen saturation, heart rate, and bowel preparation were used as intra-procedure factors. Most incomplete procedures were seen among overweight BMI patients, in 7% of those with history of abdominal surgeries, and in 14% of patients with co-morbid conditions. In regards to intra-procedure factors, complete colonoscopies has gone from 72% in adequate bowel preparation to 16% in inadequate bowel preparation. Heart rate and oxygen saturation did not add any change to the procedure completion.
Many factors affect the completion of colonoscopies. Despite the absence of statistical significance upon studying many factors, bowel preparation maintains its importance and significance to complete the procedure, and can be put into a scoring system that would predict the likelihood of completing the procedure.