Effect of Previous Gastrectomy on the Performance of Postoperative Colonoscopy

• Published in: Journal of gastric cancer 2016, Vol.16 (3), p.167-176
• Main Authors: Kim, Sunghwan, Choi, Jeongmin, Kim, Tae Han, Kong, Seong-Ho, Suh, Yun-Suhk, Im, Jong Pil, Lee, Hyuk-Joon, Kim, Sang Gyun, Jeong, Seung-Yong, Kim, Joo Sung, Yang, Han-Kwang
• Format: Article
• Language: Korean
• ISSN: 2093-582X; 2093-5641

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 and Methods: Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (1:6) 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 ($8.7{\pm}6.4$ vs. $9.7{\pm}6.5$ minutes; P=0.002), an increased intubation failure rate (0.1% vs. 1.9%; P