Anatomy-related ratios predict colonoscopy incompleteness in similar examination conditions

Adv Clin Exp Med. 2020 May;29(5):573-580. doi: 10.17219/acem/118847.

Abstract

Background: Screening colonoscopy is one of the most popular modalities for screening and surveillance of colorectal cancer and other colon disorders.

Objectives: To introduce new ratios to predict the colonoscopy course in patients with similar characteristics.

Material and methods: Five hundred screening colonoscopies (252 females and 248 males) were performed by an experienced endoscopist. Incomplete colonoscopies (without pathologic findings, i.e., disease-unrelated) were included in the study. Collected data was used to determine new ratios.

Results: An examination was completed in 231 (91.7%) females (F) and 239 (96.4%) males (M). The majority of incomplete colonoscopies were discontinued in the sigmoid colon: 8 F (38.1%) and 4 M (44.4%) or in the descendosigmoid flexure: 4 F (19%) and 2 M (22.2%). We found statistically significant higher risk of incompleteness in females (p = 0.03), patients after 2 or more surgical treatments (p = 0.007) and in males with lower body mass index (BMI) (p = 0.01) (χ2 tests). Moreover, we discovered a statistically significant correlation with 2 or more previous surgical treatments in the female group (p = 0.02) (χ2 test). We calculated the incomplete colonoscopy anatomy-related (ICAR) and modified ICAR (MICAR) ratios. The range of ICAR and MICAR was 0-0.17; the number of incomplete examinations ranged from 0 to 1 failed out of 6 attempts (calculation: 100:17 = 5.88).

Conclusions: The ICAR and MICAR ratios reflect the various risk of colonoscopy incompleteness (i.e., disease-unrelated) and highlight the differences between patients in similar examination condition.

Keywords: colon anatomy-related incomplete colonoscopy; incomplete colonoscopy; large intestine anatomy; screening colonoscopy.

MeSH terms

  • Body Mass Index
  • Colon / diagnostic imaging
  • Colon / pathology*
  • Colonic Neoplasms / diagnosis*
  • Colonoscopy / methods
  • Colonoscopy / standards*
  • Colorectal Neoplasms / diagnosis*
  • Female
  • Humans
  • Male
  • Predictive Value of Tests