Correlation between obesity and metabolic syndrome-related factors and cecal intubation time during colonoscopy

Ryo Kawasato,1 Shinichi Hashimoto,1 Tomohiro Shirasawa,1 Atsushi Goto,1 Takeshi Okamoto,1 Jun Nishikawa,2 Isao Sakaida1 1Department of Gastroenterology and Hepatology, 2Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan Purpose: To investigate which colonoscopy (CS) cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome. Patients and methods: Items investigated were sex, age, body mass index (BMI), waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy), colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training. In a retrospective analysis, cases in which a physician in training reached the cecum within 15 minutes without requiring the involvement of the supervising physician were defined as eligible cases over which a physician in training should preside, while other cases were defined as non-eligible. Results: Overall, 813 CS cases were analyzed. Males (P<0.0001), cases started by an expert physician (P<0.0001), cases of no fellow physician involvement (P<0.0001), and cases with good bowel preparation (P<0.0001) had significantly shorter cecal intubation times. Of the 562 cases presided over by a physician in training, 194 were deemed eligible and 368 non-eligible. The eligible cases had a higher proportion of males (P=0.017), younger age (P=0.033), higher BMI (P=0.034), and higher rates of hypertension (P=0.001) and good bowel preparation (P=0.001). In analysis by sex, males demonstrated significantly more eligible cases among younger patients (P=0.009) and those with good bowel preparation (P=0.008), while there were significantly more eligible cases among females with hypertension (P=0.004). Conclusion: It may be useful to select CS cases for physicians considering sex, age, BMI, hypertension, and bowel preparation. Keywords: physician training, body mass index, hypertension, bowel preparatio