Relação entre perfil dos pacientes e tempo de intubação cecal no exame de colonoscopia

Abstract

Background: Colonoscopy is a widely used procedure in medical practice, primarily indicated for the investigation of gastrointestinal symptoms and colorectal cancer screening. For the procedure to be considered effective, it must allow complete visualization of the intestinal mucosa, from the anal canal to the cecum. The time required to perform the procedure is an important factor, as longer examinations may be associated with complications, and it can be influenced both by the endoscopist’s technical skill and by patient-related characteristics. Objective: To investigate the characteristics of patients undergoing colonoscopy and to evaluate how these factors influence the time required to reach the cecum. Methods: This cross-sectional study was conducted at a digestive endoscopy clinic in Passo Fundo, Rio Grande do Sul, Brazil, between February and September 2025. Consecutive patients who agreed to participate by signing the informed consent form were included. All underwent elective colonoscopy after home bowel preparation according to the clinic’s protocol. Examinations were performed by a single endoscopist (FF) under intravenous sedation using an Olympus colonoscope. Cecal intubation time (CIT) was measured from the insertion of the colonoscope into the anus until its arrival at the cecum. CIT was compared between men and women, and between patients with and without overweight, using the Mann–Whitney test with a 5% significance level. Results: Of 115 patients enrolled, 15 were excluded due to inadequate bowel preparation or failure to reach the cecum. CIT was analyzed in 100 patients (57 women and 43 men), with a mean age of 56.1 years (SD ± 11.3) and a mean BMI of 26.3 kg/m² (SD ± 4.6). CIT was longer in women than in men [median (IQR25–75): 462 seconds (319.5–694) vs. 303 seconds (206–392); P < 0.001], and in patients without versus with overweight [n = 45, median 421 seconds (316.5–645.5) vs. n = 55, 332 seconds (238–476); P = 0.038]. Colonoscopy was most time-consuming in women without overweight and shortest in men with overweight [median 576 seconds (373–721.8) vs. 274.5 seconds (200.5–383.8); P < 0.001]. Conclusions: In this series of elective colonoscopy patients, cecal intubation time was longer in women without overweight and shorter in men with overweight. These findings highlight that colonoscopy tends to be more technically demanding in women, particularly those without overweight, which is relevant information for endoscopic practice.