Kolonoskopi Sırasında Hasta Pozisyonunun Değiştirilmesinin Kolonoskopi Süresi, İleal Entübasyon Oranı Ve Polip Sayısına Etkisi
Amaç: Kolonoskopi, adenomatöz poliplerin tanımlanması ve çıkarılması için tüm dünyada sık kullanılan yöntem olarak kabul görmektedir. Çalışmamızda, pozisyon değişikliğinin çekal ve ileal entübasyon oranlarına ve polip saptanma oranlarına etkisinin değerlendirilmesi amaçlandı. Bu sayede kolonoskopi işlem süresinin hızlandırılması ve hassasiyetinin arttırılması hedeflenmektedir. Yöntem: Çalışmaya Ocak 2008 ile Aralık 2018 tarihleri arasında hastanemiz cerrahi kliniğine tanısal kolonoskopi için başvuran 17-90 yaş arası 943 hasta dahil edildi. Bulgular: Sonuçlar, kolonoskopi işlemi sırasında sol lateral pozisyona göre hastanın sırtüstü duruşundaki değişiklik nedeniyle ortalama çekal ve ileal entübasyon sürelerinin anlamlı derecede daha düşük olduğunu ve polip saptama oranının daha yüksek olduğunu saptadık (p<0.0001). Ayrıca çekal (p<0.0001) ve ileal (p=0.001) entübasyon süreleri ile saptanan polip sayısı arasında negatif korelasyon olduğu görüldü. Dahil edilen hastaların yaşı ile tespit edilen polip sayıları arasında pozitif korelasyon olduğu izlendi (p<0.0001). Ayrıca, hastanın duruşunu sırtüstü olarak değiştirmek, çekum, çıkan kolon ve hepatik fleksur kombine bölgelerinde polip saptama oranında %11’lik bir artışa yol açtığı tespit edildi (p<0.0001). Bu bölgede polip saptanma olasılığı, sırtüstü pozisyonda sol yan pozisyona göre 2,11 (%95 GA, 1,60-2,78) kat daha yüksek olarak belirlendi. Sonuç: Yukarıdaki bulgular, kolonoskopi işlemleri sırasında polip saptanma oranında hastanın pozisyonunun önemini güçlendirmektedir.
Anahtar Kelimeler:
Kolonoskopi, Çekal Entübasyon Oranı, İleal Entübasyon Oranı, Kolorektal Kanser, Sol Yan Pozisyon, Sırtüstü Pozisyon
Effect of Changing Patient’s Position During Colonoscopy to the Colonoscopy Time, Ileal Intubation Rate and Number of Polyps
Objective: Colonoscopy is universally considered as the conventional tool for the identification and removal of adenomatous polyps. The aim was to evaluate the effect of position change on the cecal and ileal intubation rates and the detection rate of polyps. In this way, it is aimed to accelerate the colonoscopy procedure time and increase its sensitivity. Methods: The study included 943 patients aged between 17 and 90 years presented for a diagnostic colonoscopy at our hospital surgery clinic from January 2008 to December 2018. Results: The results indicated significantly lower median cecal and ileal intubation time and higher polyps detection rate owing to change in the patient’s posture to supine than in the left lateral position during colonoscopy procedure (p<0.0001). Moreover, cecal (p<0.0001) and ileal (p=0.001) intubation time was negatively correlated with the number of polyps detected. The age of the participating patients was the demographic factor found to be positively correlated with the number of polyps detected (p<0.0001). Furthermore, changing the patient’s posture to supine led to an 11% increase in the polyp detection rate in the cecum, ascending colon, and hepatic flexure combined regions (p<0.0001). The odds of detection of polyps in this region were 2.11 (95%CI, 1.60-2.78) times higher in supine posture compared to the left lateral position. Conclusion: The above findings strengthen the relevance of the position of the patient in the polyp detection rate during colonoscopy procedures.
Keywords:
Colonoscopy, Cecal Intubation Rate, Ileal İntubation Rate, Colorectal Cancer, Left Lateral Position, Supine Position,
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- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2016
- Yayıncı: Erkan YULA