LAUSR

BACKGROUND AND AIMS Difficulty of cecal intubation should be a main indicator for the necessity of sedated colonoscopy and skilled endoscopists. The present study aimed to explore the factors associated with easy and difficult cecal intubation in unsedated colonoscopy. METHODS All consecutive patients who underwent unsedated colonoscopy at our department by the same endoscopist from December 3, 2020 to August 30, 2022 were retrospectively collected. Age, gender, body mass index (BMI), reasons for colonoscopy, position change, Boston Bowel Preparation Scale score, cecal intubation time (CIT), and major colonoscopic findings were analyzed. CIT <5 min, CIT 5-10 min, and CIT >10 min or failed cecal intubation were defined as easy, moderate, and difficult cecal intubation, respectively. Logistic regression analyses were performed to identify independent factors associated with easy and difficult cecal intubation. RESULTS Overall, 1281 patients were included. The proportions of easy and difficult cecal intubation were 29.2% (374/1281) and 27.2% (349/1281), respectively. Multivariate logistic regression analyses found that age ≤50 years, male, BMI >23.0 kg/m2, and absence of position change were independently associated with easy cecal intubation, and that age >50 years, female, BMI ≤23.0 kg/m2, position change, and insufficient bowel preparation were independently associated with difficult cecal intubation. CONCLUSIONS Some convenient factors independently associated with easy and difficult cecal intubation have been identified, which will be potentially helpful to determine whether a colonoscopy should be sedated and a skilled endoscopist should be selected. The current findings should be further validated in large-scale prospective studies.