과거 복부 또는 골반수술이 대장내시경에 미치는 영향
Effect of Previous Abdominal or Pelvic Surgery on Colonoscopy
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목적: 이전에 수술을 받은 환자에서의 대장내시경 삽입시간은 다양하게 보고되고 있다. 이 연구는 복부수술이 대장내시경의 삽입에 영향을 주는지 알아보고자 하였다. 대상 및 방법: 2008년 5월부터 2010년 5월까지 삼성창원병원에서 대장내시경을 받은 3,600명의 환자 중 이전에 복부수술을 받은 192명을 대상으로 하였다. 환자의 나이, 성별, 키, 몸무게, 체질량지수, 허리둘레, 대장내시경 삽입시간, 삽입지연율, 장 정결도, 이전의 복부수술 방법을 조사하였다. 이전의 복부수술은 대장절제군, 대장절제 이외의 복부수술군, 골반수술군, 복강경수술군으로 나누었다. 결과: 수술군의 평균 삽입시간은 7.73±5.95분으로 비수술군(6.4±3.88분)과 비교해서 길게 측정되었다. 대장절제군의 나이가 많고 삽입시간이 짧으며(5.11±3.32분) 삽입지연율이 낮았다(6%). 대장절제 이외의 복부수술군, 골반수술군, 복강경수술군의 비교에서는 통계적으로 차이는 없었다. 결론: 과거의 복부수술은 대장내시경의 삽입을 어렵게 한다. 대장절제군의 삽입시간이 짧고 삽입지연율이 낮았으나 다른 수술들의 차이는 없었다.
Abstract
Background/Aims: A number of studies have reported wide variability in the colonoscope insertion time among patients who had prior abdominal surgery. The aim of this study was to investigate the effect of abdominal surgery on colonoscope insertion time. Methods: The subjects were 192 patients with prior abdominal surgery, among 3,600 patients who underwent a colonoscopy at Samsung Changwon Hospital from May 2008 to May 2010. We collected the following data: insertion time, age, gender, height, weight, BMI, waist circumference, method of abdominal surgery, and the degree of bowel cleanliness. Previous abdominal operations were divided into colectomy, non-colectomy abdominal surgery, pelvic surgery, and laparoscopic surgery groups. Results: The average colonoscope insertion time in patients with prior abdominal surgery (7.73±5.95 min) was longer than that of the non-surgery group (6.4±3.88 min). Patients in the colectomy groups were older and had a shorter insertion time (5.11±3.32 min) than patients in the other groups. Conclusions: Insertion of a colonoscope in patients with previous abdominal surgery was more difficult than that in the control group, except the colectomy group.1
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