@article{oai:ir.kagoshima-u.ac.jp:00016640,
 author = {MATSUOKA, Satoru and MAEDA, Hidehito and SASAKI, Fumisato and TSUNEYOSHI, Kengo and KABAYAMA, Masayuki and KANMURA, Shuji and IDO, Akio},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {},
 note = {OBJECTIVES: Same-day bidirectional endoscopy (BDE) has become a commonly used. Several studies have identified that the optimal sequence of a same-day BDE was esophagogastroduodenoscopy (EGD) followed by colonoscopy (CS). However, in recent years there are no reports from Japanese facilities regarding the difficulty of colonoscopy insertion along with a same-day BDE. In this study, we sought to clarify CS difficulties if EGD was performed first followed by CS on the same-day.
METHODS: This study was a single-center retrospective study, and included 61 patients who underwent EGD followed by CS (E-C group) and 120 patients who underwent CS only (CS only group). We defined a “difficult CS case” as one that required ≥650 s for colonoscope insertion.
RESULTS: The numbers of difficult CS cases were not significantly different between the E-C and CS only groups (p = 0.131). Furthermore, no correlations existed between EGD examination times and colonoscope insertion times (Spearman = 0.096). In addition, for patients whose body mass index (BMI) was <18.5 and ≥25, the number of difficult CS cases was significantly lower in the E-C group than that in the CS only group (p = 0.038).
CONCLUSIONS: No significant differences were seen between the number of difficult cases in the E-C and CS only groups. In patients with BMI of <18.5 or ≥25, fewer cases of CS difficutyl might be encountered if EGD is performed first.
【背景】上部消化管内視鏡検査（EGD），下部消化管内視鏡検査（CS）を同日に施行する際に，既報ではEGDを先行してもCSの挿入時間に変化はなかったと報告されているが，日本の施設からの報告はない．今回EGD，CSを同日に施行する際，EGDを先行するとCSの内視鏡挿入が困難になるのか明らかにすることを目的とした．
【方法】2020年5月から8月までに鹿児島県立大島病院でEGDを先行したEGD＋CS（以下E-C群とする）61例およびCSのみを施行した（以下CS単独群とする）120例を対象とした．挿入困難例の定義ついては，CS単独群での挿入時間中央値が326.5秒であったことから，挿入時間650秒以上の症例とした
【結果】挿入困難症例数は，E-C群：4例（6.6％），CS単独群：17例（14.2％）で両群間に有意差はなかった（p = 0.131）．さらに，EGDの検査時間とCSの内視鏡挿入時間の相関係数は　＝0.09であり，相関はなかった．また，BMI 18.5未満と25以上の症例において，挿入困難症例数はE-C群がCS単独群と比較して有意に少なかった（p = 0.038）．
【結論】EGDとCSを同日に連続して施行する際は，EGDを先行してもCSの内視鏡挿入が必ずしも困難になるとはいえず，既報と同様の結果であった．BMI 18.5未満や25以上の症例においては，EGDを先行するとCSの挿入が容易になる可能性がある．},
 pages = {1--7},
 title = {The Effects of Prior Esophagogastroduodenoscopy on Cecal Insertion in Same-Visit Bidirectional Endoscopy: A Pilot Study},
 volume = {74},
 year = {2022}
}