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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2022 April;181(4):219-24

DOI: 10.23736/S0393-3660.20.04447-2


language: English

The necessity of routine terminal ileum intubation during colonoscopy

Mustafa F. CELAYIR 1, Hakan M. KOKSAL 1, Mert TANAL 2 , Mehmet ULUDAG 1

1 Department of General Surgery, Sisli Hamidiye Etfal Research and Training Hospital, University of Health Sciences, Istanbul, Turkey; 2 Department of General Surgery, Tekirdag Ismail Fehmi Cumalioglu State Hospital, Tekirdag, Turkey

BACKGROUND: Although the most common cause of performing colonoscopy worldwide is screening for colon cancer, there are many indications including chronic diarrhea, anemia, and suspicion of bowel diseases. The colonoscopy procedure’s success was first defined as terminal ileum intubation. As the procedure’s morbidity risks and the difficulty of the learning curve of full colonoscopy are well-defined, a question of the necessity of cecal and terminal ileal (TI) intubation was led. The aim of this study is to evaluate the necessity of TI intubation during routine colonoscopy in patients who are considered not to have inflammatory bowel diseases (IBD).
METHODS: In this study, the records of patients who underwent colonoscopy in our hospital between 2014 January- 2020 January were evaluated retrospectively. The cohort constituted of 5355 patients between 18 years and 82 years old. The demographic data of all patients, the parts that have been examined during the colonoscopy, the detected findings and the complications were noted.
RESULTS: The mean age of the patients was 56.5±24.3 years; 3213 were male and 2142 were female. TIE was performed in 511 (9.5%) patients and was not performed in remaining 4844 (90.5%) patients. The rate of patients with macroscopic pathological findings detected in patients done TIE was 3.52%. The rate of pathological findings was 0.09% in all patients underwent colonoscopy.
CONCLUSIONS: The results show that there is no reason for routine TIE during colonoscopy especially for cancer screening because the procedure extends the colonoscopy duration, requires experience, and its diagnostic value is low.

KEY WORDS: Colonoscopy; Colorectal neoplasms; Ileum

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