Zor Kolonoskopi Yapılan Hastalarda Redundan Sigmoid Kolonun Morfometrik Analizi: Cinsiyete Dayalı Bir Çalışma

Abstract

Redundan sigmoid kolon, kolonoskopiyi zorlaştırmasına rağmen radyolojik pratikte yeterince raporlanmamaktadır. Türk popülasyonuna ait kapsamlı morfometrik veriler yetersizdir. Bu çalışma, zor kolonoskopi yapılan hastalarda redundan sigmoid kolonun prevalansını ve morfometrik özelliklerini belirlemeyi ve cinsiyete bağlı farklılıkları analiz etmeyi amaçlamıştır. Bir üniversite hastanesine ait 2458 kolonoskopi raporu retrospektif olarak incelendi (Ekim 2023–Ekim 2024). Redundans için kolonoskopik kriterleri karşılayan olgular (≥2 kriter: ilerletme süresinin uzaması, loop oluşumu, pozisyon değişikliği gereksinimi, skop >90 cm) bilgisayarlı tomografi tabanlı morfometrik analize alındı (n=86). Ölçümler; sigmoid kolon boyutları, kas kalınlığı, subkutan yağ dokusu ve anatomik mesafeleri kapsadı ve 3D Slicer yazılımı kullanılarak yapıldı. Prevalans %6,14 (151/2458) olarak bulundu. Analiz edilen 86 olgunun %76,7’si kadındı. Kolonoskopik tanıya rağmen, olguların %94,2’sinde radyologlar tarafından redundans raporlanmamıştı. Olguların çoğunda (%87,2) başlangıç eğrimi sağa doğru olup, %88,4’ünde ≥3 adet akut açılı (<90°) kıvrım saptandı. Psoas kas kalınlığı (erkekler: 37,35±8,84 mm; kadınlar: 29,83±5,59 mm; p<0,001), subkutan yağ kalınlığı (kadınlar: 32,54±12,60 mm; erkekler: 22,10±15,07 mm; p=0,003) ve sigmoid kolon uzunluğu (kadınlar: 48,41±9,55 cm; erkekler: 39,10±7,31 cm; p<0,001) açısından anlamlı cinsiyet farklılıkları saptandı. Redundan sigmoid kolon, özellikle kadınlarda daha yüksek prevalans ve daha uzun sigmoid kolon uzunluğu ile belirgin cinsiyete bağlı morfometrik farklılıklar göstermektedir. Kolonoskopi öncesi sistematik radyolojik değerlendirme, işlemin planlanmasını iyileştirebilir.

Keywords

• Redundan sigmoid kolon
• kolonoskopi
• morfometri
• anatomik varyasyon
• cinsiyet farklılıkları

Ethical Statement

Bu çalışma, Giresun Üniversitesi Eğitim ve Araştırma Hastanesi Bilimsel Araştırma Etik Kurulu'ndan onay almıştır (Tarih: 16/10/2024, Onay: 16/10/2024-02) ve Helsinki Bildirgesi'ne uygun olarak yürütülmüştür.

Morphometric Analysis of Redundant Sigmoid Colon in Patients with Difficult Colonoscopy: A Gender-Based Study

Abstract

Redundant sigmoid colon complicates colonoscopy but remains underreported in radiological practice. Comprehensive morphometric data in the Turkish population are lacking. This study aimed to determine the prevalence and morphometric characteristics of redundant sigmoid colon in patients with difficult colonoscopy and analyze gender-related differences. We retrospectively reviewed 2458 colonoscopy reports from a university hospital (October 2023-October 2024). Cases meeting colonoscopic criteria for redundancy (≥2 of: prolonged advancement time, loop formation, position changes, scope >90 cm) underwent CT-based morphometric analysis (n=86). Measurements included sigmoid dimensions, muscle thickness, subcutaneous fat, and anatomical distances using 3D Slicer software. Prevalence was 6.14% (151/2458). Among 86 analyzed cases, 76.7% were female. Despite colonoscopic diagnosis, radiologists failed to report redundancy in 94.2% of cases. Most cases (87.2%) showed rightward initial curvature with ≥3 acute-angle curves (<90°) in 88.4%. Significant gender differences emerged in psoas muscle thickness (males: 37.35±8.84 mm vs females: 29.83±5.59 mm, p<0.001), subcutaneous fat thickness (females: 32.54±12.60 mm vs males: 22.10±15.07 mm, p=0.003), and sigmoid length (females: 48.41±9.55 cm vs males: 39.10±7.31 cm, p<0.001). Redundant sigmoid colon shows marked gender-related morphometric differences, with higher prevalence and longer sigmoid length in females. Systematic radiological evaluation before colonoscopy may improve procedural planning.

Keywords

• Redundant sigmoid colon
• colonoscopy
• morphometry
• anatomical variation
• gender differences

Ethical Statement

This study received approval from the Scientific Research Ethics Committee of Giresun University Training and Research Hospital (Date: 16/10/2024, Approval: 16/10/2024-02) and was conducted according to the Declaration of Helsinki.

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