Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic

Teh, Kevin; Tay, Shu Wen; Chen, Kaina; Koh, Samantha Jingyun; Wong, Yu Jun; Kwek, Andrew; Li, Weiquan; Fock, Kwong Ming; Teo, Eng Kiong; Tan, Malcolm

doi:10.1055/a-1167-1703

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…There have been few studies on this subject but one similar one showed no difference in overall procedure time (including cecal intubation rate) between pre and post COVID-19 colonoscopy standards. 8 This was the opposite of our findings, however, this study had a lower power (N=256) compared to our study which may have skewed their results. Our study demonstrated that CIR was decreased from 2019 to 2020 (p=0.04).…”

Section: Discussioncontrasting

confidence: 96%

Effect of using personal protective equipment during the COVID-19 pandemic on the quality indicators of screening colonoscopies

Chirayath

Bahirwani

Kaur

et al. 2021

Preprint

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Background and Aims: Coronavirus Disease 2019 (COVID-19) has affected many facets of the practice of medicine including screening colonoscopies. Our study looks to observe if there has been an effect on the quality of colonoscopies, as indicated by quality measures such as cecal intubation rate (CIR), cecal intubation time (CIT), scope withdrawal time (SWT) and adenoma detection rate (ADR) with the adoption of standard COVID-19 precautions. Methods: We conducted a retrospective chart review to analyze the effects of the COVID-19 pandemic on screening colonoscopies. The study utilized data on CIR, CIT, SWT and ADR from outpatient, non-emergent procedures conducted at 3 endoscopy suites of St Lukes University Health Network. All inpatient and emergent procedures were excluded. Data was obtained by performing chart review on EPIC electronic health record. Results: Our study demonstrated that the total number of screening colonoscopies was decreased between 2019 to 2020 (318 in 2019 vs 157 in 2020, p= 0.005). CIT (320+/-105 seconds in 2019 vs 392+/-107 seconds in 2020, p=0.001) and SWT (706+/-232 seconds in 2019 vs 830+/-241 seconds in 2020, p=0.001) were increased while CIR (98.2% in 2019 vs 96.6% in 2020, p=0.04) was decreased between 2019 and 2020 likely due to PPE introduction. ADR was similar between the two groups (38.23 (12.50-66.66) in 2019 vs 38.18(16.66-66.00) in 2020, p=0.8). Conclusion: Our study showed that quality indices for screening colonoscopies like cecal intubation rate, cecal intubation time and scope withdrawal time were negatively impacted during the initial COVID time period compared to pre-COVID time. The study also displayed that though there was a significant decline in both screening and diagnostic colonoscopies during pandemic, adenoma detection rates were comparable. Thus, the efficiency of the procedures was affected by the use of PPE but it did not affect the colonoscopies clinical benefits.

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Section: Discussioncontrasting

confidence: 96%

Effect of using personal protective equipment during the COVID-19 pandemic on the quality indicators of screening colonoscopies

Chirayath

Bahirwani

Kaur

et al. 2021

Preprint

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“…On the other hand, wearing EPPE causes evident physical discomfort to the endoscopist and justifiable concern is present about the impact of EPPE on success rates and quality outcomes of endoscopic procedures. The impact of EPPE on upper gastrointestinal endoscopy and colonoscopy performance was investigated, but the effect of EPPE on ERCP quality outcomes was yet to be elucidated [10,11]. Our study showed that outcome measures such as cannulation success rate, cannulation time, difficult cannulation rate, unintended pancreatic duct cannulation rates, number of cannulation attempts, and length of hospital stay are not negatively affected by the use of EPPE compared to SPPE.…”

Section: Discussionmentioning

confidence: 76%

Endoscopic Retrograde Cholangiopancreatography During the COVID-19 Pandemic: Effects of Enhanced Personal Protective Equipment

Düzenli

Köseoğlu

2021

Dig Dis Sci

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Background and Aims Personal protective equipment (PPE) decreases the risk of disease contagion, and because of the COVID-19 pandemic, enhanced PPE (EPPE) is widely used during endoscopic procedures including endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to investigate the effects of EPPE on ERCP success parameters compared to standard PPE (SPPE). Methods ERCP procedures were evaluated retrospectively and ERCP outcomes were compared for similar time periods as before and after the COVID-19 pandemic. Primary outcomes were cannulation time, number of cannulation attempts, cannulation success rate, difficult cannulation rate, undesired pancreatic duct cannulation rate, ERCP-related adverse events, and length of hospital stay. Results Three hundred and eighty ERCP procedures were examined. One hundred and fifty-nine procedures were excluded due to missing data, previous sphincterotomy or altered anatomy. Of the final eligible sample size of 221 ERCPs, 93 were performed using SPPE and 128 were performed under EPPE. Indications of ERCP and demographic parameters were similar between groups. The majority of the ERCP cases included were for benign biliary obstruction of common bile duct stones (88.7%). No significant differences were detected in overall technical success (91.4% vs 92.2%, p = 0.832), cannulation success rates (94.6% vs 96.8%, p = 0.403), cannulation times (median times of both groups were 3 min, p = 0.824), difficult cannulation rates (37.6% vs 33.6%, p = 0.523), undesired pancreatic duct cannulation rates (29% vs 22.7%, p = 0.593), number of cannulation attempts (2.80 vs 2.71, p = 0.731), ERCP-related adverse events (9.7% vs 10.9%, p = 0.762), and length of hospital stay (6.63 vs 6.92 days, p = 0.768) between SPPE and EPPE groups, respectively. Conclusion Biliary obstructions of common bile duct stones were the major indication of ERCP in the current study. The use of EPPE had no negative effects on ERCP performance in this patient group. ERCP can be effectively performed under EPPE.

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“…The novel coronavirus disease (COVID-19) has been declared a pandemic by the World Health Organization (WHO). 24,25 During the COVID-19 pandemic, the WHO issued an advisory to avoid crowded places. 26 The Japanese government also recommended avoiding the three C's: closed spaces, crowded places, and close contact settings.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Prolonged Hospital Stay after Endoscopy

Nishizawa¹,

Yoshida²,

Toyoshima³

et al. 2021

Clin Endosc

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INTRODUCTION Endoscopic sedation reduces distress during invasive procedures; however, esophagogastroduodenoscopy (EGD) and colonoscopy can be performed without sedation. 1-3 Non-sedated endoscopy offers several potential advantages, such as lower cost, higher efficiency, and decreased post-endoscopic impairment, which allows patients to drive sooner. 4 Small-diameter endoscopes (< 6 mm) can improve the tolerability of EGDs when a sedative is not used. On the other hand, the American Society for Gastrointestinal Endoscopy (ASGE) recommends that a combination of an opiate and benzodiazepine is a safe and effective regimen for achieving minimal-to-moderate sedation for EGDs and colonoscopies in patients without risk factors for sedation-related adverse events. 5 In the United States, more than 98% of endoscopists use sedation during EGDs and colonoscopies. 6 Endoscopic sedation requires the use of a recovery room. When space is limited in the recovery room, the relatively longer residual effects of opiate and benzodiazepine administration could be problematic. If there are any delays in the recovery or discharge of patients, endoscopic procedures

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Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic

Cited by 8 publications

References 11 publications

Effect of using personal protective equipment during the COVID-19 pandemic on the quality indicators of screening colonoscopies

Effect of using personal protective equipment during the COVID-19 pandemic on the quality indicators of screening colonoscopies

Endoscopic Retrograde Cholangiopancreatography During the COVID-19 Pandemic: Effects of Enhanced Personal Protective Equipment

Risk Factors for Prolonged Hospital Stay after Endoscopy

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