Incomplete Colonoscopy: Maximizing Completion Rates of Gastroenterologists

Brahmania, Mayur; Park, Jei; Svarta, Sigrid; Tong, Jessica; Kwok, Ricky; Enns, Robert

doi:10.1155/2012/353457

Cited by 42 publications

(29 citation statements)

References 38 publications

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“…Although reasons for incomplete examination were not investigated, this could be related to patients' tolerance and calmness during examination which may be influenced by the type of bowel preparation and premedication as earlier reported. Brahmania et al [17] in their study of maximizing completion rate of incomplete colonoscopy amongst gastroenterologist in a Vancouver Hospital noted reasons for incomplete colonoscopy to include; poor bowel preparation, pain or inadequate sedation, structural anomaly including tortuous colon, diverticular disease, and obstructing mass lesion. Most of the examinations in the present study were done using conscious sedatives as opposed to use of deep sedation with agents like propofol in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Onyekwere

Odiagah

Ogunleye

et al. 2013

Diagnostic and Therapeutic Endoscopy

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Background. Colonoscopy effectiveness depends on the quality of the examination. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and also serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Method. A protocol that captured the patients' demographics, indication, and some quality indices of colonoscopy was developed and sent to all the identified colonoscopy units in Lagos to complete for all procedures performed between January 2011 and June 2012. All data were collated and analyzed. The quality indices studied were compared with guideline standard. Results. Twelve colonoscopy centers were identified but only nine centers responded. The gastroenterologist/endoscopists were physicians (3) and surgeons (5). Six hundred and seven colonoscopy procedures were performed during this period (M : F = 333 : 179) while the sex was not disclosed in 95 subjects. The examination indications were lower GI bleeding (24.2%), altered bowel habits (9.2%), lower abdominal pain (9.1%), screening for CRC (4.3%) and unspecified (46.8%). Conscious sedation was generally used while bowel preparation (good in 81.4%) was done with low residue diet and stimulant laxatives. Caecal intubation rate was 81.2%. Common endoscopic findings were haemorrhoids (43.2%), polyps/masses (13.4%), diverticulosis (11.1%), and no abnormality (23.4%). Polyp was detected in 6.8% of cases. Conclusion. Colonoscopy utilization is low, and the quality of practice is suboptimal; although limited resources could partly explain this, however it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence.

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Section: Discussionmentioning

confidence: 99%

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Onyekwere

Odiagah

Ogunleye

et al. 2013

Diagnostic and Therapeutic Endoscopy

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“…9 Some previous studies have described techniques and yields of repeat colonoscopy in patients with prior incomplete colonoscopies 6,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] . Our series has several strengths, including its large size (this series accounts for more than half of all reported cases) and referral of all cases from other gastroenterologists and surgeons.…”

mentioning

confidence: 99%

“…Next, review of the serrated lesions by an expert pathologist might increase the number of sessile serrated polyps identified, but would not change the overall conclusions. Finally, all of the colonoscopies in this study were performed by a single expert, but this scenario may be expected in some regional centers for complex colonoscopy 16 .…”

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confidence: 99%

Regional center for complex colonoscopy: yield of neoplasia in patients with prior incomplete colonoscopy

Bick

Vemulapalli

Rex

2016

Gastrointestinal Endoscopy

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“…The adequacy of bowel preparation was classified as inadequate, poor, fair, good, or excellent using the Aronchick bowel preparation scale . Cecal intubation was defined as complete visualization and intubation of the cecum, confirmed by the visual landmarks of the ileocecal valve and triradiate cecal fold . Patients with an inadequate or poor bowel preparation were excluded from cecal intubation rate calculations.…”

Section: Methodsmentioning

confidence: 99%

The Yield and Safety of Screening Colonoscopy in Patients Evaluated for Liver Transplantation

et al. 2019

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Colorectal cancer (CRC) screening with colonoscopy is commonly used in patients who are candidates for liver transplantation. We initiated this study to define the risk‐benefit ratio of performing screening colonoscopy in this population. A retrospective observational study of all consecutive patients undergoing colonoscopy during pre–liver transplantation screening between 2004 and 2017 was conducted. Endoscopic and pathological findings and clinical events potentially related to the colonoscopy in the 30 days after the procedure were registered and compared with a 30‐day inpatient control time frame. A total of 858 colonoscopies were performed in 808 patients (65% male; median age, 55 years [interquartile range (IQR), 47‐62]; median model for end‐stage liver disease (MELD) score, 15 [IQR, 11‐18]). CRC was found in 2 patients (0.2%), and advanced adenomas were found in 44 patients (5.4%). The only independent risk factor for an advanced neoplasm was age (odds ratio, 1.072 per year; 95% confidence interval, 1.031‐1.115; P < 0.001). During the 30‐day postprocedure period, 178 clinical events occurred in 128 patients compared with 101 clinical events in 72 patients in the control time frames ( P < 0.001). After colonoscopy, there was a significantly increased risk for renal failure ( P = 0.001) and gastrointestinal (GI) bleeding ( P = 0.023). Presence of ascites and MELD score were identified as independent risk factors for acute renal failure and GI bleeding. During the study observation period, 53.5% of the screened population actually underwent liver transplantation. Conclusion : CRC screening in pre–liver transplantation patients is associated with a relatively low prevalence of CRC and an increased risk of postcolonoscopy complications such as acute renal failure and GI bleeding, especially in patients with advanced liver disease. Because the risk‐benefit ratio of standard performance of a screening colonoscopy in this population appears questionable, alternative screening strategies should be considered.

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Incomplete Colonoscopy: Maximizing Completion Rates of Gastroenterologists

Cited by 42 publications

References 38 publications

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Regional center for complex colonoscopy: yield of neoplasia in patients with prior incomplete colonoscopy

The Yield and Safety of Screening Colonoscopy in Patients Evaluated for Liver Transplantation

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