Quality Assessment of Colonoscopic Cecal Intubation: An Analysis of 6 Years of Continuous Practice at a University Hospital

Aslinia, Florence; Uradomo, Lance; Steele, Allison; Greenwald, Bruce D.; Raufman, Jean‐Pierre

doi:10.1111/j.1572-0241.2006.00494.x

Cited by 163 publications

(112 citation statements)

References 26 publications

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“…Colonoscopy success depends on three factors (12): (1) endoscopist related, experience and skill; (2) patient related, vital findings during procedure, colonoscopy reason, gender, BMI, previous abdominal surgery, radiotherapy, and situation of bowel cleansing; (3) technique related, sedation technique used and colonoscopy device. In a study conducted by Aslina et al (13), it was found that the rate of reaching the cecum in females (92.7%) was lower than that in males (95.5%). As for the study by Anderson et al (14), it was determined that gender was not a factor related to failure.…”

Section: Discussionmentioning

confidence: 99%

“…American Cancer Society Colorectal Cancer Task Force determined the standard criteria of cecum intubation success as 90% and set 95% goal as the ideal rate. Rates of reaching the cecum in important centers in United States were found to be 96%-100% (13). Colonoscopy success depends on three factors (12): (1) endoscopist related, experience and skill; (2) patient related, vital findings during procedure, colonoscopy reason, gender, BMI, previous abdominal surgery, radiotherapy, and situation of bowel cleansing; (3) technique related, sedation technique used and colonoscopy device.…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting successful colonoscopy procedures: Single-center experience

et al. 2018

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Objective: Colonoscopy is a gold standard procedure for several colon pathologies. Successful colonoscopy means demonstration of the ileocecal valve and determination of colon polyps. Here we aimed to evaluate our colonoscopy success and results. Material and Methods:This retrospective descriptive study was performed in İstanbul Eren hospital endoscopy unit between 2012 and 2015. Colonoscopy results and patient demographics were obtained from the hospital database. All colonoscopy procedures were performed under general anesthesia and after full bowel preparation. Results:In all, 870 patients were included to the study. We reached to the cecum in 850 (97.8%) patients. We were unable to reach the cecum in patients who were old and obese and those with previous lower abdominal operations. Angulation, inability to move forward, and tortuous colon were the reasons for inability to reach the cecum. Total 203 polyp samplings were performed in 139 patients. We performed 1, 2, and 3 polypectomies in 97, 28, and 10 patients, respectively. There were 29 (3.3%) colorectal cancers in our series. There was no mortality or morbidity in our study. Conclusion:General anesthesia and full bowel preparation may be the reason for increased success of colonoscopy. Increased experience and patient-endoscopist cooperation increased the rate of cecum access and polyp resection and decreased the complication rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors affecting successful colonoscopy procedures: Single-center experience

et al. 2018

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“…The only unscheduled one is unsedated colonoscopy offered to patients who drink the purge solution and arrives without an escort and do not mind having the colonoscopy done without sedation. In VA 21 and community 22 practice settings this option has been provided to 1-2% of colonoscopy patients. Scheduled options include deep sedation, conscious sedation and unsedated colonoscopy.…”

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confidence: 99%

Is there a place for sedationless colonoscopy?

Leung

2011

jig

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REVIEW REVIEWUnsedated colonoscopy is available on a routine basis in many parts of the world.1 This paper will discuss the components of patient time burden of sedation, 2 tabulate the extent and significance of sedation-related complications 3 and review how various options without routine sedation impact these events in the context of colorectal cancer screening and surveillance. In the end we shall address the question in the title of this manuscript if there is a place for sedationless (unsedated) colonoscopy. Usedated colonoscopy is routinely available in many parts of the world. In the US, only educated professionals appear to be knowledgeable enough to request the unsedated option. Colonoscopists have also been willing to perform unsedated colonoscopy when a patient presents without an escort after undergoing bowel purge preparation. While the actual sideeffects of sedation are minimal, the escort requirement and time burden of sedation are barriers to the uptake of screening colonoscopy in the US. The recent trend of deep sedation with propofol for screening colonoscopy increases the efficiency of the colonoscopists at significant costs (e.g. anesthetist reimbursement). The options of as needed and on demand sedation permit patients to complete colonoscopy without sedation. The latter appears to be potentially less coercive. Nurses with experience in the unsedated options recognize the benefit of the quick turn-around of the examination room and shortened occupancy of the recovery area. Discharge planning can be optimized due to absence of amnesia. Patients completing unsedated colonoscopy have given their endorsement of the options. Pain and discomfort continue to limit the success rate of cecal intubation to about 80%. A recently described water method (warm water infusion in lieu of air insufflation combined with removal of all residual colonic air by suction and residual feces by water exchange) has the potential of decreasing procedural discomfort and enhancing cecal intubation in unsedated colonoscopy. The availability of the novel water method assures colonoscopists that high success rate of cecal intubation can be achieved in the unsedated patients.

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“…It is stated in the literature that the rate of accessing the cecum should be around 95% in academic centers (7). Aslinia et al (8) reported the success rate as 85.5% after evaluation of their colonoscopy results of 6 years. Yılmaz et al (1) stated their colonoscopic success rate as 78%.…”

Section: Discussionmentioning

confidence: 99%

Our results of lower gastrointestinal endoscopy: evaluation of 700 patients

Özsoy

Celep

Erşen

et al. 2014

UCD

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Objective: Although radiological imaging modalities like barium enema and computed tomography provide some clues, endoscopic methods still maintain superiority in assessment and differential diagnosis of large intestinal symptoms and complaints that require biopsy. We aimed to present the results of colonoscopic procedures performed in our general surgery clinic in detail. Material and Methods:Seven hundred patients who presented to Afyon Kocatepe University, Faculty of Medicine, Department of General Surgery Endoscopy Unit between January 2011 and July 2012 with an indication for colonoscopy were retrospectively evaluated.Results: Out of the 700 patients enrolled in the study 356 (50.8%) were male while 344 patients (49.2%) were female. The mean age of the patients was found to be 49 years. Within the group of 700 patients who underwent colonoscopic examinations, the terminal ileum and cecum have been reached on the first attempt in 432 patients (61.7%) and colonoscopic success has been achieved. Results of colonoscopies performed on 700 patients in our clinic revealed malignancy in 42 (6%) patients, and all of these patients were treated surgically in our clinic. Mortality was not observed in this series. Procedure-related bleeding and perforation developed in 6 patients. One patient developed respiratory arrest due to sedation and patient was responsive to resuscitation. The complication rate in our series was 1%. Conclusion:In the study where we revised our own clinical experience, we found that our success rate was lower than the literature, and our complication rate was higher. The main reasons are accepted as our colonoscopy unit's being young and the low patient volume.

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Quality Assessment of Colonoscopic Cecal Intubation: An Analysis of 6 Years of Continuous Practice at a University Hospital

Cited by 163 publications

References 26 publications

Factors affecting successful colonoscopy procedures: Single-center experience

Factors affecting successful colonoscopy procedures: Single-center experience

Is there a place for sedationless colonoscopy?

Our results of lower gastrointestinal endoscopy: evaluation of 700 patients

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