Factors that predict incomplete colonoscopy

Cirocco, William C.; Rusin, Lawrence C.

doi:10.1007/bf02049733

Cited by 168 publications

(109 citation statements)

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“…In the study conducted by Cirocco and Rusin (15), it was reported that previous hysterectomy operations are a factor for failed colonoscopy. While low BMI (<25) was found to be a failure factor in the study conducted by Anderson et al (14), failure was higher in overweight patients in our study.…”

Section: Discussionmentioning

confidence: 99%

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%

Factors affecting successful colonoscopy procedures: Single-center experience

et al. 2018

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“…The presence of certain symptoms (altered bowel habits, abdominal pain, diarrhea, constipation, hemorrhage), inflammatory bowel disease, and cancer) were also associated with incomplete examination 16 Completion rates were also lower in women and after hysterectomy. 17 However, even with these limiting factors, the colonoscopic completion rates are still approximately 90% in these subsets of patients. There is no evidence to suggest that incomplete colonoscopy is not associated with a higher complication rate.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Incomplete Flexible Sigmoidoscopy

Ramakrishnan¹,

Scheid²

2003

The Journal of the American Board of Family Medicine

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Objectives: Flexible sigmoidoscopy (flex sig) is an easily administered method of screening for colorectal polyps and cancer. In some patients, the depth of insertion is incomplete, which may result in missed polyps and cancers. To address the question of prospective patient selection for this procedure, we analyzed the factors affecting depth of insertion of sigmoidoscopies performed in outpatients over a 3-year period.Study Design: The study involved retrospective chart review of procedures performed by one endoscopist over a 3-year period.Outcomes Conclusions: Our study showed a relationship between incomplete examination and increasing age, female sex (more than 75% of the incomplete examinations were in women), poor bowel preparation (in women), hysterectomy, abdominal surgery (in men) and weight loss (in men). Further research is necessary to determine whether a predictive model can be developed that would be useful to select patients most appropriate for flex sig. In those patients in whom difficulty is anticipated, the choice can be made in to perform flex sig under sedation, analgesia, with the help of distraction techniques, or offer primary colonoscopy. Most colorectal cancers arise from adenomatous polyps.1 Their long asymptomatic phase allows for timely screening and adequate treatment of these premalignant lesions. Although screening colonoscopy is regarded as the ideal mechanism of detecting polyps because of its completeness and therapeutic potential, significant logistic barriers prevent its widespread implementation. Studies evaluating colonoscopy have suggested that screening flexible sigmoidoscopy (flex sig) using the 60-cm instrument has the capability of detecting 65% to 75% of polyps and 40% to 65% of colorectal cancers. 2-4The procedure can be performed by many physicians and physician extenders with relatively less investment in training and equipment. Hence, flex sig remains an important means of screening a major segment of the population at risk for colorectal cancer.Incomplete examination is an unfortunate drawback of flex sig, because the procedure is routinely offered without sedation or analgesia for simplicity and ease of administration. Olynyk et al 5 noted that 30% of patients had a depth of insertion of less than 50 cm. Stewart et al 6 suggest a 25% incomplete examination rate and technical difficulty in up to one third of the cases. Painter et al 7 found that in up to a quarter of the patients, the descending colon was not intubated. Using radiopaque clips, Lehman et al 8 noted that a 60-cm examination reached the splenic flexure in only 33% of patients, a 50-to 55-cm examination reached the sigmoid/ descending colon junction in most instances, a 40-

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“…57,58 Risk factors for poor bowel preparation quality include older age, overweight, diabetes and other comorbidities. 59,60 In those individuals for whom colonoscopy is difficult and therefore unsuccessful, it is probably inappropriate to recommend repeated colonoscopic surveillance; alternative surveillance strategies need to be explored.…”

Section: Examination Qualitymentioning

confidence: 99%

The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

Atkin

Brenner

Martin

et al. 2017

Health Technol Assess

131

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 04/33/01. The contractual start date was in September 2006. The draft report began editorial review in March 2015 and was accepted for publication in December 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by...

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Factors that predict incomplete colonoscopy

Abstract: Women, especially those with a history of abdominal hysterectomy, had a significantly lower cecal intubation rate usually because of an impassable sigmoid colon. Prior inability to complete colonoscopy to the cecum does not necessarily forecast future failure.

Cited by 168 publications

References 23 publications

Factors affecting successful colonoscopy procedures: Single-center experience

Factors affecting successful colonoscopy procedures: Single-center experience

Predictors of Incomplete Flexible Sigmoidoscopy

The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

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