French Society of Digestive Endoscopy (SFED) Guidelines on performing a colonoscopy

Abstract

Colonoscopy is the standard examination for diagnosing colorectal diseases and treating colorectal superficial neoplasms. Colonoscopy must be performed under the best conditions for optimum results. However, it is difficult to lay down rules as there is a scant amount of scientific data or available references on numerous points and because the practice is different from country to country, so that consulting the international literature is of limited use. Most of the options set out below are only the result of consulting experts. These guidelines are provisional and for guidance only as they are liable to change as and when new scientific information comes to light.

Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations

“…Five of these documents were updates of previously published guidelines 18,23,34 or position statements 43,45 -only the most recent versions were included 20,24,27,44,46 ; 2 citations were considered companion documents for each other and treated as a single result. 38,39 Therefore, 26 documents were included in the nal synthesis, including 19 guidelines [19][20][21][22][24][25][26][27][28][29][30][31][32][33][35][36][37]39,40 and 7 position statements. 41,42,44,[46][47][48][49] Characteristics of Included Documents A summary of the characteristics of the included documents is provided in Supplemental Table 1.…”

“…Though most documents addressed GI endoscopy procedures in general, four documents speci cally addressed colonoscopy. 33,35,39,40 Some organizations developed more than one document addressing different topics related to GI endoscopy practice, including 7 documents from the American Society of Gastrointestinal Endoscopy (ASGE), 21,26-28,32,42,49 2 documents from the Spanish Society of Gastrointestinal Endoscopy (SSGE), 31,33 and 2 documents from the Society of Gastroenterology Nurses and Associates (SGNA) 41,46 Quality Assessment Scores on the AGREE II domains were generally low (Table 1). Among guidelines, the highest scoring domains were scope and purpose (average score = 53%) and clarity of presentation (average score = 47%); the lowest scoring domain was applicability (average score = 9%).…”

“…The majority (n = 22) of included documents scored <60% in the rigor of development domain. Of these, 15 were guidelines [19][20][21][22][25][26][27][28][29][30][31][32][33]35,37 and 7 were position statements. 41,42,44,[46][47][48][49] Only 9 documents 24,26,27,29,31,33,36,40,49 provided a grade or level of evidence in support of their recommendations, making it di cult to assess the evidentiary base for the reported recommendations.…”

“…Twelve documents provided guidance on the choice of sedatives for GI endoscopy (Table 2). 19,21,22,24,26,27,31,33,35,36,40,47 Two documents made recommendations about speci c agents for moderate sedation. Both the German Society for Gastroenterology, Digestive and Metabolic Diseases (GSGMD) 36 and the SSGE 31 stated that midazolam is the preferred benzodiazepine for moderate sedation based on systematic reviews of cohort studies.…”

La coloscopie en France en 2008: résultats de l’enquête de deux jours d’endoscopie en France

“…Enfin, l'espérance de vie, en augmentation de trois mois chaque année, peut faire discuter l'arrêt du dépis-tage du CCR à partir de 74 ans. Ces limites ont été fixées en 1998 et doivent être réactualisées [26,27].…”