Withdrawal Times and Associated Factors in Colonoscopy: A Quality Assurance Assessment in Ambulatory Surgery Centers

Overholt, Gene; Brooks-Belli, Linda; Grace, Michael; Rankin, Kristin; Harrell, Royce; Turyk, Mary E.; Rosenberg, Fred; Barish, Robert W.; Gilinsky, Norman H.

doi:10.14309/00000434-200910003-01093

Cited by 3 publications

(3 citation statements)

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“…Both of these factors may influence their reported procedure duration. Studies evaluating time to cecum in adult patients completed by adult gastroenterology endoscopists report an average insertion time of 7 to 9 minutes and typically do not include time to intubate TI (9,22,23). Our study did not include this information; however, we are now routinely documenting time to extent reached specifically to evaluate this metric.…”

Section: Discussionmentioning

confidence: 99%

A Single‐center Review of Pediatric Colonoscopy Quality Indicators

Pasquarella¹,

Kaplan²,

Mahajan³

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objectives: Colonoscopy with terminal ileal (TI) intubation is an important diagnostic and therapeutic tool in the care of children with digestive diseases, especially in those with inflammatory bowel disease. Ileal intubation rate is a recognized quality indicator for pediatric colonoscopy. Our primary aim was to identify our single-center ileal intubation rate and to secondarily identify specific factors, including bowel preparation quality, procedure duration, and cecal intubation rates which affect successful ileal intubation and by extension, complete colonoscopy. Methods: A retrospective chart review of all colonoscopies in 2015 was completed, identifying 458 procedures. Sixty-seven patients were excluded, resulting in 391 colonoscopies reviewed. Results: We analyzed 391 colonoscopy procedures with a mean patient age of 14.4 ± 5.3 years. The most frequent primary indications for colonoscopy included abdominal pain with “red flag” symptoms (35.5%), known inflammatory bowel disease (25.1%), and isolated abdominal pain (11.5%). Ileal intubation was achieved in 91% of all colonoscopies, with a 94.4% cecal intubation rate. Failure of ileal and cecal intubations was classified into 4 categories: disease-related conditions, bowel preparation, technical aspects, and miscellaneous issues. Potentially modifiable factors accounted for the majority of cases of failed TI intubation. The mean colonoscopy time with and without successful TI intubation were 39 and 48.1 minutes, respectively. Conclusions: Completion of colonoscopy to the TI is an essential part of a complete colonoscopy. TI intubation was possible in 91% of patients. This rate could potentially improve to 95% with optimization of modifiable factors such as improving bowel preparation or further refinement of endoscopic skills.

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Section: Discussionmentioning

confidence: 99%

A Single‐center Review of Pediatric Colonoscopy Quality Indicators

Pasquarella¹,

Kaplan²,

Mahajan³

et al. 2019

J. pediatr. gastroenterol. nutr.

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“…Several large population-based studies have evaluated these KPIs for colonoscopy [9,[14][15][16][17][18][19][20][21][22][23]. Some studies included all patients undergoing colonoscopy [14][15][16]18]; however, others elected to exclude patients who have previously had a colonic resection (i.e. patients with nonintact colons) from calculations of CIR, ADR, CWT and other KPIs [9,17,[19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Colonoscopy quality indicators in patients with and without prior colonic resection: A single‐centre prospective comparative study

et al. 2021

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“…The US Multi-Society Task Force on Colorectal Cancer advises a minimum of 6 min for optimal mean WT in routine colonoscopy, 18 whereas more recent studies have recommended a WT in the range of 6–9 min. 12 19 20 …”

Section: Introductionmentioning

confidence: 99%

Impact of feedback and monitoring on colonoscopy withdrawal times and polyp detection rates

Nielsen

Hendel

2017

BMJ Open Gastroenterol

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BackgroundPrevious studies have shown colonoscopy withdrawal time (WT) to be a reliable surrogate indicator for polyp detection rate (PDR) and adenoma detection rate (ADR) in colonoscopy. Our aim was to assess the impact of feedback and monitoring of WT on PDR in routine colonoscopies with long-term follow-up.Materials and methodsA total of 307 colonoscopies were performed in three separate clinical scenarios. First, PDR and WT were recorded without the staff being aware of the specific objective of the study. Before the second scenario, the staff was given interventional information and feedback on WTs and PDRs from the first scenario and was encouraged to aim for a minimum WT of 8 min. Retention of knowledge gained was reassessed in the third scenario 1 year later.ResultsThe PDR in the first two scenarios differed significantly (p<0.01), with a more than 90% increase in PDR after intervention from 22% to 42% (95% CI 1.44 to 4.95), although the mean WT did not change (6.8 vs 7.2 min; p>0.05). The increase in PDR between the first and second scenarios was retained in the third follow-up scenario 1 year later where the WT of both polyp-positive and polyp-negative colonoscopies was found to be longer.ConclusionsPDR almost doubled from the first to the second scenario of a real-life colonoscopy setting, indicating that awareness of WT is crucial. The knowledge gained from this intervention in routine practice was even retained after a year.

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Withdrawal Times and Associated Factors in Colonoscopy: A Quality Assurance Assessment in Ambulatory Surgery Centers

Cited by 3 publications

References 0 publications

A Single‐center Review of Pediatric Colonoscopy Quality Indicators

A Single‐center Review of Pediatric Colonoscopy Quality Indicators

Colonoscopy quality indicators in patients with and without prior colonic resection: A single‐centre prospective comparative study

Impact of feedback and monitoring on colonoscopy withdrawal times and polyp detection rates

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